Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain.
lifestyle
musculoskeletal pain
pain neuroscience
physiotherapy
rehabilitation medicine
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
19 Jul 2019
19 Jul 2019
Historique:
received:
06
06
2019
revised:
03
07
2019
accepted:
16
07
2019
entrez:
24
7
2019
pubmed:
25
7
2019
medline:
25
7
2019
Statut:
epublish
Résumé
Chronic Low Back Pain (CLBP) is a major and highly prevalent health problem. Given the high number of papers available, clinicians might be overwhelmed by the evidence on CLBP management. Taking into account the scale and costs of CLBP, it is imperative that healthcare professionals have access to up-to-date, evidence-based information to assist them in treatment decision-making. Therefore, this paper provides a state-of-the-art overview of the best evidence non-invasive rehabilitation for CLBP. Taking together up-to-date evidence from systematic reviews, meta-analysis and available treatment guidelines, most physically inactive therapies should not be considered for CLBP management, except for pain neuroscience education and spinal manipulative therapy if combined with exercise therapy, with or without psychological therapy. Regarding active therapy, back schools, sensory discrimination training, proprioceptive exercises, and sling exercises should not be considered due to low-quality and/or conflicting evidence. Exercise interventions on the other hand are recommended, but while all exercise modalities appear effective compared to minimal/passive/conservative/no intervention, there is no evidence that some specific types of exercises are superior to others. Therefore, we recommend choosing exercises in line with the patient's preferences and abilities. When exercise interventions are combined with a psychological component, effects are better and maintain longer over time.
Identifiants
pubmed: 31331087
pii: jcm8071063
doi: 10.3390/jcm8071063
pmc: PMC6679058
pii:
doi:
Types de publication
Journal Article
Langues
eng
Déclaration de conflit d'intérêts
Jo Nijs has co-authored a Dutch book for clinicians on pain neuroscience education, but the royalties for that book are collected by the Vrije Universiteit Brussel and not him personally. Besides that, the authors have no conflict of interest to disclose.
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