Bruce Rothschild, MD
Are nonsurgical treatments effective for low back pain and radiculopathy?
Included studies evaluated target injections or other nonsurgical treatments in patients > 18 years of age who had low (lumbar or sacral) back pain. Studies reported ≥ 1 of the following outcomes: back-specific function, general health status, pain, work disability, and patient satisfaction. Exclusion criteria included pregnancy and low back pain associated with acute major trauma, cancer, infection, the cauda equina syndrome, fibromyalgia, spondyloarthropathy, osteoporosis, and vertebral compression fracture.
MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (all to Jul 2008) and reference lists were searched for randomized controlled trials (RCTs) published in English or included in English-language systematic reviews and English-language systematic reviews published after 1999. Experts were contacted. 97 RCTs, including 75 reported in 26 systematic reviews, met the inclusion criteria.
The main results are in the Table.
Evidence supporting the effectiveness of nonsurgical interventions for low back pain and radiculopathy is limited.
Nonsurgical interventions for low back pain*
*FJSI = facet joint steroid injection; IDET = intradiscal electrothermal therapy; PIRFT = percutaneous intradiscal radiofrequency thermocoagulation; RCT = randomized controlled trial.
†Trials were rated high quality (≥6 of 11 criteria) unless otherwise noted.
Rothschild B. Review: Evidence for the effectiveness of nonsurgical interventions for low back pain and radiculopathy is limited. Ann Intern Med. ;151:JC4–10. doi: 10.7326/0003-4819-151-8-200910200-02010
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Published: Ann Intern Med. 2009;151(8):JC4-10.
Back Pain, Neurology, Neuropathy, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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