Effective Healthcare
Bulletin on the effectiveness of health service interventions for decision makers
Source: Centre for Reviews and Dissemination, University of York
- Low back pain is very common in developed countries, especially in adults of working age. The costs of back pain to society are huge. In 1998, the direct health care costs of back pain in the UK were estimated at £1632 million.
- For acute low back pain, advice to continue ordinary activity can give equivalent or faster symptomatic recovery from the acute attack and lead to less chronic disability and less time off work. Bed rest should not be recommended as a treatment for acute low back pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for short-term symptomatic relief in patients with acute low back pain. Several types of NSAIDs appear similarly effective, but can have harmful side-effects.
- Muscle relaxants (benzodiazepines) are effective at reducing pain for patients with acute low back pain but can have harmful side-effects. Different benzodiazepines appeared to be similarly effective.
- There is strong evidence that exercise therapy may help chronic low back pain patients return to normal daily activities and work.
- Multidisciplinary treatment programmes, involving components such as education, active exercise programmes, behavioural treatment, relaxation exercises, and work-place visits, can improve long-term outcomes for pain, functional status and sick leave compared with other treatments for chronic low back pain.
The Effective Health Care bulletins are based on systematic review and synthesis of research on clinical effectiveness, cost effectiveness and acceptability of health service interventions. This is carried out by a research team using established methodological guidelines, with advice from expert consultants for each topic. Great care is taken to ensure that the work, and the conclusions reached, fairly and accurately summarise the research findings. The University of York accepts no responsibility for any consequent damage arising from the use of Effective Health Care.
Note: The contents of the bulletins should be considered in relation to the time of original publication. Significant new research evidence is likely to have become available since then.
The bulletins are also available free of charge via the World Wide Web. The address is: www.york.ac.uk/inst/crd/ehcb.htm
Enquiries concerning the bulletins should be addressed to:
Centre for Reviews and Dissemination, University of York, York, YO10 5DD. Telephone: +44 (0) 1904 321040; Fax: +44 (0) 1904 321041; email: crd@york.ac.uk
Acute and Chronic Low Back Pain. Effective Health Care, November 2000, Volume 6, Number 5. ISSN: 0965-0288
