OBJECTIVE: Because of complicated etiological factors, low back pain (LBP) has no effective therapeutic method, although there are many therapeutic methods. It is characteristics of slow effect and easy to recurring. To summarize the clinical therapeutic methods of LBP and analyzed comprehensively. DATA SOURCES: A computer-based search was performed in Wanfang database to search the relevant literatures published between June 2001 and July 2006 in Chinese about the clinical therapy of LBP with the key words of 'low back pain, clinical therapy'. Meanwhile, the English literatures of same aspect published in Ovid published from June 2001 to July 2006 were also retrieved with the same key words. STUDY SELECTION: After arrangement, the literatures aimed directly at the clinical therapy of LBP were selected. The randomized, controlled clinical trials were selected, prospective studies selected and system review selected. Of the same field, we chose the articles published recently or on the authority journals. Same study, experience summarization and case report were excluded. DATA EXTRACTION: A total of 82 pertinent literatures were collected and 20 ones were accorded with inclusive criteria. Sixty-two articles were excluded, including 15 of clinical trial without randomized and controlled principle, 2 of retrospective study, 10 of review, 25 of same study, 7 of experience summarization and 3 of case report. DATA SYNTHESIS: At present, the clinical therapy of LBP included: (1) rehabilitative therapy included bed rest, traction, physical therapy. It was a safe and effective method of treating LBP. (2) Medications: nonsteroidal anti-inflammatory drugs, opioids, muscle relaxants, antidepressant, calcium extender or estrogen, tumor necrosis factor (TNF) inhibition could reduce pain and improve clinical assessment. (3) Nerve blocking: crotherapy and the treatment of dehydrated alcohol could achieve the effect of analgesia for long time by blocking dorsal ramus of spinal never for low back pain. (4) Surgery: interbody fusion was the first choice for lumbar discogenic pain in all kinds of surgery. (5) Microinvasive therapy: the effect of intradiscal electrothermal treatment and neucleoplasty was reliable. (6) tradition Chinese medical treatment included acupuncture and spinal manipulation. Acupuncture was effective for LBP. Spinal manipulation was the first choice for nonspecific LBP. (7) others: back school was one of the most effective methods of treating LBP. Long-term effect of small needle scaple therapy for chronic LBP was stable. Acupressure was also effective. CONCLUSION: Currently, rehabilitation and surgery are the main methods for LBP. At the same time, some microinvasive therapy such as intradiscal electrothermal treatment, neucleoplasty are in use, but still limited. Moreover, the specific therapies are in need of further study.

Full text (sometimes free) may be available at these link(s):      help

• PDF locator
• publisher