Skip to main content

Evidence-Based Medicine for Low Back Pain

  • Chapter
Book cover Spinal Imaging

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

During the last decade, the importance of evidencebased medicine has steadily gained ground. Sackett, in his landmark book published in 1997, defined evidence-based medicine as ‘conscientious, explicit and judicious use of current best evidence in making decisions about care of individual patients’ (Sackett 1997). The evidence may refer to new or existing interventions and to preventive, diagnostic or therapeutic interventions. Sackett suggested five steps on how individual care providers can practice evidence-based medicine: (1) ask clinical questions that you can answer, (2) search for the best evidence, (3) critically appraise the evidence, (4) apply the evidence in care for your patient, and (5) self-evaluation (of the above steps). Although this seems very reasonable, it is probably impossible for individual care providers to search for and critically appraise the evidence. At present, there are more than 2 million new articles published every year.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Andersson GBJ (1997) The epidemiology of spinal disorders. In: Frymoyer JW (ed) The adult spine: principles and practice. Lippincott-Raven, Philadelphia, pp 93–141

    Google Scholar 

  • Assendelft WJJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG (2003) Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies. Ann Intern Med 138:871–81

    PubMed  Google Scholar 

  • Atkinson JH, Slater MA, Williams RA et al. (1998) A placebocontrolled randomized clinical trial of nortriptyline for chronic low back pain. Pain 76:287–296

    Article  PubMed  CAS  Google Scholar 

  • Atkinson JH, Slater MA, Wahlgren DR et al. (1999) Effects of noradrenergic and serotonergic antidepressants on chronic low back pain intensity. Pain 83:137–145

    Article  PubMed  CAS  Google Scholar 

  • Bendix AF, Bendix T, Ostenfeld S et al. (1995) Active treatment programs for patients with chronic low back pain: a prospective, randomized, observer-blinded study. Eur Spine J 4:148–52

    Article  PubMed  CAS  Google Scholar 

  • Bendix AF, Bendix T, Labriola M et al. (1998) Functional restoration for chronic low back pain: two-year follow-up of two randomized clinical trials. Spine 23:717–725

    Article  PubMed  CAS  Google Scholar 

  • Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA (1998) Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ 317:465–468

    Article  PubMed  CAS  Google Scholar 

  • Beurskens AJ, de Vet HCW, Köke AJ et al. (1995) Efficacy of traction for non-specific low back pain: a randomised clinical trial. Lancet 346:1596–1600

    Article  PubMed  CAS  Google Scholar 

  • Bombardier C, Esmail R, Nachemson AL (1997) Back Review Group Editorial Board. The Cochrane Collaboration Back Review Group for spinal disorders. Spine 22:837–840

    Article  PubMed  CAS  Google Scholar 

  • Bouter LM, Pennick V, Bombardier C (2003) The Editorial Board of the Back Review Group. Cochrane Back Review Group. Spine 28:1215–1218

    PubMed  Google Scholar 

  • Browning R, Jackson JF, O’Malley PG (2001) Cyclobenzaprine and back pain. Arch Intern Med 161:1613–1620

    Article  PubMed  CAS  Google Scholar 

  • Carlsson CPO, Sjölund BH (2001) Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain 17:296–305

    Article  PubMed  CAS  Google Scholar 

  • Cherkin DC, Eisenberg D, Sherman KJ et al. (2001) Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med 161:1081–1088

    Article  PubMed  CAS  Google Scholar 

  • Chok B, Lee R, Latimer J et al. (1999) Endurance training of the trunk extensor muscles in people with subacute low back pain. Phys Ther 79:1032–1042

    PubMed  CAS  Google Scholar 

  • Deville WL, van der Windt DA, Dzaferagic A, Bezemer PD, Bouter LM (2000) The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs. Spine 25:1140–1147

    Article  PubMed  CAS  Google Scholar 

  • Deyo RA, Rainville J, Kent DL (1992) What can the history and physical examination tell us about low back pain? JAMA 268:760–765

    Article  PubMed  CAS  Google Scholar 

  • Dickens C, Jayson M, Sutton C et al. (2000) The relationship between pain and depression in a trial using paroxetine in sufferers of chronic low back pain. Psychosomatics 41:490–499

    Article  PubMed  CAS  Google Scholar 

  • Ernst E, White AR (1998) Acupuncture for back pain. A meta-analysis of randomized controlled trials. Arch Intern Med 158:2235–2241

    Article  PubMed  CAS  Google Scholar 

  • Famaey JP, Bruhwyler J, Vandekerckhove K et al. (1998) Open controlled randomised multicenter comparison of nimesulide and diclofenac in the treatment of subacute and chronic low back pain. J Drug Assess 1:349–368

    Google Scholar 

  • Friedrich M, Gittler G, Halberstadt Y et al. (1998) Combined exercise and motivation program: effect on the compliance and level of disability of patients with chronic low back pain: a randomized controlled trial. Arch Phys Med Rehabil 79:475–487

    Article  PubMed  CAS  Google Scholar 

  • Frymoyer JW (1988) Back pain and sciatica. N Eng J Med 318:291–300

    Article  CAS  Google Scholar 

  • Frymoyer JW, Cats-Baril W (1991) An overview of the incidences and costs of low back pain. Orthop Clin N Am 22:263–271

    CAS  Google Scholar 

  • Furlan AD, Brosseau L, Imamura M, Irvin E (2002) Massage for low-back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 27:1896–1910

    Article  PubMed  Google Scholar 

  • Grimshaw J, Shirran L, Thomas R (2001) Changing provider behavior: an overview of systematic reviews of interventions. Medical Care 29:II2–II45

    Google Scholar 

  • Grol R (1997) Beliefs and evidence in changing clinical practice. BMJ 315:418–421

    Article  PubMed  CAS  Google Scholar 

  • Hagen EM, Eriksen HR, Ursin H (2000) Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine 25:1973–1976

    Article  PubMed  CAS  Google Scholar 

  • Hagen KB, Hilde G, Jamtvedt G et al. (2003) Bed rest for acute low back pain and sciatica (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford, Update Software

    Google Scholar 

  • Hameroff SR, Cork RC, Scherer K et al. (1982) Doxepin effects on chronic pain, depression and plasma opioids. J Clin Psychiatry 43:22–27

    PubMed  CAS  Google Scholar 

  • Hameroff SR, Weiss JL, Lerman JC et al. (1984) Doxepin’s effects on chronic pain and depression: a controlled study. J Clin Psychiatry 45:47–52

    PubMed  CAS  Google Scholar 

  • Hasenbring M, Ulrich HW, Hartmann M et al. (1999) The efficacy of a risk factor-based cognitive behavioral intervention and electromyographic biofeedback in patients with acute sciatic pain: an attempt to prevent chronicity. Spine 24:2525–2535

    Article  PubMed  CAS  Google Scholar 

  • Hides JA, Richardson CA, Jull GA (1996) Multifidus muscle recovery is not automatic after resolution of acute first episode low back pain. Spine 21:2763–2769

    Article  PubMed  CAS  Google Scholar 

  • Hilde G, Hagen KB, Jamtvedt G et al. (2003) Advice to stay active as a single treatment for low back pain and sciatica (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford, Update Software

    Google Scholar 

  • Hildebrandt VH, Proper KI, van den Berg R et al. (2000) Cesar therapy is temporarily more effective in patients with chronic low back pain than the standard treatment by family practitioner: randomized, controlled and blinded clinical trial with 1 year follow-up. [Dutch]. Ned Tijdschr Geneesk 144:2258–2264

    CAS  Google Scholar 

  • Jarvik JG, Deyo RA (2002) Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med 137:586–597

    PubMed  Google Scholar 

  • Jarvik JG, Hollingworth W, Martin B, Emerson SS, Gray DT, Overman S, Robinson D, Staiger T, Wessbecher F, Sullivan SD, Kreuter W, Deyo RA (2003) Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA 289:2810–2818

    Article  PubMed  Google Scholar 

  • Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331:69–73

    Article  PubMed  CAS  Google Scholar 

  • Kankaanpaa M, Taimela S, Airaksinen O et al. (1999) The efficacy of active rehabilitation in chronic low back pain. Effect on pain intensity, self-experienced disability, and lumbar fatigability. Spine 24:1034–1042

    Article  PubMed  CAS  Google Scholar 

  • Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, Koes B (2001) Multidisciplinary biopsychosocial rehabilitation for subacute low back pain in working-age adults. Spine 26:262–269

    Article  PubMed  CAS  Google Scholar 

  • Koes BW, Scholten RJPM, Mens JMA et al. (1999) Epidural steroid injections for low back pain and sciatica: an updated systematic review of randomized clinical trials. Pain Digest 9:241–247

    Google Scholar 

  • Koes BW, van Tulder MW, Ostelo R, Kim BA, Waddell G (2001) Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 26:2504–2513

    Article  PubMed  CAS  Google Scholar 

  • Kuukkanen T, Malkia E (2000) Effects of a three-month therapeutic exercise programme on flexibility in subjects with low back pain. Physiother Res Int 5:46–61

    Article  PubMed  CAS  Google Scholar 

  • Laws D (1994) Double blind parallel group investigation in general practice of the efficacy and tolerability of acemetacin, in comparison with diclofenac, in patients suffering with acute low back pain. Br J Clin Res 5:55–64

    Google Scholar 

  • Mannion AF, Muntener M, Taimela S et al. (1999) A randomized clinical trial of three active therapies for chronic low back pain. Spine 24:2435–2448

    Article  PubMed  CAS  Google Scholar 

  • Mannion AF, Muntener M, Taimela S et al. (2001) Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatology 40:772–778

    Article  PubMed  CAS  Google Scholar 

  • Mannion AF, Junge A, Taimela S et al. (2001) Active therapy for chronic low back pain: part 3. Factors influencing selfrated disability and its change following therapy. Spine 26:920–929

    Article  PubMed  CAS  Google Scholar 

  • Mannion AF, Taimela S, Muntener M et al. (2001) Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength. Spine 26:897–908

    Article  PubMed  CAS  Google Scholar 

  • Nelemans PJ, de Bie RA, de Vet HCW et al. (2002) Injection therapy for subacute and chronic benign low back pain. In: The Cochrane Library, Issue 3

    Google Scholar 

  • O’Sullivan PB, Twomey LT, Allison GT (1997) Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 24:2959–2967

    Article  Google Scholar 

  • Pohjolainen T, Jekunen A, Autio L et al. (2000) Treatment of acute low back pain with the COX-2 selective anti-inflammatory drug nimesulide: results of a randomised, double-blind comparative trial versus ibuprofen. Spine 25:1579–1585

    Article  PubMed  CAS  Google Scholar 

  • Rozenberg S, Delval C, Rezvani Y, Olivieri-Apicella N, Kuntz JL, Legrand E, Valat JP, Blotman F, Meadeb J, Rolland D, Hary S, Duplan B, Feldmann JL, Bourgeois P (2002) Bed rest or normal activity for patients with acute low back pain: a randomized controlled trial. Spine 27:1487–1493

    Article  PubMed  Google Scholar 

  • Sackett D (1997) Evidence-based medicine. Churchill Livingstone, Chicago

    Google Scholar 

  • Salerno SM, Browning R, Jackson JL (2002) The effect of antidepressant treatment in chronic back pain: a metaanalysis. Arch Intern Med 162:19–24

    Article  PubMed  CAS  Google Scholar 

  • Schonstein E, Kenny DT, Keating J, Koes BW (2003) Work conditioning, work hardening and functional restoration for workers with back and neck pain (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford, Update Software

    Google Scholar 

  • Soukup MG, Glomsrod B, Lonn JH et al. (1999) The effect of a Mensendieck exercise program as secondary prophylaxis for recurrent low back pain. A randomized, controlled trial with 12-month follow-up. Spine 24:1585–1591

    Article  PubMed  CAS  Google Scholar 

  • Soukup MG, Lonn J, Glomsrod B et al. (2001) Exercises and education as secondary prevention for recurrent low back pain. Physiother Res Int 6:27–39

    Article  PubMed  CAS  Google Scholar 

  • Treves R, Montane de la Roque P, Dumond JJ et al. (1991) Prospective study of the analgesic action of clomipramine versus placebo in refractory low back pain and sciatica (68 cases). [French]. Rev Rhum Mal Osteoartic 58:549–552

    PubMed  CAS  Google Scholar 

  • Van den Hoogen HMM, Koes BW, van Eijk JThM, Bouter LM (1995) On the accuracy of history, physical examination and erythrocyte sedimentation rate in diagnosing low back pain in general practice. A criteria-based review of the literature. Spine 20:318–327

    Article  PubMed  Google Scholar 

  • Van der Heijden GJMG, Beurskens AJHM, Koes BW, de Vet HCW, Bouter LM (1995) The efficacy of traction for back and neck pain: a systematic, blinded review of randomized clinical trial methods. Phys Ther 75:93–104

    PubMed  Google Scholar 

  • van Tulder MW, Koes BW, Bouter LM (1995) A cost-of-illness study of back pain in The Netherlands. Pain 62:233–240

    Article  PubMed  Google Scholar 

  • van Tulder MW, Assendelft WJJ, Koes BW, Bouter LM (1997a) Spinal radiographic findings and nonspecific low back pain: a systematic review of observational studies. Spine 22:427–434

    Article  PubMed  Google Scholar 

  • van Tulder MW, Koes BW, Bouter LM (1997b) Conservative treatment of acute and chronic non-specific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine 22:2128–2156

    Article  PubMed  Google Scholar 

  • van Tulder MW, Cherkin DC, Berman B, Lao L, Koes BW (1999) The effectiveness of acupuncture in the treatment of acute and chronic low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 24:1113–1123

    Article  PubMed  Google Scholar 

  • van Tulder MW, Esmail R, Bombardier C, Koes BW (2000a) Back schools for non-specific low back pain (Cochrane Review). In: The Cochrane Library, Issue 3. Oxford, Update Software

    Google Scholar 

  • van Tulder MW, Ostelo RWJG, Vlaeyen JWS, Linton SJ, Morley SJ, Assendelft WJJ (2000b) Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Collaboration. Spine 25:2688–2699

    Article  PubMed  Google Scholar 

  • van Tulder MW, Malmivaara M, Esmail R, Koes BW (2000c) Exercise therapy for low back pain: a systematic review within the framework of the Cochrane Collaboration. Spine 25:2784–2796

    Article  PubMed  Google Scholar 

  • van Tulder MW, Scholten RJPM, Koes BW, Deyo RA (2000d) Non-steroidal anti-inflammatory drugs for low back pain: a systematic review within the framework of the Cochrane Collaboration. Spine 25:2501–2513

    Article  PubMed  Google Scholar 

  • van Tulder MW, Jellema P, Nachemson AL, van Poppel MNM, Bouter LM (2000e) Lumbar supports for prevention and treatment of low back pain (Cochrane Review). In: The Cochrane Library, Issue 3. Oxford: Update Software

    Google Scholar 

  • van Tulder M, Furlan A, Bombardier C, Bouter L (2003a) The Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine 28:1290–1299

    PubMed  Google Scholar 

  • van Tulder MW, Koes BW (2003b) Acute low back pain and sciatica. Clin Evid 9:1245–1259

    PubMed  Google Scholar 

  • van Tulder MW, Koes BW (2003c) Chronic low back pain and sciatica. Clin Evid 9:1260–1276

    PubMed  Google Scholar 

  • Veenema KR, Leahey N, Schneider S (2000) Ketorolac versus meperidine: ED treatment of severe musculoskeletal low back pain. Am J Emerg Med 18:404–407

    Article  PubMed  CAS  Google Scholar 

  • Von Korff M, Saunders K (1996) The course of back pain in primary care. Spine 21:2833–2837

    Article  Google Scholar 

  • Waddell G, Feder G, Lewis M (1997) Systematic reviews of bed rest and advice to stay active for acute low back pain. Br J Gen Pract 47:647–652

    PubMed  CAS  Google Scholar 

  • Watson PJ, Main CJ, Waddell G, Gales TF, Purcell-Jones G (1998) Medically certified work loss, recurrence and costs of wage compensation for back pain: a follow-up study of the working population of Jersey. Br J Rheumatol 37:82–86

    Article  PubMed  CAS  Google Scholar 

  • Webster BS, Snook SH (1990) The cost of compensable low back pain. J Occup Med 32:13–15

    Article  PubMed  CAS  Google Scholar 

  • Werners R, Pynsent PB, Bulstrode CJK (1999) Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back pain in a primary care setting. Spine 24:1579–1584

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

van Tulder, M., Koes, B. (2007). Evidence-Based Medicine for Low Back Pain. In: Van Goethem, J.W.M., van den Hauwe, L., Parizel, P.M. (eds) Spinal Imaging. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68483-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-68483-1_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-21344-4

  • Online ISBN: 978-3-540-68483-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics