Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline

作者：Roger Chou, Laurie Hoyt Huffman · 发表于：Annals of Internal Medicine · 年份：2007 · DOI：10.7326/0003-4819-147-7-200710020-00007 · 被引用次数：1063 · 研究领域：Musculoskeletal pain and rehabilitation、Acupuncture Treatment Research Studies、Biofield Effects and Biophysics

BACKGROUND: Many nonpharmacologic therapies are available for treatment of low back pain. PURPOSE: To assess benefits and harms of acupuncture, back schools, psychological therapies, exercise therapy, functional restoration, interdisciplinary therapy, massage, physical therapies (interferential therapy, low-level laser therapy, lumbar supports, shortwave diathermy, superficial heat, traction, transcutaneous electrical nerve stimulation, and ultrasonography), spinal manipulation, and yoga for acute or chronic low back pain (with or without leg pain). DATA SOURCES: English-language studies were identified through searches of MEDLINE (through November 2006) and the Cochrane Database of Systematic Reviews (2006, Issue 4). These electronic searches were supplemented by hand searching of reference lists and additional citations suggested by experts. STUDY SELECTION: Systematic reviews and randomized trials of 1 or more of the preceding therapies for acute or chronic low back pain (with or without leg pain) that reported pain outcomes, back-specific function, general health status, work disability, or patient satisfaction. DATA EXTRACTION: We abstracted information about study design, population characteristics, interventions, outcomes, and adverse events. To grade methodological quality, we used the Oxman criteria for systematic reviews and the Cochrane Back Review Group criteria for individual trials. DATA SYNTHESIS: We found good evidence that cognitive-behavioral therapy, exerci...