Filip Gedin, Tobias Sundberg, Vibeke Sparring, Martin Skeppholm, Emelie Heintz, Niklas Zethraeus
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引用次数: 0
Abstract
Objectives: The purpose of this study was to identify, critically assess, and summarize evidence of the effectiveness of primary care treatments for adults with non-specific chronic low back pain (NSCLBP).
Methods: We conducted an umbrella review of systematic reviews focusing on primary care treatments for NSCLBP. We searched the PubMed and Cochrane library databases for systematic reviews of randomized controlled trials (RCTs) evaluating primary care treatments for adults with NSCLBP published between January 2007 and March 2021. Two reviewers independently assessed the quality of these systematic reviews using the AMSTAR checklist. We selected systematic reviews with a low or moderate risk of bias and graded the evidence based on Grading of GRADE criteria.
Results: Among the initial 66 systematic reviews meeting our inclusion criteria, 19 systematic reviews with low or moderate bias risk were selected for analysis. These reviews included a total of 365 studies involving 62 832 participants. The evidence suggested moderate to high support for the effectiveness of certain primary care treatments in improving pain and function in NSCLBP patients. These treatments included NSAIDs and opioids compared to placebos, spinal manipulation versus exercise/physical therapy, and MBR versus exercise/education/advice/no treatment.
Conclusions: Recommendations for specific primary care treatments for NSCLBP in adults remain inconclusive. Further high-quality systematic reviews and RCTs are needed to better understand the effectiveness of these treatments. Future RCTs should prioritize the assessment of NSAIDs, opioids, spinal manipulation, and MBR, as they appear promising for improving NSCLBP outcomes in certain comparisons.
期刊介绍：
The Journal of Manipulative and Physiological Therapeutics (JMPT) is an international and interdisciplinary journal dedicated to the advancement of conservative health care principles and practices. The JMPT is the premier biomedical publication in the chiropractic profession and publishes peer reviewed, research articles and the Journal''s editorial board includes leading researchers from around the world.
The Journal publishes original primary research and review articles of the highest quality in relevant topic areas. The JMPT addresses practitioners and researchers needs by adding to their clinical and basic science knowledge and by informing them about relevant issues that influence health care practices.
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