NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Chou R, Deyo R, Friedly J, et al. Noninvasive Treatments for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. (Comparative Effectiveness Reviews, No. 169.)
Table H1Strength of evidence
| Key Question Outcome | Study Design Number of Studies | Study Limitations | Consistency | Directness | Precision | Reporting Bias | Strength of Evidence |
|---|---|---|---|---|---|---|---|
| 1. What are the comparative benefits and harms of different pharmacological therapies for acute or chronic nonradicular low back pain, radicular low back pain, or spinal stenosis? (Including NSAIDs, acetaminophen, opioids, muscle relaxants, antiseizure medications, antidepressants, corticosteroids, and topicals/patch-delivered medications) | |||||||
| Acetaminophen | |||||||
| Acetaminophen vs. Placebo, acute LBP : Pain and function | 1 RCT | Low | Unable to determine | Direct | Precise | Undetected | Low |
| Acetaminophen vs. NSAID, acute LBP: Pain and global improvement | 3 RCTs | High | Consistent | Direct | Precise | Undetected | Low |
| Acetaminophen vs. Placebo, chronic LBP | No studies | - | - | - | - | - | Insufficient |
| Acetaminophen vs. NSAID, chronic LBP | 1 RCT | High | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Acetaminophen vs. other interventions, acute LBP | 4 RCTs | High | Consistent | Direct | Imprecise | Undetected | Insufficient |
| Acetaminophen vs. placebo: Adverse events (serious adverse events) | 1 RCT | Low | Consistent | Direct | Imprecise | Undetected | Moderate |
| Acetaminophen vs. NSAIDs : Adverse events | 3 RCTs in systematic revie | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Acetaminophen vs. Placebo, NSAID or Other intervention, radicular LBP | No studies | - | - | - | - | - | Insufficient |
| NSAIDs | |||||||
| NSAIDs vs. Placebo, acute LBP : Pain, function | 4 RCTs in systematic review and 1 RCT for pain; 1 RCT for function | Moderate | Consistent for pain Unable to determine for function | Direct | Precise for pain Imprecise for function | Undetected | Moderate for pain, low for function |
| NSAIDs vs. Placebo, chronic LBP : Pain, function | 4 RCTs in systematic review for pain 2 RCTs for function | Moderate | Consistent | Direct | Precise for pain Imprecise for function | Undetected | Moderate for pain, low for function |
| NSAIDs vs. Placebo, radicular LBP : Pain | 2 RCTs in systemtic review | Moderate | Inconsistent | Direct | Imprecise | Undetected | Low |
| NSAID plus another intervention vs. Other intervention alone | 2 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| NSAIDs vs. Interventions other than acetaminophen and opioids | 2 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| NSAID vs. NSAID, acute or chronic LBP : Pain | 27 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| NSAIDs vs. Placebo : Adverse events | 10 RCTs | Moderate | C onsistent | Direct | Precise | Undetected | Moderate |
| COX-2-selective NSAIDs vs. nonselective NSAIDs : Adverse events | 4 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Opioids, Tramadol and Tapentadol | |||||||
| Opioids vs. Placebo, chronic LBP : Pain and function | 6 RCTs in systematic review and 3 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Tramadol vs. Placebo, chronic LBP : Pain and function | 5 RCTs in systematic review and 2 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Buprenorphine patch vs. Placebo, subacute or chronic LBP : Pain and function | 2 RCTs in systematic review | Moderate | Consistent for pain Inconsistent for function | Direct | Imprecise | Undetected | Low for pain Insufficient for function |
| Opioids vs. NSAIDs, chronic LBP : Pain relief, function | 3 RCTs for pain 1RCT for function | Moderate | Inconsistent for pain Unable to determine for function | Direct | Imprecise | Undetected | Insufficient |
| Opioids vs. Acetaminophen, acute LBP : Days to return to work, pain | 1 RCT for return to work No studies for pain | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Long acting opioids vs. Long acting opioids : Pain, function | 4 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Long acting opioids vs. Short acting opioids : Pain | 6 RCTs | Moderate | Inconsistent | Direct | Precise | Undetected | Low |
| Opioids vs. Placebo: Adverse events | 16 RC Ts in systematic review | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Skeletal Muscle Relaxants (SMR) | |||||||
| SMRs vs. Placebo, acute LBP : Pain | 4 RCTs in a systematic review and 1 RCT | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| SMR plus NSAID vs. NSAID alone, acute LBP : Pain | 2 RCTs in systematic review and 1 RCT | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| SMR vs. Placebo, chronic LBP : Pain | 3 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| SMR vs. SMR, acute or chronic LBP : Pain | 3 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| SMR vs. Placebo, acute LBP : Adverse events | 8 RCTs in systematic review and 1 RCT | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Benzodiazepines | |||||||
| Benzodiazepines vs. Placebo, acute LBP : Pain, function | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Tetrazepam vs. Placebo, chronic LBP:Pain, overall improvement | 2 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Diazepam vs. Placebo, acute or subacute radicular pain : Pain, function | 1 RCT | Low | Unable to determine | Direct | Precise | Undetected | Low |
| Benzodiazepines vs. Skeletal muscle relaxants, chronic LBP: Pain, function | 2 RCTs | Low | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Diazepam vs. Cyclobenzaprine, chronic LBP : Muscle spasms | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Benzodiazepines vs. Placebo: Adverse events | 8 RCTs in systematic review and 1 RCT | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Antidepressants | |||||||
| Tricyclic antidepressants or SSRI vs. Placebo, chronic LBP : Pain, function | 4 RCTs of tricyclics and 3 RCTs of SSRIs in systematic review for pain; 2 RCTs evaluated function | Moderate | Consistent | Direct | Imprecise | Undetected | Moderate for pain, low for function |
| Duloxetine vs. Placebo, chronic LBP : Pain, Function | 3 RCTs | Low | Consistent | Direct | Precise | Undetected | Moderate |
| Duloxetine vs. Tricyclic antidepressants | No studies | - | - | - | - | - | Insufficient |
| Antidepressants vs. Placebo : Adverse events, Serious adverse events | 9 RCTs in systematic review and 3 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Antiseizure medications | |||||||
| Antiseizure medications, acute non-radicular LBP | No studies | - | - | - | - | - | Insufficient |
| Gabapentin vs. Placebo, chronic non-radicular LBP | 1 RCT (abstract only, excluded) | - | - | - | - | Suspected | Insufficient |
| Gabapentin vs. Placebo, chronic radicular LBP: Pain and function | 3 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Topiramate vs. Placebo, chronic radicular or mixed radicular and non-radicular LBP: Pain | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Pregabalin vs. Placebo, chronic radicular LBP : pain, function | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Pregabalin plus transdermal buprenorphine vs. transdermal buprenorphine, chronic non-radicular LBP : Pain | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Pregabalin plus another anaglesic vs. the other analgesica alone: Pain | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Gabapentin vs. Placebo : Adverse events | 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Topiramate vs. Placebo : Withdrawal due to adverse events, sedation, diarrhea | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Pregabalin vs. Placebo : Withdrawal due to adverse events, somnolence, dizziness | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Corticosteroids | |||||||
| Systemic corticosteroids vs. Placebo, acute non-radicular LBP : Pain, function | 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Systematic corticosteroids vs. Placebo, radicular LBP : Pain, function | 5 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Systemic corticosteroids vs. Placebo, spinal stenosis: Pain, function | 1 RCT | Moderate | Unable to determine | Direct | Precise | Undetected | Low |
| Systemic corticosteroids : Adverse events | 12 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| 2. What are the comparative benefits and harms of different nonpharmacological, noninvasive therapies for acute or chronic nonradicular low back pain, radicular low back pain, or spinal stenosis? | |||||||
| Exercise | |||||||
| Exercise vs. Usual care, acute to subacute LBP : Pain, function | 8 RCTs in systematic review and 3 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Exercise vs. Usual care, chronic LBP: Pain, Function | 19 RCTs in systematic review 3 RCTs in another systematic review, and 20 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| MCE vs. Minimal intervention, chronic LBP : Pain, function | 2 RCTs for pain and 3 RCTs for function in systematic review | Modeate | Consistent | Direct | Imprecise | Undetected | Low |
| Exercise vs. Usual care, non- acute LBP: Work disability | 8 RCTs in systematic review | Moderate | Consistent | Direct | Precise | Undetected` | Moderate |
| Exercise vs. Usual care, radicular LBP: Pain, function | 3 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Exercise vs. Exercise, acute or chronic LBP | >20 RCTs | Moderate | Consistent | Direct | Precise | Suspected | Moderate |
| Exercise : Adverse events | Low | ||||||
| MCE vs. General exercise, chronic LBP : Pain, function | 6 RCTs in systematic review and 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| MCE vs. Multimodal PT, chronic LBP : Pain, function | 4 RCTs for pain and 2 RCTs for function in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| MCE plus exercise vs. Exercise alone | 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| MCE : Adverse events | 6 RCTs | Moderate | Consistent | Direct | Precise | Suspected | Low |
| Pilates | |||||||
| Pilates vs. usual care plus physical activity, chronic LBP: Pain, function | 7 RCTs in systematic review | Moderate | Inconsistent | Direct | Precise | Undetected | Low |
| Pilates vs. other exercise, chronic LBP: Pain, function | 3 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Tai Chi | |||||||
| Tai Chi vs. waitlist or no Tai Chi, chronic LBP : Pain, function | 2 RCTs for pain, 1 RCT for function | Moderate | Consistent for pain Unable to determine for function | Direct | Imprecise | Undetected | Low |
| Tai Chi vs. other exercise, chronic LBP : Pain | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Tai Chi : Adverse events | 2 RCTs | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Yoga | |||||||
| Yoga vs. Usual care, chronic LBP :Pain, Function | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Yoga vs. Exercise, chronic LBP : Pain, Function | 5 RCTs in sytematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Yoga vs. Education, chronic LBP : Pain, function | 5 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Yoga : Adverse events | 5 RC Ts | Moderate | Consistent | Direct | Imprecise | Suspected | Low |
| Psychological Therapies | |||||||
| Progressive relaxation vs. wait list control, chronic LBP : Pain, Function | 3 RCTs in systematic review | Moderate | Inconsistent | Direct | Precise | Undetected | Low |
| EMG biofeedback, chronic LBP : Pain, Function | 3 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Operant therapy, chronic LBP : Pain, Function | 3 RCTs for pain, 2 RCTs for function in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Cognitive therapy vs. Wait list control, chronic LBP | 2 RCTs in systematic review | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Cognitive-behavioral and other combined therapy vs. Wait list control, chronic LBP : Pain, Function | 5 RCTs for pain, 4 RCTs for function in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Psychological therapies vs. exercise or physical therapy, chronic LBP : Pain | 8 RCTs | Moderate | Inconsistent | Direct | Precise | Undetected | Low |
| Psychological therapies vs. Psychological therapies : Pain, Function | 10 RCTs | Modeate | Inconsistent | Direct | Precise | Undetected | Moderate |
| Psychological therapies : Adverse events | 28 RCTs in systematic review | High | Consisent | Direct | Imprecise | Suspected | Low |
| Multidisciplinary rehabilitation | |||||||
| Multidisciplinary rehabilitation vs. Usual care, chronic LBP : Pain, function, return to work | 9 RCTs in systematic review | Moderate | Inconsistent | Direct | Precise | Undetected | Moderate |
| Multidisciplinary rehabilitation vs. No multidisciplinary rehabilitation, chronic LBP : Pain, function | 3 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Multidisciplinary rehabilitation vs. Physical therapy, chronic LBP : Pain, function | 13 RCTs in systematic review | Moderate | Inconsistent | Direct | Precise | Undetected | Moderate |
| Multidisciplinary rehabilitation, acute LBP, radicular LBP | No studies | Insufficient | |||||
| Multidisciplinary rehabilitation : Adverse events | 2 RCTs | High | Consistent | Direct | Imprecise | Suspected | Low |
| Acupuncture | |||||||
| Acupuncture vs. Sham acupuncture, subacute LBP : Pain | 3 RCTs in systematic review and 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Acupuncture vs. Sham acupuncture, chronic LBP : Pain, function | 7 RCTs in systematic review and 1 RCT | Moderate | Inconsistent | Direct | Precise | Undetected | Moderate |
| Acupuncture vs. No acupuncture, chronic low back pain | 5 RCTs in systematic review | Moderate | Inconsistent | Direct | Precise | Undetected | Moderate |
| Acupuncture vs. NSAIDs, acute LBP : Overall improvement | 5 RCTs in systematic review | Moderate | Consistent | Direc t | Imprecise | Undetected | Low |
| Acupuncture vs. Medications, chronic LBP : Pain, Function | 3 RCTs in systematic review | High | Consistent | Direct | Precise | Undetected | Low |
| Acupuncture : Adverse events | 3 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Massage | |||||||
| Massage vs. Sham massage, acute LBP: Pain, function | 2 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Massage vs. Usual care, chronic LBP: Pain, function | 2 RCTs | Moderate | Inconsistent | Direct | Precise | Undetected | Low |
| Massage vs. Other interventions, subacute to chronic LBP: Pain, function | 9 RCTs for pain and 4 RCTs for function in systematic review | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Massage plus another active intervention vs. the Other intervention alone, subacute to chronic low back pain: Pain, function | 5 RCTs in systematic review and 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Massage vs. massage: Pain, function | 6 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Massage: Adverse events | 12 RCTs | High | Consistent | Direct | Prec ise | Suspected | Low |
| Spinal manipulation | |||||||
| Spinal manipulation, acute LBP : Pain, function | 1 RCT for pain and 2 RCTs for function | High | Unable to determine for pain Consistent for function | Direct | Imprecise | Undetected | Low for function Insufficient for pain |
| Spinal manipulation vs. Sham manipulation, chronic LBP : Pain, function | 3 RCTs in systematic review and 1 RCT | Moderate | Inconsistent | Direct | Precise | Undetected | Low for pain Insufficient for function |
| Spinal manipulation vs. Intert treatment, acute LBP : Pain, Function | 3 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Spinal manipulation vs. Inert treatment, chronic LBP | 4 RCTs in systematic review and 3 RCTs | Modeate | Inconsistent | Direct | Precise | Undetected | Low |
| Spinal manipulation vs. Other active interventions, acute LBP : Pain, function | 3 RCTS in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Moderate |
| Spinal manipulation vs. Other interventions, chronic LBP : Pain, function | 6 RCTs in systematic review and 3 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Spinal manipulation plus exercise or advice vs. exercise or advice alone, acute LBP : Function | 4 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Spinal manipulation plus another active treatment, chronic LBP : Pain, function | 3 RCTS in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Spinal manipulation : Adverse events | 55 RCTs | Moderate | Consistent | Direct | Precise | Suspected | Low |
| Ultrasound | |||||||
| Ultrasound vs. Sham ultrasound, chronic LBP : Pain, function | 5 RCTs | Moderate | Consistent for pain Inconsistent for function | Direct | Imprecise | Undetected | Low for pain Insufficient for function |
| Ultrasound vs. No ultrasound, chronic LBP : Pain, function | 2 RCTs | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Ultrasound plus exercise vs. Exercise, chronic LBP : Pain, Function | 2 RCTs | High | Consistent | Direct | Imprecise | Undetected | Insufficient |
| Ultrasound plus exercise vs. Exercise, Radicular LBP: Back pain, leg pain | 1 RCT | Moderate | Unable to determine | Direct | Precise | Undetected | Moderate |
| Ultrasound vs. Other interventions | 3 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Ultrasound vs. Other interventions, radiculopathy | 2 RCT | High | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Ultrasound, acute non-radicular LBP | No studies | Insufficient | |||||
| Spinal manipulation plus home exercise and advice, radicular LBP | 1 RCT | Moderate | Unable to determine | Direct | Precise | Suspected | Low |
| Ultrasound vs. Sham ultrasound : Adverse events | 1 RCT | Low | Unable to determine | Direct | Imprecise | Suspected | Low |
| Transcutaneous electrical nerve stimulation [TENS] | |||||||
| TENS vs. Sham TENS, acute or subacute LBP: Pain, function | 2 RCTs | High | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| TENS vs. Sham TENS, chronic LBP : Pain, function | 4 RCTs for pain and 2 RCTs for function in systematic review | Moderate | Consistent | Direct | Iimprecise | Undetected | Low |
| TENS vs. Acupuncture, chronic LBP : Pain | 4 RCTs for pain and 2 RCTs for function in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| TENS : Adverse events | 8 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Suspected | Low |
| Electrical muscle stimulation [EMS] | |||||||
| EMS plus exercise vs. Exercise, EMS vs. Other interventions, acute or chronic LBP: Pain, function | 5 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| EMS: Adverse events | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Suspected | Insufficient |
| Percutaneous Electrical Nerve Stimulation [PENS] | |||||||
| PENS vs. Sham PENS, PENS plus exercise vs. exercise, PENS vs. other interventions, chronic LBP (with or without radiculopathy) | 7 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| PENS : Adverse events | 1 RCT | High | Unable to determine | Direct | -- | Suspected | Insufficient |
| Interferential therapy [IFT] | |||||||
| IFT vs. other interventions, IFT plus another intervention vs. the other intervention,subacute to chronic LBP: Pain, function | 4 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| IFT : Adverse events | No studies | Suspected | Insufficient | ||||
| Superficial Heat or Cold | |||||||
| Heat wrap vs. Placebo, acute or subacute LBP : Pain, function | 2 RCTs in systematic review and 2 RCTs | Moderate | Consistent | Direct | Precise | Undetected | Moderate |
| Heat plus exercise vs. exercise alone, acute LBP : Pain, function | 1 RCT | Low | Unable to determine | Direct | Imprecise | Undetected | Low |
| Heat plus NSAID vs. NSAID alone, acute LBP:Pain | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Heat vs. Simple analgesics, acute or subacute LBP : Pain, function | 1 RCT in systematic review | Low | Unable to determine | Direct | Imprecise | Undetected | Low |
| Heat vs. Exercise, acute LBP : Pain, Function | 1 RCT in systematic review | Low | Unable to determine | Direct | Imprecise | Undetected | Low |
| Cold plus naproxen vs. naproxen alone, acute LBP: Pain | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Superficial Cold vs. Placebo | No studies | Insufficient | |||||
| Heat vs. Cold | 3 RCTs | High | Consistent | Direct | Imprecise | Undetected | Insufficient |
| Heat vs. No heat or placebo : Adverse events, flushing | 2 RCTs | Low | Consistent | Direct | Imprecise | Suspected | Low |
| Low Level Laser Therapy [LLLT] | |||||||
| LLLT vs. Sham laser, acute LBP | 1 RCT | High | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| LLLT vs. Sham laser, chronic LBP : Pain, Function | 3 RCTs for pain, 1 RCT for function | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| LLLT plus NSAID vs. Sham plus NSAID, acute or subacute LBP : Pain, function | 1 RCT | Low | Unable to determine | Direct | Imprecise | Undetected | Low |
| LLLT plus another intervention vs. the other intervention alons, chronic LBP: Pain, function | 3 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| LLLT vs. anotehr intervention: Pain, function | 2 RCTs | High | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| LLLT differing wavelengths or doses | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| LLLT : Adverse events | 10 RCTs | High | Consistent | Direct | Imprecise | Suspected | Low |
| Short-wave Diathermy | |||||||
| Short-wave diathermy vs. Sham diathermy, mixed duration LBP : Effectiveness, Adverse events | 4 RCTs | High | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Short-wave diathermy: Adverse events | No studies | Suspected | Insufficient | ||||
| Lumbar Supports | |||||||
| Lumbar supports vs. no lumbar supports or an inactive treatment, acute or subacute LBP: Pain, function | 4 RCTs in systematic review and 1 RCT | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Lumbar supports vs. no lumbar supports, chronic LBP | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Lumbar supports vs. no lumbar supports, mixed duration LBP: Pain and function | 1 RCT | Moderate | Unable to determine | Direct | Precise | Undetected | Low |
| Lumbar support plus education vs. education, acute or subacute LBP : Pain, function | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Lumbar support plus exercise vs. exercise alone, chronic LBP : Pain, function | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Low |
| Lumbar support vs. other active treaatments : Pain, Function | 3 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Low |
| Lumbar supports vs. Lumbar supports: Pain, function | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Lumbar supports : Adverse events | 8 RCTs in systematic review and 3 RCTs | Moderate | Consistent | Direct | Imprecise | Suspected | Low |
| Traction | |||||||
| Traction vs. placebo, sham or no treatment, LBP with or without radicular symptoms : Pain, function | 13 RCTs in systematic review and 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Insufficient |
| Traction vs. physiotherapy, LBP with or without radicular symptoms: Pain, function | 5 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Traction vs. other interventions, LBP with or without radicular symptoms : Pain, function | 15 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Traction vs. Traction: Pain, function | 5 RCTs in systematic review | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Traction : Adverse events | 11 RCTs in systematic reviews | Moderate | Consistent | Direct | Imprecise | Undetected | Low |
| Taping | |||||||
| Kinesio Taping vs. Sham taping, chronic LBP : Pain, Function | 2 RCTs | Low | Inconsistent for pain Consistent for function | Direct | Imprecise | Undetected | Insufficient for pain Low for function |
| Functional Fascial Taping plus exercise vs. Sham taping plus exercise, chronic LBP: Pain, function | 1 RCT | Moderate | Unable to determine | Direct | Imprecise | Undetected | Insufficient |
| Kinesio Taping vs. exercise therapy, chronic LBP : Pain, Function | 2 RCTs | Moderate | Inconsistent | Direct | Imprecise | Undetected | Low |
| Taping : Adverse events | Insufficient |
- Strength of Evidence - Noninvasive Treatments for Low Back PainStrength of Evidence - Noninvasive Treatments for Low Back Pain
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