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Related Experiment Videos

Complementary and alternative therapies for low back pain.

Maurits W van Tulder1, Andrea D Furlan, Joel J Gagnier

  • 1Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. mw.vantulder@vumc.nl

Best Practice & Research. Clinical Rheumatology
|June 14, 2005
PubMed
Summary

Complementary and alternative medicine (CAM) therapies show promise for chronic low back pain (LBP). Acupuncture, botanical medicine, massage, neuroreflexotherapy, and spinal manipulation offer benefits compared to sham treatments, with some comparable to conventional care.

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Area of Science:

  • Integrative Medicine
  • Evidence-Based Practice
  • Pain Management

Background:

  • Growing acceptance of evidence-based principles in Complementary and Alternative Medicine (CAM).
  • Non-specific low back pain (LBP) is a prevalent condition requiring effective treatment options.
  • Need to evaluate CAM therapies against established benchmarks for LBP management.

Purpose of the Study:

  • To assess the efficacy of various CAM therapies for acute/subacute and chronic non-specific LBP.
  • Compare CAM interventions against placebo, no intervention, or other established treatments.
  • Synthesize findings from high-quality systematic reviews (Cochrane) for reliable conclusions.

Main Methods:

  • Systematic review of Cochrane reviews focusing on acupuncture, botanical medicine, massage, neuroreflexotherapy, and spinal manipulation.

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  • Analysis of comparative effectiveness for acute/subacute and chronic non-specific LBP.
  • Inclusion of comparisons against placebo, sham treatments, no intervention, and conventional therapies.

    • Main Results:

    • Acupuncture demonstrated effectiveness for chronic LBP versus no or sham treatment, with comparable results to conventional therapies.
    • Botanical medicines showed short-term benefits for acute episodes of chronic LBP; long-term data is lacking.
    • Massage and neuroreflexotherapy indicated benefits over sham treatments for chronic LBP, with mixed comparisons to conventional care.
    • Spinal manipulation proved superior to sham/ineffective therapies and equivalent to conventional treatments for LBP.

    Conclusions:

    • CAM therapies present promising options for managing chronic LBP, particularly acupuncture and spinal manipulation.
    • Further research is required to establish the cost-effectiveness of CAM interventions relative to conventional treatments.
    • Evidence supports the integration of specific CAM therapies into LBP management strategies, pending further economic evaluations.