Articles: low-back-pain.
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Review Randomized Controlled Trial Comparative Study Clinical Trial
The Cochrane review of bed rest for acute low back pain and sciatica.
A systematic review within the Cochrane Collaboration Back Review Group. ⋯ Bed rest compared with advice to stay active at best has no effect, and at worst may have slightly harmful effects on LBP. There is not an important difference in the effects of bed rest compared with exercises in the treatment of acute low back pain, or 7 days compared with 2-3 days of bed rest in patients with low back pain of different durations with and without radiating pain.
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Clinical Trial Controlled Clinical Trial
Training primary care physicians to give limited manual therapy for low back pain: patient outcomes.
Randomized controlled study of standard manual therapy given by 31 generalist physicians to 295 patients, in primary care practice. ⋯ Limited training in manual therapy techniques offers very modest benefit compared with high-quality (enhanced) care for acute low back pain. Outcomes may have been modified by failure of some participant physicians to undertake the required sequence of maneuvers. Intensity of manual therapy may be a factor in improving patient outcomes and needs further study.
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A systematic review of randomized controlled trials was performed. ⋯ The evidence summarized in this systematic review does not indicate that specific exercises are effective for the treatment of acute low back pain. Exercises may be helpful for patients with chronic low back pain to increase return to normal daily activities and work.
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This study evaluated physicians' self-reported management of acute low back problems in adults and adherence with published guidelines. ⋯ The management of patients with acute low back problems by primary care physicians differs significantly from Agency for Health Care Policy and Research guideline recommendations in several key areas that include awareness of red flags, use of medication, use of radiographic studies, the need for patient education, and the use of physical modalities. Future research should focus on the impact of guideline compliance on patient outcomes and cost-effectiveness. Arch Fam Med. 2000;9:1015-1021