List of trials by intervention

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WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings [Internet]. Geneva: World Health Organization; 2023.

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WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings [Internet].

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Web Annex EList of trials by intervention

A.1. Structured and standardized education and/or advice

1.: Akca NK, Aydin G, Gumus K. Effect of body mechanics brief education in the clinical setting on pain patients with lumbar disc hernia: a randomized controlled trial. Int J Caring Sci. 2017;10(3):1498–1506.
2.: Ayanniyi O, Ige GO. Back care education on peasant farmers suffering from chronic mechanical low back pain. J Experim Integrat Med. 2015;5(4):215–221.
3.: Bodes Pardo G, Lluch Girbes E, Roussel NA, Gallego Izquierdo T, Jimenez Penick V, Pecos Martin D. Pain neurophysiology education and therapeutic exercise for patients with chronic low back pain: A single-blind randomized controlled trial. Arch Phys Med Rehabil. 2018;99(2):338–347. doi: 10.1016/j.apmr.2017.10.016 [PubMed: 29138049] [CrossRef]
4.: da Silva TMJC, da Silva NN, de Souza Rocha SH et al. Back school program for back pain: education or physical exercise? ConScientiae Saúde. 2014;13(4):506–515.
5.: Ibrahimi Ghavamabadi L, Mohammadi A, Behzadi A, Dehaghi BF. Effectiveness of a training program on the low back pain and functional disability in industrial workers. Int J Health Promot Educ. 2022;60:343–353.
6.: Jassi FJ, Del Antonio TT, Azevedo BO, Moraes R, George SZ, Chaves TC. Star-shape kinesio taping is not better than a minimal intervention or sham kinesio taping for pain intensity and postural control in chronic low back pain: a randomized controlled trial. Arch Phys Med Rehabil. 2021;102(7):1352–1360.e3. doi: 10.1016/j.apmr.2021.03.007 [PubMed: 33819489] [CrossRef]
7.: Kim KS, An J, Kim JO, Lee MY, Lee BH. Effects of pain neuroscience education combined with lumbar stabilization exercise on strength and pain in patients with chronic low back pain: randomized controlled trial. J Pers Med. 2022;12(2):303. doi: 10.3390/jpm12020303. [PMC free article: PMC8876043] [PubMed: 35207790] [CrossRef]
8.: Miyamoto GC, Fagundes FRC, de Melo do Espirito Santo C et al. Education with therapeutic alliance did not improve symptoms in patients with chronic low back pain and low risk of poor prognosis compared to education without therapeutic alliance: a randomized controlled trial. J Orthop Sports Phys Ther. 2021;51(8):392–400. doi: 10.2519/jospt.2021.9636 [PubMed: 33962515] [CrossRef]
9.: Morone G, Paolucci T, Alcuri MR et al. Quality of life improved by multidisciplinary back school program in patients with chronic non-specific low back pain: a single blind randomized controlled trial. Eur J Phys Rehabil Med. 2011;47(4):533–541. [PubMed: 21508915]
10.: Pires D, Cruz EB, Caeiro C. Aquatic exercise and pain neurophysiology education versus aquatic exercise alone for patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2015;29(6):538–547. doi: 10.1177/0269215514549033 [PubMed: 25200879] [CrossRef]
11.: Rantonen J, Karppinen J, Vehtari A et al. Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - a randomised controlled trial with a natural course control. BMC Public Health. 2018;18(1):598. doi: 10.1186/s12889-018-5476-8 [PMC free article: PMC5941604] [PubMed: 29739371] [CrossRef]
12.: Saracoglu I, Arik MI, Afsar E, Gokpinar HH. The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: A single-blind randomized controlled trial. Physiother Theory Pract. 2020:1–11. doi: 10.1080/09593985.2020.1809046. [PubMed: 32812478] [CrossRef]
13.: Shojaei S, Sadat Tavafian S, Reza Jamshidi A, Wagner J. A multidisciplinary workplace intervention for chronic low back pain among nursing assistants in Iran. Asian Spine J. 2017;11(3):419–426. doi: 10.4184/asj.2017.11.3.419 [PMC free article: PMC5481597] [PubMed: 28670410] [CrossRef]
14.: Shojaei S, Sadat Tavafian S, Reza Jamshidi A, Wagner J, Reza Sepahvandi M. Social cognitive theory-based intervention and low back pain among health care workers in Qom hospitals of Iran. Int J Musculoskelet Pain Prev. 2017;2(1):193–201.
15.: Tellez-Garcia M, de-la-Llave-Rincon AI, Salom-Moreno J, Palacios-Cena M, Ortega-Santiago R, Fernandez-de-Las-Penas C. Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial. J Bodyw Mov Ther. 2015;19(3):464–472. doi: 10.1016/j.jbmt.2014.11.012 [PubMed: 26118519] [CrossRef]
16.: Zhang Y, Wan L, Wang X. The effect of health education in patients with chronic low back pain. J Int Med Res. 2014;42(3):815–820. doi: 10.1177/0300060514527059 [PubMed: 24781721] [CrossRef]

B.1. Structured exercise therapies or programmes

1.: Chhabra HS, Sharma S, Verma S. Smartphone app in self-management of chronic low back pain: a randomized controlled trial. Eur Spine J. 2018;27(11):2862–2874. doi:10.1007/s00586-018-5788-5 [PubMed: 30324496] [CrossRef]
2.: Costa LO, Maher CG, Latimer J et al. Motor control exercise for chronic low back pain: a randomized placebo-controlled trial. Phys Ther. 2009;89(12):1275–1286. doi:10.2522/ptj.20090218 [PubMed: 19892856] [CrossRef]
3.: Fukuda TY, Aquino LM, Pereira P et al. Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial. Braz J Phys Ther. 2021;25(6):900–907. doi:10.1016/j.bjpt.2021.10.005 [PMC free article: PMC8721074] [PubMed: 34824001] [CrossRef]
4.: Jinnouchi H, Matsudaira K, Kitamura A et al. Effects of brief self-exercise education on the management of chronic low back pain: A community-based, randomized, parallel-group pragmatic trial. Mod Rheumatol. 2020;31(4):890–898. doi:10.1080/14397595.2020.1823603 [PubMed: 32930621] [CrossRef]
5.: Miyamoto GC, Costa LO, Galvanin T, Cabral CM. Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back pain: a randomized controlled trial. Phys Ther. 2013;93(3):310–320. doi:10.2522/ptj.20120190 [PubMed: 23064732] [CrossRef]
6.: Nardin DMK, Stocco MR, Aguiar AF, Machado FA, de Oliveira RG, Andraus RAC. Effects of photobiomodulation and deep water running in patients with chronic non-specific low back pain: a randomized controlled trial. Lasers Med Sci. 2022;37(4):2135–2144. doi:10.1007/s10103-021-03443-6 [PubMed: 35246766] [CrossRef]
7.: Rahbar M, Salekzamani Y, Jahanjou F, Eslamian F, Niroumand A, Dolatkhah N. Effect of hippotherapy simulator on pain, disability and range of motion of the spinal column in subjects with mechanical low back pain: A randomized single-blind clinical trial. J Back Musculoskelet Rehabil. 2018;31(6):1183–1192. doi:10.3233/BMR-170832 [PubMed: 30056412] [CrossRef]
8.: Rotter G, Ortiz M, Binting S et al. Mindful walking in patients with chronic low back pain: a randomized controlled trial. J Integr Complement Med. 2022;28(6):474–483. doi:10.1089/jicm.2021.0361 [PMC free article: PMC9232228] [PubMed: 35363058] [CrossRef]
9.: Shamsi M, Ahmadi A, Mirzaei M, Jaberzadeh S. Effects of static stretching and strengthening exercises on flexion relaxation ratio in patients with LBP: A randomized clinical trial. J Bodyw Mov Ther. 2022;30:196–202. doi:10.1016/j.jbmt.2022.02.023 [PubMed: 35500971] [CrossRef]
10.: Smeets R, Vlaeyen JWS, Hidding A, Kester ADM, van der Heijden G, Knottnerus AJ. Chronic low back pain: physical training, graded activity with problem solving training, or both? The one-year post-treatment results of a randomized controlled trial. Pain. 2008;134(3):263–276. doi:10.1016/j.pain.2007.04.021 [PubMed: 17498879] [CrossRef]
11.: Takinaci Z et al. Clinical efficacy of spa therapy (balneotherapy) for chronic low back pain: A randomized single-blind trial. Eur J Integr Med. 2019;29:100928.
12.: Tilbrook HE, Cox H, Hewitt CE et al. Yoga for chronic low back pain: a randomized trial. Ann Intern Med. 2011;155(9):569–578. doi:10.7326/0003-4819-155-9-201111010-00003 [PubMed: 22041945] [CrossRef]
13.: Weiner DK, Perera S, Rudy TE, Glick RM, Shenoy S, Delitto A. Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial. Pain. 2008;140(2):344–357. doi:10.1016/j.pain.2008.09.005 [PMC free article: PMC2864648] [PubMed: 18930352] [CrossRef]
14.: Abadi FH, Sankaravel M, Zainuddin FF, Elumalai G, Razli AI. The effect of aquatic exercise program on low-back pain disability in obese women. J Exerc Rehabil. 2019;15(6):855–860. doi:10.12965/jer.1938688.344 [PMC free article: PMC6944883] [PubMed: 31938709] [CrossRef]
15.: Abdel-Aziem AA, Abdelraouf OR, El-Basatiny HMY, Draz AH. The effects of stabilization exercises combined with pelvic floor exercise in women with nonspecific low back pain: a randomized clinical study. J Chiropr Med. 2021;20(4):229–238. doi:10.1016/j.jcm.2021.12.008 [PMC free article: PMC9051137] [PubMed: 35496721] [CrossRef]
16.: Afzal MW, Ahmad A, Mohseni Bandpei MA, Gilani SA, Hanif A, Waqas MS. Effects of virtual reality exercises and routine physical therapy on pain intensity and functional disability in patients with chronic low back pain. J Pak Med Assoc. 2022;72(3):413–417. doi:10.47391/JPMA.3424 [PubMed: 35320216] [CrossRef]
17.: Ahmadizadeh Z, Ehsani F, Samaei SA, Mirmohammadkhani M. The effect of stabilization exercises along with self-care training on transverse abdominal activity, pain, and disability in mothers with low back pain having children with cerebral palsy: a randomized controlled trial. Am J Phys Med Rehabil. 2020;99(2):156–160. doi:10.1097/PHM.0000000000001315 [PubMed: 31503028] [CrossRef]
18.: Ain SQT, Rehman SSU, Maryam M, Kiani SK. Effects of sustained natural apophyseal glides with and without thoracic posture correction techniques on mechanical back pain: a randomized control trial. J Pak Med Assoc. 2019;69(11):1584–87. doi: 10.5455/JPMA.274875 [PubMed: 31740859] [CrossRef]
19.: Alikhajeh Y, Barabadi E, Rahimi GRM. A Comparison of 6 weeks of aquatic exercise and kinesio taping in patients with chronic nonspecific low back pain. J Sport Rehabil. 2021;30:37–42. doi: 10.1123/jsr.2019-0185 [PubMed: 32087600] [CrossRef]
20.: Alvani E, Shirvani H, Shamsoddini A. Neuromuscular exercises on pain intensity, functional disability, proprioception, and balance of military personnel with chronic low back pain. J Can Chiropr Assoc. 2021;65(2):193–206. [PMC free article: PMC8480371] [PubMed: 34658391]
21.: Ansari S, Elmieh A, Alipour A. The effect of aquatic exercise on functional disability, flexibility and function of trunk muscles in postmenopausal women with chronic non-specific low back pain: randomized controlled trial. Science and Sports. 2021;36(3):e103–e110.
22.: Barni L, Calabretta L, Lepori L, Pasquetti P, Gulisano M, Freddolini M. Does an aerobic exercise improve outcomes in older sedentary nonspecific low back pain subjects? A randomized controlled study. Top Geriatr Rehabil. 2018;34(2):88–94.
23.: Bruehl S, Burns JW, Koltyn K et al. Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial. Pain. 2020;161(12):2887–2897. doi:10.1097/j.pain.0000000000001969 [PMC free article: PMC7669643] [PubMed: 32569082] [CrossRef]
24.: Dimer da Luz R, da Silva Santos M, Steffen Evaldt A, da Silva Matos L, Boff Daitx R, Dohnert MB. Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial. Muscles, Ligaments and Tendons Journal. 2019;9(3):446–456.
25.: da Silva TMJC, da Silva NN, de Souza Rocha SH et al. Back school program for back pain: education or physical exercise? ConScientiae Saúde. 2014;13(4):506–515.
26.: Dalichau S, Scheele K. Status of aquatic functional training in the therapy of chronic back pain. Phys Med Rehabil Kuror. 2003;13:35–41.
27.: Dalichau S, Stein B, Schafer K, Buhlmann JJ, Menken P. Quantification of spinal configuration and postural capacity by ultrasound topometry for evaluation of different muscle strengthening programs in the therapy of back pain. Z Orthop. 2005;143:79–85. doi: 10.1055/s-2004-820416 [PubMed: 15754236] [CrossRef]
28.: Dineshkumar SK, Dibyendunarayan B, Ramalingam AT. Effect of abdominal drawing-in maneuver along with resisted ankle dorsiflexion to activate transverse abdominis muscle in chronic non-specific low back pain. Romanian J Phys Ther. 2015;21(36):40–47.
29.: Fouda KZ, Dewir IM, Abdelsalam MS. Effects of proprioceptive neuromuscular facilitation techniques in treating chronic nonspecific low back pain patients. Physiother Quart. 2021;29(2):32–37.
30.: Gao F, Yuan S, Liu N, Zheng S. Effect observation of Baduanjin training on chronic nonspecific low back pain. Rehabilitation Medicine. 2018;28(4):13–17.
31.: Ge L, Huang H, Yu Q et al. Effects of core stability training on older women with low back pain: a randomized controlled trial. Eur Rev Aging Phys Act. 2022;19(1):10. doi:10.1186/s11556-022-00289-x [PMC free article: PMC9011968] [PubMed: 35428169] [CrossRef]
32.: Gupta P, Mohanty PP, Pattnaik M. The effectiveness of aerobic exercise program for improving functional performance and quality of life in chronic low back pain. Indian J Physiother Occup Ther. 2019;13(2):155–160.
33.: Hatefi M, Babakhani F, Ashrafizadeh M. The effect of static stretching exercises on hip range of motion, pain, and disability in patients with non-specific low back pain. J Exp Orthop. 2021;8(1):55. doi:10.1186/s40634-021-00371-w [PMC free article: PMC8316530] [PubMed: 34318348] [CrossRef]
34.: Heidari RS, Sahebozamani M, Karimi AF. Comparison of the effects of 8 weeks of core stability exercise on ball and sling exercise on the quality of life and pain in the female with non-specific chronic low back pain (NSLBP). Journal of Zanjan University of Medical Sciences and Health Services. 2018;26(117):44–56.
35.: Hemmati S, Rajabi R, Karimi N, Jahandideh A. Effects of consecutive supervised core stability training on pain and disability in women with nonspecific chronic low back pain. Koomesh. 2011;12(3):244–252.
36.: Idowu OA, Adeniyi AF. Efficacy of graded activity with and without daily-monitored-walking on pain and back endurance among patients with concomitant low-back pain and type-2 diabetes: a randomized trial. Ethiop J Health Sci. 2020;30(2):233–242. doi:10.4314/ejhs.v30i2.11 [PMC free article: PMC7060385] [PubMed: 32165813] [CrossRef]
37.: Joseph LH, Hancharoenkul B, Sitilertpisan P, Pirunsan U, Paungmali A. Effects of massage as a combination therapy with lumbopelvic stability exercises as compared to standard massage therapy in low back pain: a randomized cross-over study. Int J Ther Massage Bodywork. 2018;11(4):16–22. [PMC free article: PMC6279433] [PubMed: 30524633]
38.: Kanwal S, Yaqoob I, Shakil-Ur-Rehman S, Ghous M, Ghazal J, Namroz N. Effects of core muscle stability on low back pain and quality of life in post- menopausal women: A comparative study. J Pak Med Assoc. 2021;71(1(A)):37–40. doi:10.47391/JPMA.151 [PubMed: 33484515] [CrossRef]
39.: Karimi N, Talimkhani A, Mosallanezhad Z, Arab AM, Keshavarz R. The effects of consecutive supervised functional lumbar stabilizing exercises on the postural balance and functional disability in low back pain. Iran Rehabil J. 2014;12(20):21–27.
40.: Karimzadeh F, Ghasemi GA, Letafatkar A. The effect of 8 weeks core stabilization exercises on pain and functional disability induced by low back pain in the mothers of children with cerebral palsy. Scientific Journal of Kurdistan University of Medical Sciences. 2016;21(44):5931–5994.
41.: Kell RT, Risi AD, Barden JM. The response of persons with chronic nonspecific low back pain to three different volumes of periodized musculoskeletal rehabilitation. J Strength Cond Res. 2011;25(4):1052–1064. doi:10.1519/JSC.0b013e3181d09df7 [PubMed: 20647943] [CrossRef]
42.: Kim S, Jee Y. Effects of 3D Moving platform exercise on physiological parameters and pain in patients with chronic low back pain. Medicina (Kaunas). 2020;56(7):351. doi:10.3390/medicina56070351 [PMC free article: PMC7404725] [PubMed: 32679755] [CrossRef]
43.: Kim B, Yim J. Core stability and hip exercises improve physical function and activity in patients with non-specific low back pain: a randomized controlled trial. Tohoku J Exp Med. 2020;251(3):193–206. doi:10.1620/tjem.251.193 [PubMed: 32669487] [CrossRef]
44.: Lang AE, Hendrick PA, Clay L et al. A randomized controlled trial investigating effects of an individualized pedometer driven walking program on chronic low back pain. BMC Musculoskelet Disord. 2021;22(1):206. doi:10.1186/s12891-021-04060-8 [PMC free article: PMC7896363] [PubMed: 33607979] [CrossRef]
45.: Li L, Feng Z. Clinical observation of treating chronic nonspecific low back pain with Baduanjin combining sling exercise therapy. Rheumatism and Arthritis. 2015;4(4):16–17. doi: 10.3390/ijerph15020206 [CrossRef]
46.: Li Z, Yu Q, Luo H et al. The effect of virtual reality training on anticipatory postural adjustments in patients with chronic nonspecific low back pain: a preliminary study. Neural Plast. 2021;2021:9975862. doi:10.1155/2021/9975862 [PMC free article: PMC8337111] [PubMed: 34367274] [CrossRef]
47.: Liu J, Zhao W, Yuan Y. Effects of Tai Chi on the event-related potential of patients with chronic non-specific low back pain. Chin J Sports Med. 2018;37(10):826–832.
48.: Liu J, Yeung A, Xiao T et al. Chen-Style Tai Chi for individuals (aged 50 years old or above) with chronic non-specific low back pain: a randomized controlled trial. Int J Environ Res Public Health. 2019;16(3). doi:10.3390/ijerph16030517 [PMC free article: PMC6388249] [PubMed: 30759778] [CrossRef]
49.: Madadi-Shad M, Jafarnezhadgero AA, Sheikhalizade H, Dionisio VC. Effect of a corrective exercise program on gait kinetics and muscle activities in older adults with both low back pain and pronated feet: A double-blind, randomized controlled trial. Gait Posture. 2020;76:339–345. doi:10.1016/j.gaitpost.2019.12.026 [PubMed: 31896537] [CrossRef]
50.: McIlveen B, Robertson VJ. A randomised controlled study of the outcome of hydrotherapy for subjects with low back or back and leg pain. Physiotherapy. 1998;84(1):17–26.
51.: Mendes PRF, Gomes SRA, Costa LDO, Liguori A, Bulhoes LCC, Brasileiro JS. Core stabilisation exercises reduce chronic low back pain in Air Force fighter pilots: a randomised controlled trial. BMJ Mil Health. 2022. doi:10.1136/bmjmilitary-2021-002005 [PubMed: 35470256] [CrossRef]
52.: Noormohammadpour P, Kordi M, Mansournia MA, Akbari-Fakhrabadi M, Kordi R. The role of a multi-step core stability exercise program in the treatment of nurses with chronic low back pain: a single-blinded randomized controlled trial. Asian Spine J. 2018;12(3):490–502. doi:10.4184/asj.2018.12.3.490 [PMC free article: PMC6002169] [PubMed: 29879777] [CrossRef]
53.: Park S, Park S, Min S, Kim C-J, Jee Y-S. A randomized controlled trial investigating the effects of equine simulator riding on low back pain, morphological changes, and trunk musculature in elderly women. Medicina. 2020;56(610):1–14. doi: 10.3390/medicina56110610. [PMC free article: PMC7696898] [PubMed: 33202928] [CrossRef]
54.: Prado ERA, Meireles SM, Carvalho ACA et al. Influence of isostretching on patients with chronic low back pain. A randomized controlled trial. Physiother Theory Pract. 2021;37(2):287–294. doi:10.1080/09593985.2019.1625091 [PubMed: 31161855] [CrossRef]
55.: Raoul T, Malfériot J, Barizien N, Lhuissier FJ. Effects of a spinal extensor muscle strengthening program in chronic low back pain triathletes. Randomized controlled study in 67 athletes. Journal de Traumatologie du Sport. 2019;36(3):183–193. doi:10.1016/j.jts.2019.07.011 [CrossRef]
56.: Rathi M. Effect of pelvic floor muscle strengthening exercises in chronic low back pain. Indian J Physiother Occup Ther. 2013;7(1):121–125. doi: 10.1007/s10072-022-06430-z. [CrossRef]
57.: Raza S, Awan WA, Ghauri MW, Mahmood T, Abbas S. Effectiveness of spinal stabilization exercises with and without stretching of Latissimus dorsi Muscle in chronic mechanical low back pain. Rawal Medical Journal. 2020;45(4):857–862.
58.: Sedaghati P, Ardjmand A, Sedaghati N. Comparison of the effects of different training approaches on dynamic balance and pain intensity in the patients with chronic back pain. Scientific Journal of Kurdistan University of Medical Sciences. 2017;90:6–13.
59.: Shariat A, Alizadeh R, Moradi V et al. The impact of modified exercise and relaxation therapy on chronic lower back pain in office workers: a randomized clinical trial. J Exerc Rehabil. 2019;15(5):703–708. doi:10.12965/jer.1938490.245 [PMC free article: PMC6834712] [PubMed: 31723560] [CrossRef]
60.: Shu J, Li D, Tao W, Chen S. Observation on the curative effect of massage manipulation combined with core strength training in patients with chronic nonspecific low back pain. Evid Based Complement Alternat Med. 2021;2021:7534577. doi:10.1155/2021/7534577 [PMC free article: PMC8556100] [PubMed: 34721644] [CrossRef]
61.: Sokhangoi Y, Noorabadi MH, Noorabadi MS. The effect of Pilates exercises on chronic non-specific low back pain and stable range of motion in women 40 to 60 years old. Scientific Research Journal of Zanjan University of Medical Sciences. 2017;25(108):20–30.
62.: Srivastav N, Joshi S, Kushwah SS. Comparison between effectiveness of lumbar stabilization exercises and conventional physical therapy in the management of mechanical low back pain. Indian J Physiother Occup Ther. 2018;12(4):28–33.
63.: Suh JH, Kim H, Jung GP, Ko JY, Ryu JS. The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine (Baltimore). 2019;98(26):e16173. doi:10.1097/MD.0000000000016173 [PMC free article: PMC6616307] [PubMed: 31261549] [CrossRef]
64.: Wattamwar RB, Nadkarni K. Effect of conventional occupational therapy and yoga in chronic low back Pain. Indian J Occup Ther. 2012;45(3):13–20.
65.: Xu C, Fu Z, Wang X. Effect of transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain. BMC Sports Sci Med Rehabil. 2021;13(1):35. doi:10.1186/s13102-021-00262-8 [PMC free article: PMC8017650] [PubMed: 33794983] [CrossRef]
66.: Yalfani A, Abedi M, Raeisi Z. Effects of an 8-week virtual reality training program on pain, fall risk, and quality of life in elderly women with chronic low back pain: double-blind randomized clinical trial. Games Health J. 2022;11(2):85–92. doi:10.1089/g4h.2021.0175 [PubMed: 35290742] [CrossRef]
67.: Zadro JR, Shirley D, Simic M et al. Video-game-based exercises for older people with chronic low back pain: a randomized controlled table trial (GAMEBACK). Phys Ther. 2019;99(1):14–27. doi:10.1093/ptj/pzy112 [PubMed: 30247715] [CrossRef]
68.: Zakari UU, Bello B, Sokumbi GO, Yakasai AM, Danazumi MS. Comparison of the effects of positional release therapy and lumbar stabilization exercises in the management of chronic mechanical low back pain—randomized controlled trial. Crit Rev Phys Rehabil Med. 2019;31(4):321–332. doi:10.1615/CritRevPhysRehabilMed.2020032738 [CrossRef]

B.2. Needling therapies

1.: Brinkhaus B, Witt CM, Jena S et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med. 2006;166(4):450–457. doi: 10.1001/archinte.166.4.450. [PubMed: 16505266] [CrossRef]
2.: Cherkin DC, Sherman KJ, Avins AL et al. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med. 2009;169(9):858–866. doi: 10.1001/archinternmed.2009.65. [PMC free article: PMC2832641] [PubMed: 19433697] [CrossRef]
3.: Cho YJ, Song YK, Cha YY et al. Acupuncture for chronic low back pain: a multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. Spine (Phila Pa). 2013;38(7):549–557. doi: 10.1097/BRS.0b013e318275e601. [PubMed: 23026870] [CrossRef]
4.: de Castro Moura C, Chaves ECL, Chianca TCM et al. Contribution of Chinese and French ear acupuncture for the management of chronic back pain: a randomised controlled trial. J Clin Nurs. 2019;28(21–22):3796–3806. doi: 10.1111/jocn.14983 [PubMed: 31237981] [CrossRef]
5.: de Castro Moura C, de Cássia Lopes Chaves E, Couto Machado Chianca T, Ruginsk SG, Alves Nogueira D, Iunes DH. Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial. Revista da escola de enfermagem da USP. 2019;53:1–9. doi: 10.1590/S1980-220X2018009003418. [PubMed: 30673051] [CrossRef]
6.: Depaoli Lemos VJ, Selau RC, Blos C, Baptista Dohnert M, Boff Daitx R, de Almeida Brito V. Electroacupuncture and transcutaneous electrical nerve stimulation in chronic nonspecific low back pain: a blind randomized clinical trial. Muscles, Ligaments and Tendons journal (MLTJ). 2021;11(4):719–727.
7.: Haake M, Muller HH, Schade-Brittinger C et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007;167(17):1892–1898. doi: 10.1001/archinte.167.17.1892. [PubMed: 17893311] [CrossRef]
8.: Huang Z, Liu S, Zhou J, Yao Q, Liu Z. Efficacy and safety of acupuncture for chronic discogenic sciatica, a randomized controlled sham acupuncture trial. Pain Medicine (Malden Ma). 2019;20(11):2303–2310. doi: 10.1093/pm/pnz167. [PubMed: 31369674] [CrossRef]
9.: Kerr DP, Walsh DM, Baxter D. Acupuncture in the management of chronic low back pain: a blinded randomized controlled trial. Clin J Pain. 2003;19(6):364–370. doi: 10.1097/00002508-200311000-00004. [PubMed: 14600536] [CrossRef]
10.: Kim H, Mawla I, Lee J et al. Reduced tactile acuity in chronic low back pain is linked with structural neuroplasticity in primary somatosensory cortex and is modulated by acupuncture therapy. NeuroImage. 2020;217:116899. doi: 10.1016/j.neuroimage.2020.116899 [PMC free article: PMC7395964] [PubMed: 32380138] [CrossRef]
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21.: Shi F, Dong B, Lin X, Fu Y. [Clinical observation on treatment of non-specific low back pain based on meridian theory and acupuncture](article in Chinese). Journal of Practical Traditional Chinese Internal Medicine. 2021;35(2):93–96.
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27.: Weiß J, Quante S, Xue F, Muche R, Reuss-Borst M. Effectiveness and acceptance of acupuncture in patients with chronic low back pain: results of a prospective, randomized, controlled trial. J Altern Complement Med. 2013;19(12):935–941. doi: 10.1089/acm.2012.0338. [PubMed: 23738680] [CrossRef]
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35.: Zhu X, Shen X, Kang L et al. Clinical study on acupuncture combined with bone setting manipulation in the treatment of lumbar disc herniation. Hebei Journal of Traditional Chinese Medicine. 2020;42(6):927–931.
36.: Zhu Z. Clinical study on warming-needle moxibustion combined with joint loosening for chronic low back pain. Journal of New Chinese Medicine. 2021;53(1):117–120.
37.: Koppenhaver SL, Weaver AM, Randall TL et al. Effect of dry needling on lumbar muscle stiffness in patients with low back pain: a double blind, randomized controlled trial using shear wave elastography. J Man Manip Ther. 2022;30(3):154–164. doi: 10.1080/10669817.2021.1977069 [PMC free article: PMC9255226] [PubMed: 34525901] [CrossRef]

B.3. Spinal manipulative therapy

1.: Balthazard P et al. Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2012;13:162–162. doi: 10.1186/1471-2474-13-162 [PMC free article: PMC3518179] [PubMed: 22925609] [CrossRef]
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9.: Gibson T et al. Controlled comparison of short-wave diathermy treatment with osteopathic treatment in non-specific low back pain. Lancet. 1985;8440:1258–1261. doi: 10.1016/s0140-6736(85)92323-2. [PubMed: 2860453] [CrossRef]
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11.: Koes BW et al. The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. Spine. 1992;17:28–35. [PubMed: 1531552]
12.: Krekoukiasa G, Gelalisa ID, Xenakisa T, Gioftsosb G, Dimitriadisc Z, Sakellarib V. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017;25(2):66–73. doi: 10.1080/10669817.2016.1184435 [PMC free article: PMC5430451] [PubMed: 28559665] [CrossRef]
13.: Licciardone JC et al. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11(2):122–129. doi: 10.1370/afm.1468 [PMC free article: PMC3601389] [PubMed: 23508598] [CrossRef]
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15.: Nambi G et al. Spinal manipulation plus laser therapy versus laser therapy alone in the treatment of chronic non-specific low back pain: a randomized controlled study. Eur J Phys Rehabil Med. 2018;54(6):880–889. doi: 10.23736/S1973-9087.18.05005-0 [PubMed: 29687966] [CrossRef]
16.: Nejati P et al. Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: a randomized controlled trial. Pain Physician. 2019;22(1):53–61. [PubMed: 30700068]
17.: Rasmussen J et al. Manipulation does not add to the effect of extension exercises in chronic low-back pain (LBP). A randomized, controlled, double-blind study. Joint Bone Spine: Revue du Rhumatisme. 2008;75(6):708–713. doi: 10.1016/j.jbspin.2007.12.011 [PubMed: 19028434] [CrossRef]
18.: Schulz C et al. Spinal manipulative therapy and exercise for older adults with chronic low back pain: a randomized clinical trial. Chiropr Man Therap. 2019;27:21. doi: 10.1186/s12998-019-0243-1. [PMC free article: PMC6518769] [PubMed: 31114673] [CrossRef]
19.: Senna MK, Machaly SA. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome? Spine (Phila Pa). 2011;36(18):1427–1437. doi: 10.1097/BRS.0b013e3181f5dfe0 [PubMed: 21245790] [CrossRef]
20.: Tavares FAG, Chaves TC., Silva ED, Guerreiro GD, Gonçalves JF, Alves de Albuquerque AA. Immediate effects of joint mobilization compared to sham and control intervention for pain intensity and disability in chronic low back pain patients: randomized controlled clinical trial. Rev Dor. 2017;18(1):2–7.
21.: Thomas JS et al. Effect of spinal manipulative and mobilization therapies in young adults with mild to moderate chronic low back pain: a randomized clinical trial. JAMA Network Open. 2020;3(8):e2012589–e2012589. doi: 10.1001/jamanetworkopen.2020.12589 [PMC free article: PMC7407093] [PubMed: 32756930] [CrossRef]
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23.: Verma Y et al. Pain, range of motion and back strength in chronic mechanical low back pain before and after lumbar mobilisation. Int J Physioth. 2013;Res 3:48–57.
24.: Vismara L et al. Osteopathic manipulative treatment in obese patients with chronic low back pain: A pilot study. Man Ther. 2012;17:451–455. doi: 10.1016/j.math.2012.05.002 [PubMed: 22658268] [CrossRef]
25.: Waagen GN et al. Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med. 1986;2:63–67.
26.: Walker B.F et al. Short-term usual chiropractic care for spinal pain: a randomized controlled trial. Spine (Phila Pa). 2013;38(24):2071–2078. doi: 10.1097/01.brs.0000435032.73187.c7. [PubMed: 24026159] [CrossRef]
27.: Wang SQ et al. Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain. Revista da Associacao Medica Brasileira. 2019;65(6):886–892. [PubMed: 31340321]
28.: Xia T et al. Similar effects of thrust and nonthrust spinal manipulation found in adults with subacute and chronic low back pain: a controlled trial with adaptive allocation. Spine (Phila Pa). 2016;41(12):E702–E779. doi: 10.1097/BRS.0000000000001373 [PMC free article: PMC4902754] [PubMed: 26656041] [CrossRef]
29.: Zaworski K, Latosiewicz R. The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial. Eur J Phys Rehabil Med. 2021;57(2):280–287. doi: 10.23736/S1973-9087.21.06344-9. [PubMed: 33650840] [CrossRef]

B.4. Massage

1.: Ajimsha MS, Daniel B, Chithra S. Effectiveness of myofascial release in the management of chronic low back pain in nursing professionals. J Bodyw Mov Ther. 2014;18(2):273–281. doi: 10.1016/j.jbmt.2013.05.007. [PubMed: 24725797] [CrossRef]
2.: Arguisuelas MD, Lisón JF, Sánchez-Zuriaga D, Martínez-Hurtado I, Doménech-Fernández J. Effects of myofascial release in nonspecific chronic low back pain: a randomized clinical trial. Spine (Phila Pa). 2017;42(9):627–634. doi: 10.1097/BRS.0000000000001897 [PubMed: 28441294] [CrossRef]
3.: Arguisuelas MD, Lison JF, Domenech-Fernandez J, Martinez-Hurtado I, Coloma PS, Sanchez-Zuriaga D. Effects of myofascial release in erector spinae myoelectric activity and lumbar spine kinematics in non-specific chronic low back pain: randomized controlled trial. Clin Biomech (Bristol Avon). 2019;63:27–33. doi: 10.1016/j.clinbiomech.2019.02.009 [PubMed: 30784788] [CrossRef]
4.: Bellido-Fernández L, Jiménez-Rejano JJ, Chillón-Martínez R, Lorenzo-Muñoz A, Pinero-Pinto E, Rebollo-Salas M. Clinical relevance of massage therapy and abdominal hypopressive gymnastics on chronic nonspecific low back pain: A randomized controlled trial. Disabil Rehabil. 2022;44(16):4233–4240. doi: 10.1080/09638288.2021.1884903 [PubMed: 33587856] [CrossRef]
5.: Boff TA, Pasinato F, Ben ÂJ, Bosmans JE, van Tulder M, Carregaro RL. Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial. Physiotherapy. 2020;107:71–80. doi: 10.1016/j.physio.2019.11.002 [PubMed: 32026838] [CrossRef]
6.: Cherkin DC, Sherman KJ, Kahn J, Wellman R, Cook AJ, Johnson E, Deyo RA. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2011;155(1):1–9. doi: 10.7326/0003-4819-155-1-201107050-00002 [PMC free article: PMC3570565] [PubMed: 21727288] [CrossRef]
7.: Geisser ME, Wiggert EA, Haig AJ, Colwell MO. A randomized, controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain. Clin J Pain. 2005;21(6):463. doi: 10.1097/01.ajp.0000135237.89834.23 [PMC free article: PMC1360691] [PubMed: 16215330] [CrossRef]
8.: Khorsand A, Najafian Y, Morovatdar N, Yousefi M, Khazaei Z, Zarvandi M. The effectiveness of Persian massage in treating radicular chronic low back pain: a randomized controlled trial. J Biochem Technol. 2019;2: 45–55.
9.: Kim SK, Park H. The effect of auricular acupressure for chronic low back pain in elders: a randomized controlled study. Holist Nurs Pract. 2021;35(4):182–190. doi: 10.1097/HNP.0000000000000457 [PubMed: 34115736] [CrossRef]
10.: Kobayashi D, Shimbo T, Hayashi H, Takahashi O. Shiatsu for chronic lower back pain: randomized controlled study. Complement Ther Med. 2019;45:33–37. doi: 10.1016/j.ctim.2019.05.019 [PubMed: 31331579] [CrossRef]
11.: Ozsoy G, Ilcin N, Ozsoy I, Gurpinar B, Buyukturan O, Buyukturan B, Sas S. The effects of myofascial release technique combined with core stabilization exercise in elderly with non-specific low back pain: a randomized controlled, single-blind study. Clin Interv Aging. 2019;14:1729. doi: 10.2147/CIA.S223905 [PMC free article: PMC6790630] [PubMed: 31631992] [CrossRef]
12.: Poole H, Glenn S, Murphy P. A randomised controlled study of reflexology for the management of chronic low back pain. Eur J Pain. 2007;11(8): 878–887. doi: 10.1016/j.ejpain.2007.01.006 [PubMed: 17459741] [CrossRef]
13.: Quinn F, Hughes CM, Baxter GD. Reflexology in the management of low back pain: a pilot randomised controlled trial. Complement Ther Med. 2008;16(1):3–8. doi: 10.1016/j.ctim.2007.05.001 [PubMed: 18346622] [CrossRef]
14.: Shu J, Li D, Tao W, Chen S. Observation on the curative effect of massage manipulation combined with core strength training in patients with chronic nonspecific low back pain. Evid Based Complement Alternat Med. 2021; 2021:7534577. doi: 10.1155/2021/7534577. [PMC free article: PMC8556100] [PubMed: 34721644] [CrossRef]
15.: Zheng Z, Wang J, Gao Q, Hou J, Ma L, Jiang C, Chen G. Therapeutic evaluation of lumbar tender point deep massage for chronic non-specific low back pain. J Trad Chin Med. 2012;32(4):534–537. doi: 10.1016/s0254-6272(13)60066-7. [PubMed: 23427384] [CrossRef]

B.5. Traction

1.: Al Amer HS, Nassif AA, Eldesoky MT. The effect of lumbar traction in low back pain patients with sciatica. Biosci Res. 2019;16:3432–3442.
2.: Amjad F, Mohseni-Bandpei MA, Gilani SA, Ahmad A, Hanif A. Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord. 2022;23(1):255. doi:10.1186/s12891-022-05196-x [PMC free article: PMC8924735] [PubMed: 35296293] [CrossRef]
3.: Bilgilisoy Filiz M, Kiliç Z, Uçkun A, Çakir T, Koldaş Doğan Ş, Toraman NF. Mechanical traction for lumbar radicular pain: supine or prone? A randomized controlled trial. Am J Phys Med Rehabil. 2018;97(6):433–439. doi:10.1097/PHM.0000000000000892 [PubMed: 29309314] [CrossRef]
4.: Borman P, Keskin D, Bodur H. The efficacy of lumbar traction in the management of patients with low back pain. Rheumatol Int. 2003;23(2):82–86. doi:10.1007/s00296-002-0249-0 [PubMed: 12634941] [CrossRef]
5.: Diab AA, Moustafa IM. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial. J Manipulative Physiol Ther. 2012;35(4):246–253. doi: 10.1016/j.jmpt.2012.04.021 [PubMed: 22632584] [CrossRef]
6.: Gáti T, Czímer É, Cserháti G et al. A multicentre randomized controlled follow-up study of the effects of the underwater traction therapy in chronic low back pain. Int J Biometeorol. 2020;64(8):1393–1400. doi:10.1007/s00484-020-01919-8 [PMC free article: PMC7374437] [PubMed: 32361959] [CrossRef]
7.: Gulsen M, Atici E, Aytar A, Sahin FN. Effects of traction therapy in addition to conventional physiotherapy modalities on pain and functionality in patients with lumbar disc herniation: randomized controlled study. Acta Medica Mediterranea. 2018;34:2017. doi: 10.19193/0393-6384_2018_6_315 [CrossRef]
8.: Mohamed HE, Elsayed WH, Aneis YM. The combined effect of Maitland spinal mobilization with mechanical lumbar traction in patients with chronic nonspecific low back pain. Egypt J Appl Sci. 2020;35(12):136–150.
9.: Moustafa IM, Diab AA. Extension traction treatment for patients with discogenic lumbosacral radiculopathy: a randomized controlled trial. Clin Rehabil. 2013;27(1):51–62. doi:10.1177/0269215512446093 [PubMed: 22684211] [CrossRef]
10.: Schimmel JJ, de Kleuver M, Horsting PP, Spruit M, Jacobs WC, van Limbeek J. No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy. Eur Spine J. 2009;18(12):1843–1850. doi:10.1007/s00586-009-1044-3 [PMC free article: PMC2899427] [PubMed: 19484433] [CrossRef]

B.6. Therapeutic ultrasound

1.: Ansari NN, Ebadi S, Talebian S, Naghdi S, Mazaheri H, Olyaei G, Jalaie S. A randomized, single blind placebo controlled clinical trial on the effect of continuous ultrasound on low back pain. Electromyogr Clin Neurophysiol. 2006;46(6):329–336. [PubMed: 17147074]
2.: Durmuş D, Akyol Y, Cengiz K, Terzi T, Cantürk F. Effects of therapeutic ultrasound on pain, disability, walking performance, quality of life, and depression in patients with chronic low back pain: a randomized, placebo controlled trial. Arch Rheumatol. 2010;25(2):082–087. doi: 10.1007/s00296-009-1072-7. [PubMed: 19644691] [CrossRef]
3.: Durmus D, Durmaz Y, Canturk F. Effects of therapeutic ultrasound and electrical stimulation program on pain, trunk muscle strength, disability, walking performance, quality of life, and depression in patients with low back pain: a randomized-controlled trial. Rheumatol Int. 2010;30(7):901–910. doi: 10.1007/s00296-009-1072-7. [PubMed: 19644691] [CrossRef]
4.: Durmus D, Alayli G, Goktepe AS, Taskaynatan MA, Bilgici A, Kuru O. Is phonophoresis effective in the treatment of chronic low back pain? A single-blind randomized controlled trial. Rheumatol Int. 2013;33(7):1737–1744. doi: 10.1007/s00296-012-2634-7. [PubMed: 23283539] [CrossRef]
5.: Ebadi S, Ansari NN, Naghdi S, Jalaei S, Sadat M, Bagheri H, Vantulder MW, Henschke N, Fallah E. The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial. BMC Musculoskelet Disord. 2012;13:192. doi: 10.1186/1471-2474-13-192. [PMC free article: PMC3537701] [PubMed: 23031570] [CrossRef]
6.: Grubišić F, Grazio S, Jajić Z, Nemčić T. Therapeutic ultrasound in chronic low back pain treatment. Reumatizam. 2006;53(1):18–21. [PubMed: 17580544]
7.: Khan S, Shamsi S, Alyaemni AA, Abdelkader S. Effect of Ultrasound and Exercise Combined and Exercise alone in the Treatment of Chronic Back Pain. Indian J Physiother Occup Ther. 2013;7:202–206.
8.: Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013;11(2):122–129. doi: 10.1370/afm.1468. [PMC free article: PMC3601389] [PubMed: 23508598] [CrossRef]
9.: Rubira AP, Rubira MC, Rubira LD, Comachio J, Magalhães MO, Marques AP. Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial. Adv Rheumatol. 2019;59(1):57. doi: 10.1186/s42358-019-0099-z. [PubMed: 31847915] [CrossRef]
10.: Tantawy SA, Abdelbasset WK, Kamel DM, Alrawaili SM, Alsubaie SF. Laser photobiomodulation is more effective than ultrasound therapy in patients with chronic nonspecific low back pain: a comparative study. Lasers Med Sci. 2019;34(4):793–800. doi: 10.1007/s10103-018-2665-8. [PubMed: 30334124] [CrossRef]
11.: Tanveer F, Arslan SA, Darain H, Ahmad A, Gilani SA, Hanif A. Effects of low-intensity pulsed ultrasound on pain and functional disability in patients with early-stage lumbar spondylolysis: A randomized controlled trial. J Bodyw Move Ther. 2022;30:125–131. doi: 10.1016/j.jbmt.2022.02.025. [PubMed: 35500960] [CrossRef]
12.: Yurdakul OV, Beydoğan E, Yalçınkaya EY. Effects of physical therapy agents on pain, disability, quality of life, and lumbar paravertebral muscle stiffness via elastography in patients with chronic low back pain. Turk J Phys Med Rehabil. 2019;65(1):30–39. doi: 10.5606/tftrd.2019.2373. [PMC free article: PMC6648177] [PubMed: 31453542] [CrossRef]

B.7. Transcutaneous electrical nerve stimulation

1.: Shimoji K, Takahashi N, Nishio Y, Koyanagi M, Aida S. Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: a randomized, double-blind, sham-controlled study. Neuromodulation. 2007;10(1):42–51. doi: 10.1111/j.1525-1403.2007.00086.x. [PubMed: 22151811] [CrossRef]
2.: Alizadeh MH, Ahmadizad S. A Comparison of Exercise Therapy and Transcutaneous Electrical Nerve Stimulation for the Treatment of Chronic Low Back Pain. World Journal of Sport Sciences (WJSS). 2009;2(1):43–47.
3.: Bloodworth DM, Nguyen BN, Garver W et al. Comparison of stochastic vs. conventional transcutaneous electrical stimulation for pain modulation in patients with electromyographically documented radiculopathy. Am J Phys Med Rehabil. 2004;83(8):584–591. doi: 10.1097/01.phm.0000133439.28817.51. [PubMed: 15277959] [CrossRef]
4.: Cheing GL, Hui-Chan CW. Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain. Arch Phys Med Rehabil. 1999;80(3):305–312. doi: 10.1016/s0003-9993(99)90142-9. [PubMed: 10084439] [CrossRef]
5.: de Alencar Caldas VV, Maciel DG, Cerqueira MS et al. Effect of pain education, cryotherapy, and transcutaneous electrical nerve stimulation on the pain, functional capacity, and quality of life in patients with nonspecific chronic low back pain: A single-blind randomized controlled trial. Am J Phys Med Rehabil. 2021;100(3):243–249. doi: 10.1097/PHM.0000000000001552. [PubMed: 33595936] [CrossRef]
6.: Depaoli Lemos VJ, Selau RC, Blos C, Baptista Dohnert M, Boff Daitx R, de Almeida Brito V. Electroacupuncture and transcutaneous electrical nerve stimulation in chronic nonspecific low back pain: a blind randomized clinical trial. Muscles, Ligaments and Tendons Journal (MLTJ). 2021;11(4):719–727.
7.: Dias LV, Cordeiro MA, Schmidt de Sales R et al. Immediate analgesic effect of transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) on chronic low back pain: Randomised placebo-controlled trial. J Bodyw Mov Ther. 2021;27:181–190. doi: 10.1016/j.jbmt.2021.03.005. [PubMed: 34391232] [CrossRef]
8.: Elserty N, Kattabei O, Elhafez H. Effect of fixed versus adjusted transcutaneous electrical nerve stimulation amplitude on chronic mechanical low back pain. J Altern Complement Med. 2016;22(7):557–562. doi: 10.1089/acm.2015.0063. [PubMed: 27144300] [CrossRef]
9.: Ezema CI, Onyeso OK, Nna EO et al. Transcutaneous electrical nerve stimulation effects on pain-intensity and endogenous opioids levels among chronic low-back pain patients: A randomised controlled trial. J Back Musculoskelet Rehabil. 2022;35(5):1053–1064. doi: 10.3233/BMR-210146. [PubMed: 35253730] [CrossRef]
10.: Jamison RN, Wan L, Edwards RR, Mei A, Ross EL. Outcome of a high-frequency transcutaneous electrical nerve stimulator (hfTENS) device for low back pain: a randomized controlled trial. Pain Pract. 2019;19(5):466–475. doi: 10.1111/papr.12764 [PubMed: 30636101] [CrossRef]
11.: Kibar S, Konak HE, Ay S, Doganay Erdogan B, Evcik D. The effectiveness of combined transcutaneous electrical nerve stimulation and interferential current therapy on chronic low back pain: a randomized, double-blind, sham-controlled study. Turkiye Fiziksel Tip ve Rehabilitasyon Bilimleri Dergisi [Turk J Phys Med Rehabil] 2020;23(1):32–40.
12.: Kofotolis ND, Vlachopoulos SP, Kellis E. Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain. Clin Rehabil. 2008;22(2):99–111. doi: 10.1177/0269215507080122 [PubMed: 18212032] [CrossRef]
13.: Petrofsky J, Laymon M, Lee H. The effect of transcutaneous electrical nerve stimulation and low-level continuous heat on non-specific low back pain: a randomized controlled trial. Gazzetta Medica Italiana. 2020;179(6):419–427.
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16.: Yaksi E, Ketenci A, Baslo MB, Orhan EK. Does transcutaneous electrical nerve stimulation affect pain, neuropathic pain, and sympathetic skin responses in the treatment of chronic low back pain? A randomized, placebo-controlled study. Korean J Pain. 2021;34(2):217–228. doi: 10.3344/kjp.2021.34.2.217. [PMC free article: PMC8019954] [PubMed: 33785674] [CrossRef]

B.8. Assistive products: lumbar braces, belts and/or supports

1.: Annaswamy TM, Cunniff KJ, Kroll M, Yap L, Hasley M, Lin CK, Petrasic J. Lumbar bracing for chronic low back pain: a randomized controlled trial. Am J Phys Med Rehabil. 2021;100:742–749. doi: 10.1097/PHM.0000000000001743. [PubMed: 33789322] [CrossRef]
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3.: Azadinia F, Ebrahimi-Takamjani I, Kamyab M, Parnianpour M, Asgari M. A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain. Med J Islam Repub Iran. 2017;31:26. doi: 10.18869/mjiri.31.26 [PMC free article: PMC5804426] [PubMed: 29445655] [CrossRef]
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5.: Samani M, Shirazi ZR, Hadadi M, Sobhani S. A randomized controlled trial comparing the long-term use of soft lumbosacral orthoses at two different pressures in patients with chronic nonspecific low back pain. Clin Biomech. 2019;69:87–95. doi: 10.1016/j.clinbiomech.2019.07.003. [PubMed: 31302494] [CrossRef]
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C.1-4. Psychological therapies

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9.

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31.

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D.1. Systemic pharmacotherapies

1.: Buynak R, Shapiro DY, Okamoto A et al. Efficacy and safety of tapentadol extended release for the management of chronic low back pain: results of a prospective, randomized, double-blind, placebo- and active-controlled Phase III study. [Erratum appears in Expert Opin Pharmacother. 2010;11(16):2773.] Expert Opin Pharmacother. 2010;11(11):1787–1804. [PubMed: 20578811]
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3.: Chu LF, D’Arcy N, Brady C et al. Analgesic tolerance without demonstrable opioid-induced hyperalgesia: a double-blinded, randomized, placebo-controlled trial of sustained-release morphine for treatment of chronic nonradicular low-back pain. Pain. 2012;153(8):1583–1592. [PubMed: 22704854]
4.: Cloutier C, Taliano J, O’Mahony W et al. Controlled-release oxycodone and naloxone in the treatment of chronic low back pain: a placebo-controlled, randomized study. Pain Res Manag. 2013;18(2):75–82. [PMC free article: PMC3718056] [PubMed: 23662289]
5.: Gimbel J, Spierings EL, Katz N, Xiang Q, Tzanis E, Finn A. Efficacy and tolerability of buccal buprenorphine in opioid-experienced patients with moderate to severe chronic low back pain: results of a phase 3, enriched enrollment, randomized withdrawal study. [Erratum appears in Pain. 2017;158(2):366.] Pain. 2016;157(11):2517–2526. [PMC free article: PMC5065057] [PubMed: 27434505]
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7.: Gordon A, Rashiq S, Moulin DE et al. Buprenorphine transdermal system for opioid therapy in patients with chronic low back pain. Pain Res Manag. 2010;15(3):169–178. [PMC free article: PMC2912613] [PubMed: 20577660]
8.: Hale M, Khan A, Kutch M, Li S. Once-daily OROS hydromorphone ER compared with placebo in opioid-tolerant patients with chronic low back pain. Curr Med Res Opin. 2010;26(6):1505–1518. [PubMed: 20429852]
9.: Hale ME, Ahdieh H, Ma T, Rauck R. Efficacy and safety of OPANA ER (oxymorphone extended release) for relief of moderate to severe chronic low back pain in opioid-experienced patients: a 12-week, randomized, double-blind, placebo-controlled study. J Pain. 2007;8(2):175–184. [PubMed: 17145204]
10.: Hale ME, Zimmerman TR, Eyal E, Malamut R. Efficacy and safety of a hydrocodone extended-release tablet formulated with abuse-deterrence technology in patients with moderate-to-severe chronic low back pain. J Opioid Manag. 2015;11(6):507–518. [PubMed: 26728648]
11.: Katz N, Kopecky EA, O’Connor M, Brown RH, Fleming AB. A phase 3, multicenter, randomized, double-blind, placebo-controlled, safety, tolerability, and efficacy study of Xtampza ER in patients with moderate-to-severe chronic low back pain. Pain. 2015;156(12):2458–2467. [PubMed: 26262828]
12.: Katz N, Rauck R, Ahdieh H et al. A 12-week, randomized, placebo-controlled trial assessing the safety and efficacy of oxymorphone extended release for opioid-naive patients with chronic low back pain. Current Med Res Opin. 2007;23(1):117–128. [PubMed: 17257473]
13.: Kawamata M, Iseki M, Kawakami M et al. Efficacy and safety of controlled-release oxycodone for the management of moderate-to-severe chronic low back pain in Japan: results of an enriched enrollment randomized withdrawal study followed by an open-label extension study. J Pain Res. 2019;12:363–375. [PMC free article: PMC6342210] [PubMed: 30705602]
14.: Kopecky EA, Vaughn B, Lagasse S, O’Connor M. Tolerability, safety, and effectiveness of oxycodone DETERx in elderly patients >=65 years of age with chronic low back pain: a randomized controlled trial. Drugs Aging. 2017;34(8):603–613. [PMC free article: PMC5541102] [PubMed: 28600725]
15.: Lin JC, Chu LF, Stringer EA et al. One month of oral morphine decreases gray matter volume in the right amygdala of individuals with low back pain: confirmation of previously reported magnetic resonance imaging results. Pain Med. 2016;17(8):1497–1504. [PMC free article: PMC4921346] [PubMed: 26814280]
16.: Markman J, Meske DS, Kopecky EA, Vaughn B, O’Connor ML, Passik SD. Analgesic efficacy, safety, and tolerability of a long-acting abuse-deterrent formulation of oxycodone for moderate-to-severe chronic low back pain in subjects successfully switched from immediate-release oxycodone. J Pain Res. 2018;11:2051–2059. [PMC free article: PMC6163025] [PubMed: 30288095]
17.: Markman JD, Bolash RB, McAlindon TE et al. Tanezumab for chronic low back pain: a randomized, double-blind, placebo- and active-controlled, phase 3 study of efficacy and safety. Pain. 2020;161(9):2068–2078. [PMC free article: PMC7431140] [PubMed: 32453139]
18.: Miller K, Yarlas A, Wen W et al. Buprenorphine transdermal system and quality of life in opioid-experienced patients with chronic low back pain. Expert Opin Pharmacother. 2013;14(3):269–277. [PubMed: 23374027]
19.: Miller K, Yarlas A, Wen W et al. The impact of buprenorphine transdermal delivery system on activities of daily living among patients with chronic low back pain: an application of the international classification of functioning, disability and health. Clin J Pain. 2014;30(12):1015–1022. [PubMed: 24394747]
20.: Nalamachu S, Hale M, Khan A. Hydromorphone extended release for neuropathic and non-neuropathic/nociceptive chronic low back pain: a post hoc analysis of data from a randomized, multicenter, double-blind, placebo-controlled clinical trial. J Opioid Manag. 2014;10(5):311–322. [PubMed: 25350473]
21.: Rauck RL, Hale ME, Bass A et al. A randomized double-blind, placebo-controlled efficacy and safety study of ALO-02 (extended-release oxycodone surrounding sequestered naltrexone) for moderate-to-severe chronic low back pain treatment. Pain. 2015;156(9):1660–1669. [PubMed: 25993547]
22.: Rauck RL, Nalamachu S, Wild JE et al. Single-entity hydrocodone extended-release capsules in opioid-tolerant subjects with moderate-to-severe chronic low back pain: a randomized double-blind, placebo-controlled study. Pain Med. 2014;15(6):975–985. [PubMed: 24517082]
23.: Rauck RL, Potts J, Xiang Q, Tzanis E, Finn A. Efficacy and tolerability of buccal buprenorphine in opioid-naive patients with moderate to severe chronic low back pain. Postgrad Med. 2016;128(1):1–11. [PubMed: 26634956]
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25.: Steiner DJ, Sitar S, Wen W et al. Efficacy and safety of the seven-day buprenorphine transdermal system in opioid-naive patients with moderate to severe chronic low back pain: an enriched, randomized, double-blind, placebo-controlled study. Journal of pain and symptom management. J Pain Symptom Manage. 2011;42(6):903–917. [PubMed: 21945130]
26.: Tominaga Y, Koga H, Uchida N et al. Methodological issues in conducting pilot trials in chronic pain as randomized, double-blind, placebo-controlled studies. Drug Res (Stuttg). 2016;66(7):363–370. [PubMed: 27224908]
27.: Uberall MA, Mueller-Schwefe GH, Terhaag B. Efficacy and safety of flupirtine modified release for the management of moderate to severe chronic low back pain: results of SUPREME, a prospective randomized, double-blind, placebo- and active-controlled parallel-group phase IV study. Current Med Res Opin. 2012;28(10):1617–1634. [PubMed: 22970658]
28.: van de Donk T, van Cosburgh J, van Dasselaar T et al. Tapentadol treatment results in long-term pain relief in patients with chronic low back pain and associates with reduced segmental sensitization. Pain Rep. 2020;5(6):e877. [PMC free article: PMC7752667] [PubMed: 33364540]
29.: Vondrackova D, Leyendecker P, Meissner W et al. Analgesic efficacy and safety of oxycodone in combination with naloxone as prolonged-release tablets in patients with moderate to severe chronic pain. J Pain. 2008;9(12):1144–1154. [PubMed: 18708300]
30.: Vorsanger GJ, Xiang J, Gana TJ, Pascual ML, Fleming RR. Extended-release tramadol (tramadol ER) in the treatment of chronic low back pain. J Opioid Manag. 2008;4(2):87–97. [PubMed: 18557165]
31.: Webster LR, Butera PG, Moran LV, Wu N, Burns LH, Friedmann N. Oxytrex minimizes physical dependence while providing effective analgesia: a randomized controlled trial in low back pain. J Pain. 2006;7(12):937–946. [PubMed: 17157780]
32.: Weil AJ, Masters ET, Barsdorf AI et al. Patient-reported health-related quality of life, work productivity, and activity impairment during treatment with ALO-02 (extended-release oxycodone and sequestered naltrexone) for moderate-to-severe chronic low back pain. Health Qual Life Outcomes. 2017;15(1):202. [PMC free article: PMC5645978] [PubMed: 29041942]
33.: Wen W, Sitar S, Lynch SY, He E, Ripa SR. A multicenter, randomized, double-blind, placebo-controlled trial to assess the efficacy and safety of single-entity, once-daily hydrocodone tablets in patients with uncontrolled moderate to severe chronic low back pain. Expert Opin Pharmacother. 2015;16(11):1593–1606. [PubMed: 26111544]
34.: Yarlas A, Miller K, Wen W et al. A randomized, placebo-controlled study of the impact of the 7-day buprenorphine transdermal system on health-related quality of life in opioid-naive patients with moderate-to-severe chronic low back pain. J Pain. 2013;14(1):14–23. [PubMed: 23200931]
35.: Yarlas A, Miller K, Wen W et al. A subgroup analysis found no diminished response to buprenorphine transdermal system treatment for chronic low back pain patients classified with depression. Pain Pract. 2016;16(4):473–485. [PubMed: 25865734]
36.: Yarlas A, Miller K, Wen W et al. Buprenorphine transdermal system compared with placebo reduces interference in functioning for chronic low back pain. Postgrad Med. 2015;127(1):38–45. [PubMed: 25526229]
37.: Khoromi S, Cui L, Nackers L, Max MB. Morphine, nortriptyline and their combination vs. placebo in patients with chronic lumbar root pain. Pain. 2007;130(1–2):66–75. [PMC free article: PMC1974876] [PubMed: 17182183]
38.: Ionescu AM, Manolescu BN, Popa R et al. Effects of tramadol treatment on aerobic exercise capacity in subjects with chronic non-specific low back pain. Palestrica of the third millennium: Civilization and Sport. 2015;16(3):214–218.
39.: Birbara CA, Puopolo AD, Munoz DR et al. Treatment of chronic low back pain with etoricoxib, a new cyclo-oxygenase-2 selective inhibitor: improvement in pain and disability—a randomized, placebo-controlled, 3-month trial. J Pain. 2003;4(6):307–315. [PubMed: 14622687]
40.: Katz N, Borenstein DG, Birbara C et al. Efficacy and safety of tanezumab in the treatment of chronic low back pain. Pain. 2011;152(10):2248–2258. [PubMed: 21696889]
41.: Kivitz AJ, Gimbel JS, Bramson C et al. Efficacy and safety of tanezumab versus naproxen in the treatment of chronic low back pain. Pain. 2013;154(7):1009–1021. [PubMed: 23628600]
42.: Pallay RM, Seger W, Adler JL et al. Etoricoxib reduced pain and disability and improved quality of life in patients with chronic low back pain: a 3 month, randomized, controlled trial. Scand J Rheumatol. 2004;33(4):257–266. [PubMed: 15370723]
43.: Berry H, Bloom B, Hamilton EB, Swinson DR. Naproxen sodium, diflunisal, and placebo in the treatment of chronic back pain. Ann Rheum Dis. 1982;41(2):129–132. [PMC free article: PMC1000895] [PubMed: 6462116]
44.: Ghosh P, Taylor TKF, Meachin AD. A double-blind crossover trial of indomethacin, flurbiprofen and placebo in the management of lumbar spondylosis. Curr Ther Res Clin Exp. 1981;30(3):318–326.
45.: Gurrell R, Dua P, Feng G et al. A randomised, placebo-controlled clinical trial with the α2/3/5 subunit selective GABAA positive allosteric modulator PF-06372865 in patients with chronic low back pain. Pain. 2018;159(9):1742–1751 [PubMed: 29787472]
46.: Konno S, Oda N, Ochiai T, Alev L. Randomized, double-blind, placebo-controlled phase iii trial of duloxetine monotherapy in Japanese patients with chronic low back pain. Spine (Phila Pa). 2016;41(22):1709–1717. [PMC free article: PMC5113250] [PubMed: 27831985]
47.: Skljarevski V, Desaiah D, Liu-Seifert H et al. efficacy and safety of duloxetine in patients with chronic low back pain. Spine. 2010;35(13):E578–585. [PubMed: 20461028]
48.: Skljarevski V, Ossanna M, Liu-Seifert H et al. A double-blind, randomized trial of duloxetine versus placebo in the management of chronic low back pain. Eur J Neurol. 2009;16(9):1041–1048. [PubMed: 19469829]
49.: Skljarevski V, Zhang S, Desaiah D et al. Duloxetine versus placebo in patients with chronic low back pain: a 12-week, fixed-dose, randomized, double-blind trial. J Pain. 2010;11(12):1282–1290. [PubMed: 20472510]
50.: Atkinson JH, Slater MA, Capparelli EV et al. Efficacy of noradrenergic and serotonergic antidepressants in chronic back pain: a preliminary concentration-controlled trial. J Clin Psychopharmacol. 2007;27(2):135–142. [PubMed: 17414235]
51.: Gould HM, Atkinson JH, Chircop-Rollick T et al. A randomized placebo-controlled trial of desipramine, cognitive behavioral therapy, and active placebo therapy for low back pain. Pain. 2020;161(6):1341–1349. [PubMed: 32068667]
52.: Urquhart DM, Wluka AE, van Tulder M et al. Efficacy of low-dose amitriptyline for chronic low back pain: a randomized clinical trial. JAMA Intern Med. 2018;178(11):1474–1481. [PMC free article: PMC6248203] [PubMed: 30285054]
53.: Atkinson JH, Slater MA, Wahlgren DR et al. Effects of noradrenergic and serotonergic antidepressants on chronic low back pain intensity. Pain. 1999;83(2):137–145. [PubMed: 10534584]
54.: Dickens C, Jayson M, Sutton C, Creed F. The relationship between pain and depression in a trial using paroxetine in sufferers of chronic low back pain. Psychosomatics. 2000;41(6):490–499. [PubMed: 11110112]
55.: Johnson K, Chatterjee N, Noor N, Crowell A, McCue R, Mackey S. Effects of duloxetine and placebo in patients with chronic low back pain. J Pain. 2011;12(4):49.
56.: Schnitzer TJ et al. Effect of Milnacipran in Chronic Neuropathic Low Back Pain. ClinicalTrials.gov Identifier NCT01225068, 2012. (https://classic.clinicaltrials.gov/ct2/show/NCT01225068, accessed 12 July 2023).
57.: Schukro RP, Oehmke MJ, Geroldinger A, Heinze G, Kress HG, Pramhas S. Efficacy of duloxetine in chronic low back pain with a neuropathic component: a randomized, double-blind, placebo-controlled crossover trial. Anesthesiology. 2016;124(1):150–158. [PubMed: 26517858]
58.: Atkinson HJ, Slater MA, Williams RA et al. A placebo-controlled randomized clinical trial of nortriptyline for chronic low back pain. Pain. 1998;76(3):287–296. [PubMed: 9718247]
59.: Pheasant H, Bursk A, Goldfarb J, Azen SP, Weiss JN, Borelli L. Amitriptyline and chronic low-back pain. A randomized double-blind crossover study. Spine (Phila Pa). 1983;8(5):552–557. [PubMed: 6228015]
60.: Alcoff J, Jones E, Rust P, Newman R. Controlled trial of imipramine for chronic low back pain. J Fam Pract. 1982;14(5):841–846. [PubMed: 6210751]
61.: Loldrup D, Langemark M, Hansen HJ, Olesen J, Bech P. Clomipramine and mianserin in chronic idiopathic pain syndrome. A placebo-controlled study. Psychopharmacology (Berl). 1989;99(1):1–7. [PubMed: 2506594]
62.: Trèves R, Montaine de la Roque P, Dumond JJ, Bertin P, Arnaud M, Desproges-Gotteron R. [Prospective study of the analgesic action of clomipramine versus placebo in refractory lumbosciatica] (article in French). Rev Rhum Mal Osteoartic. 1991;58(7):549–552. [PubMed: 1833813]
63.: Atkinson JH, Slater MA, Capparelli EV et al. A randomized controlled trial of gabapentin for chronic low back pain with and without a radiating component. Pain. 2016;157(7):1499–1507. [PMC free article: PMC5001843] [PubMed: 26963844]
64.: McCleane GJ. Gabapentin reduces chronic benign nociceptive pain: a double-blind, placebo-controlled cross-over study. The Pain Clinic. 2000;12(2):81–85.
65.: McCleane GJ. Does gabapentin have an analgesic effect on background, movement and referred pain? A randomised, double-blind, placebo controlled study. The Pain Clinic. 2001;13(2):103–107.
66.: Muehlbacher M, Nickel MK, Kettler C et al. Topiramate in treatment of patients with chronic low back pain: a randomized, double-blind, placebo-controlled study. Clin J Pain. 2006;22(6):526–531. [PubMed: 16788338]
67.: Cogné M, Petit H, Creuzé A, Liguoro D, de Seze M. Are paraspinous intramuscular injections of botulinum toxin a (BoNT-A) efficient in the treatment of chronic low-back pain? A randomised, double-blinded crossover trial. BMC Musculoskelet Disord. 2017;18(1):454. [PMC free article: PMC5688690] [PubMed: 29141611]
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D.2. Cannabis-related pharmaceutical preparations for therapeutic use

No trials identified

D.3. Injectable local anaesthetics

1.: Collée G, Dijkmans BA, Vandenbroucke JP, Cats A. Iliac crest pain syndrome in low back pain. A double blind, randomized study of local injection therapy. J Rheumatol. 1991;18(7):1060–1063. [PubMed: 1833543]
2.: Giladi H, Lamb L, Etheridge P, Tan Z, Shir Y. A prospective, randomized, double-blind clinical trial comparing bupivacaine versus saline for lumbar trigger point injection therapy. Pain Res Manag. 2014;19:e74.
3.: Imamura M, Imamura ST, Targino RA, Morales-Quezada L, Onoda Tomikawa LC, Onoda Tomikawa LG, Alfieri FM, Filippo TR, da Rocha ID, Neto RB, Fregni F, Battistella LR. paraspinous lidocaine injection for chronic nonspecific low back pain: a randomized controlled clinical trial. J Pain. 2016;17(5):569–575. doi: 10.1016/j.jpain.2016.01.469. [PMC free article: PMC4910884] [PubMed: 26828801] [CrossRef]

D.4. Herbal medicines

1.: Chrubasik S, Zimpfer CH, Schütt U, Ziegler R. Effectiveness of Harpagophytum procumbens in the treatment of acute low back pain. Phytomedicine. 1996;3(1):1–10. doi: 10.1016/S0944-7113(96)80003-1. [PubMed: 23194854] [CrossRef]
2.: Chrubasik S, Junck H, Breitschwerdt H, Conradt C, Zappe H. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double-blind study. Eur J Anaesthesiol. 1999;16(2):118–129. doi: 10.1046/j.1365-2346.1999.00435.x. [PubMed: 10101629] [CrossRef]
3.: Chrubasik S, Eisenberg E, Balan E, Weinberger T, Luzzati R, Conradt C. Treatment of low back pain exacerbations with willow bark extract: A randomized double-blind study. Am J Med. 2000;109(1):9–14. doi: 10.1016/s0002-9343(00)00442-3. [PubMed: 10936472] [CrossRef]
4.: Chrubasik S, Weiser T, Beime B. Effectiveness and safety of topical capsaicin cream in the treatment of chronic soft tissue pain. Phytother Res. 2010;24(12):1877–1885. doi: 10.1002/ptr.3335 [PubMed: 21104944] [CrossRef]
5.: Da Silva AG, de Sousa CPG, Koehler J, Fontana J, Christo AG, Guedes-Bruni RR. Evaluation of an extract of Brazilian Arnica (Solidago chilensis Meyen, Asteraceae) in treating lumbago. Phytother Res. 2010;24(2):283–287. doi: 10.1002/ptr.2934. [PubMed: 19827029] [CrossRef]
6.: Frerick H, Keitel W, Kuhn U, Schmidt S, Bredehorst A, Kuhlmann M. Topical treatment of chronic low back pain with a capsicum plaster. Pain. 2003;106(1–2):59–64. doi: 10.1016/s0304-3959(03)00278-1. [PubMed: 14581111] [CrossRef]
7.: Hashemi M, Ghasemi M, Taheri M, Dadkhah P. Comparing the effect of ginger and vitamin D3 supplement on inflammatory factors and pain severity in adults with low back pain. Electron J Gen Med. 2018;16(2):1–6. doi: 10.29333/ejgm/94055 [CrossRef]
8.: Keitel W, Frerick H, Kuhn U, Schmidt U, Kuhlmann M, Bredehoorst A. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung. 2001;51(11):896–903. doi: 10.1055/s-0031-1300134. [PubMed: 11765591] [CrossRef]
9.: Krivoy N, Pavlotzky E, Chrubasik S, Eisenberg E, Brook G. Effects of salicis cortex extract on human platelet aggregation. Planta Medica. 2001;67(3):209–212. doi: 10.1055/s-2001-12000. [PubMed: 11345689] [CrossRef]
10.: Laosee O, Sritoomma N, Wamontree P, Rattanapan C, Sitthi-Amorn C. The effectiveness of traditional Thai massage versus massage with herbal compress among elderly patients with low back pain: A randomised controlled trial. Complement Ther Med. 2020;48:102253. doi: 10.1016/j.ctim.2019.102253. [PubMed: 31987237] [CrossRef]
11.: Rasoulinezhad S, Yekta NH, Fallah E. Promising pain-relieving activity of an ancient Persian remedy (mixture of white Lily in sesame oil) in patients with chronic low back pain. J Family Med Prim Care. 2019;8(2):634. doi: 10.4103/jfmpc.jfmpc_423_18. [PMC free article: PMC6436283] [PubMed: 30984686] [CrossRef]
12.: Uğurlu M, Aksekili MA, Alkan BM, Kara H, Çağlar C. Effects of Artcure Diffusional Patch application on pain and functional status in lumbar disc herniation patients: a prospective randomized controlled study. Turk J Med Sci. 2017;47(3):874–882. doi: 10.3906/sag-1603-98. [PubMed: 28618737] [CrossRef]

E.1. Weight management

1.: Irandoust K, Taheri M, Shavikloo J. the effect of water-based aerobic training on the dynamic balance and walking speed of obese elderly men with low back pain. Sleep and Hypnosis. 2018;20(3):233–240. doi:10.5350/Sleep.Hypn.2017.19.0155 [CrossRef]
2.: Kwon YJ, Lee H, Nam CM, Chang HJ, Yoon YR, Lee HS, Lee JW. Effects of orlistat/phentermine versus phentermine on vascular endothelial cell function in obese and overweight adults: a randomized, double-blinded, placebo-controlled trial. Diabetes Metab Syndr Obes. 2021;14:941–950. doi: 10.2147/DMSO.S300342. [PMC free article: PMC7936679] [PubMed: 33688228] [CrossRef]
3.: Mendonça CR, Noll M, Cardoso CKS, Santos ASAC, Rodrigues APDS, Silveira EA. Reduction in pain and pain intensity with nonpharmacological treatment in severely obese patients: a randomized clinical trial. Int J Environ Res Public Health. 2021;18(21):11112. doi: 10.3390/ijerph182111112. [PMC free article: PMC8582684] [PubMed: 34769633] [CrossRef]
4.: Muehlbacher M, Nickel MK, Kettler C, Tritt K, Lahmann C, Leiberich PK, Nickel C, Krawczyk J, Mitterlehner FO, Rother WK, Loew TH, Kaplan P. Topiramate in treatment of patients with chronic low back pain: a randomized, double-blind, placebo-controlled study. Clin J Pain. 2006;22(6):526–531. doi: 10.1097/.ajp.0000192516.58578.a4. [PubMed: 16788338] [CrossRef]
5.: Safari MB, Nozad A, Ghaffari F, Ghavamzadeh S, Alijaniha F, Naseri M. Efficacy of a short-term low-calorie diet in overweight and obese patients with chronic sciatica: a randomized controlled trial. J Altern Complement Med. 2020;26(6):508–514. doi: 10.1089/acm.2019.0360. [PubMed: 32434372] [CrossRef]
6.: Torlak MS, Bagcaci S, Akpinar E, Okutan O, Nazli MS, Kuccukturk S. The effect of intermittent diet and/or physical therapy in patients with chronic low back pain: A single-blinded randomized controlled trial. Explore (NY). 2022;18(1):76–81. doi: 10.1016/j.explore.2020.08.003. [PubMed: 32859542] [CrossRef]
7.: Williams A, Wiggers J, O’Brien KM, Wolfenden L, Yoong SL, Hodder RK, Lee H, Robson EK, McAuley JH, Haskins R, Kamper SJ, Rissel C, Williams CM. Effectiveness of a healthy lifestyle intervention for chronic low back pain: a randomised controlled trial. Pain. 2018;159(6):1137–1146. doi: 10.1097/j.pain.0000000000001198. [PubMed: 29528963] [CrossRef]

E.2. Multicomponent biopsychosocial care

1.: Abbasi M, Dehghani M, Keefe FJ, Jafari H, Behtash H, Shams J. Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: A 1-year randomized controlled trial. Eur J Pain. 2012;16(7):1033–43. doi: 10.1002/j.1532-2149.2011.00097.x [PubMed: 22337646] [CrossRef]
2.: Basler H, Jakle C, Kroner-Herwig B. Incorporation of cognitive behavioral treatment into the medical care of chronic low back patients: A controlled randomized study in German pain treatment centers. Patient Educ Couns. 1997;31:113–124. doi: 10.1016/s0738-3991(97)00996-8. [PubMed: 9216352] [CrossRef]
3.: Bendix AF, Bendix T, Vaegter K, Lund C, Frolund L, Holm L. Multidisciplinary intensive treatment for chronic low back pain: a randomized, prospective study. Cleve Clin J Med. 1996;63:62–69. doi: 10.3949/ccjm.63.1.62. [PubMed: 8590519] [CrossRef]
4.: Bendix AE, Bendix T, Haestrup C, Busch E. A prospective, randomized 5-year follow-up study of functional restoration in chronic low back pain patients. Eur Spine J. 1998;7(2):111–119. doi: 10.1007/s005860050040. [PMC free article: PMC3611221] [PubMed: 9629934] [CrossRef]
5.: Lambeek LC, Bosmans JE, van Royen BJ, van Tulder MW, van Mechelen W, Anema JR. Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial. BMJ. 2010;341:6414. doi: 10.1136/bmj.c6414. [PMC free article: PMC2995018] [PubMed: 21118874] [CrossRef]
6.: Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340(7749):750. doi: 10.1136/bmj.c1035. [PMC free article: PMC2840223] [PubMed: 20234040] [CrossRef]
7.: Linton SJ, Boersma K, Jansson M, Svärd L, Botvalde M. The effects of cognitive-behavioral and physical therapy preventive interventions on pain-related sick leave: a randomized controlled trial. Clin J Pain. 2005;21(2):109–119. doi: 10.1097/00002508-200503000-00001. [PubMed: 15722803] [CrossRef]
8.: Lukinmaa A. [Low back pain as a biopsychosocial problem. A controlled clinical trial and a cost-effectiveness analysis](article in Finnish). Kansanelakelaitoksen Julkaisuja. 1989;ML:1–90.
9.: Mitchell RI, Carmen GM. The functional restoration approach to the treatment of chronic pain in patients with soft tissue and back injuries. Spine. 1994;19:633–642. doi: 10.1097/00007632-199403001-00001 [PubMed: 8009327] [CrossRef]
10.: Moix J, Canellas M, Osorio C, Bel X, Girvent F, Martos A. [Efficacy of an interdisciplinary educational program in patients with chronic back pain] (article in Spanish). Dolor. 2003;18(3):149–157.
11.: Morone G, Paolucci T, Alcuri MR, Vulpiani MC, Matano A, Bureca I. Quality of life improved by multidisciplinary back school program in patients with chronic non-specific low back pain: a single blind randomized controlled trial. Eur J Phys Rehabil Med. 2011;47(4):533–541. [PubMed: 21508915]
12.: Morone G, Iosa M, Paolucci T, Fusco A, Alcuri R, Spadini E. Efficacy of perceptive rehabilitation in the treatment of chronic nonspecific low back pain through a new tool: a randomized clinical study. Clin Rehabil. 2012;26(4):339–350. doi: 10.1177/0269215511414443. [PubMed: 21965520] [CrossRef]
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14.: Strand LI, Ljunggren AE, Haldorsen EMH, Espehaug B. The impact of physical function and pain on work status at 1-year follow-up in patients with back pain. Spine (Phila Pa). 2001;26(7):800–808. doi: 10.1097/00007632-200104010-00022. [PubMed: 11295903] [CrossRef]
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WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings [Internet]. Geneva: World Health Organization; 2023. Web Annex E, List of trials by intervention.
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Structured and standardized education and/or advice
Structured exercise therapies or programmes
Needling therapies
Spinal manipulative therapy
Massage
Traction
Therapeutic ultrasound
Transcutaneous electrical nerve stimulation
Assistive products: lumbar braces, belts and/or supports
Psychological therapies
Systemic pharmacotherapies
Cannabis-related pharmaceutical preparations for therapeutic use
Injectable local anaesthetics
Herbal medicines
Weight management
Multicomponent biopsychosocial care

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