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The effectiveness of non-pharmacological interventions for low back pain in China: A systematic review and network meta-analysis.

作者信息

Liu Junshi, Peng Weng Kung, Jia Yingxian

机构信息

Department of Physical Education, Education School, Dongguan University of Technology, Dongguan City, Guangdong Province, China.

Graduate School of Engineering Science, Osaka University, Osaka, Japan.

出版信息

PLoS One. 2025 May 9;20(5):e0322929. doi: 10.1371/journal.pone.0322929. eCollection 2025.


DOI:10.1371/journal.pone.0322929
PMID:40343982
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12063812/
Abstract

Low back pain (LBP) is the most common and incapacitating musculoskeletal disorder globally. The use of non-pharmacological interventions for the management of LBP is recommended by global clinical practice guidelines. However, existing guidelines often exhibit poor quality, as evidenced by inadequate systematic reviews of evidence. This necessitates further reviews tailored to the specific context of different countries. This review searched the CINAHL, EMBASE, MEDLINE, The Cochrane Library, Web of Science, and Wanfang databases from their inception to May 14, 2024. After data extraction by two independent researchers, a total of 57 randomized control trials (RCTs) were included. The Bayesian network meta-analysis results demonstrated that: (1) non-pharmacological therapies generally exhibited superior efficacy over pharmaceuticals in improving functional disability and overall efficacy; (2) pharmaceuticals, both alone and in combination with non-pharmacological therapies, were generally more effective than most non-pharmacological therapies in reducing pain intensity. High heterogeneity was observed, which could be explained by LBP subtypes in the analysis of functional disability. While heterogeneity had a limited impact on the confidence of results for pain intensity and functional disability, it significantly influenced the assessment of overall efficacy with major concerns of imprecision. The high volume of studies with a high risk of overall bias necessitates cautious interpretation of these findings. Chinese LBP patients may benefit most from non-pharmacological interventions, particularly those rooted in Traditional Chinese Medicine, for improving disability. For pain intensity reduction, pharmaceuticals and multi-component therapies incorporating pharmaceuticals may be more effective.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/36a6489630f6/pone.0322929.g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/fbfde87e1213/pone.0322929.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/1e3964b3c1d2/pone.0322929.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/f2018baa3367/pone.0322929.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/d51f3d102fb3/pone.0322929.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/72c1a537ca2c/pone.0322929.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/bcbf09b650b7/pone.0322929.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/6ec20addc37b/pone.0322929.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/e934e11e9bd0/pone.0322929.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/f5e3e91bc1bf/pone.0322929.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/75abf3f0cd12/pone.0322929.g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/36a6489630f6/pone.0322929.g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/fbfde87e1213/pone.0322929.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/1e3964b3c1d2/pone.0322929.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/f2018baa3367/pone.0322929.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/d51f3d102fb3/pone.0322929.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/72c1a537ca2c/pone.0322929.g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/bcbf09b650b7/pone.0322929.g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/6ec20addc37b/pone.0322929.g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/e934e11e9bd0/pone.0322929.g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/f5e3e91bc1bf/pone.0322929.g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/75abf3f0cd12/pone.0322929.g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e785/12063812/36a6489630f6/pone.0322929.g011.jpg

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本文引用的文献

[1]
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J Psychosom Res. 2024-6

[2]
The effectiveness, acceptability, and sustainability of non-pharmacological interventions for chronic pain management in older adults in mainland China: A systematic review.

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[3]
[Management of chronic non-oncologic pain by multicomponent programs using non-pharmacologic therapies: A systematic review of the literature].

J Healthc Qual Res. 2024

[4]
Efficacy of Core Muscle Exercise Combined with Interferential Therapy in Alleviating Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial.

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[5]
Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain: A prospective, multicenter randomized trial.

J Integr Med. 2024-1

[6]
The Efficacy of Acupuncture and Acupoint Massage in Enhancing Lumbar Mobility and Alleviating Pain in Individuals with Lumbar Disc Herniation.

Altern Ther Health Med. 2024-10

[7]
Efficacy of cognitive functional therapy in patients with low back pain: A systematic review and meta-analysis.

Int J Nurs Stud. 2024-3

[8]
Population ageing and sustainability of healthcare financing in China.

Cost Eff Resour Alloc. 2023-12-19

[9]
Effects of Baduanjin exercise on patients with chronic nonspecific low back pain and surface electromyography signs of erector spinal muscle: A randomized controlled trial.

Medicine (Baltimore). 2023-10-27

[10]
Clinical Efficacy of Acupuncture with Canggui Tanxue Technique on Huantiao Point for Treating Sciatica Caused by Lumbar Disc Herniation.

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