Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Mar 27;3(3):CD014691.
doi: 10.1002/14651858.CD014691.pub2.

Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews

Rodrigo Rn Rizzo  1   2 , Aidan G Cashin  1   2 , Benedict M Wand  3 , Michael C Ferraro  1   2 , Saurab Sharma  1   2   4   5 , Hopin Lee  6 , Edel O'Hagan  2   7 , Christopher G Maher  8   9 , Andrea D Furlan  10 , Maurits W van Tulder  11 , James H McAuley  1   2
Affiliations
Meta-Analysis

Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews

Rodrigo Rn Rizzo et al. Cochrane Database Syst Rev. .

Abstract

Background: Low back pain (LBP) is a significant public health issue due to its high prevalence and associated disability burden. Clinical practice guidelines recommend non-pharmacological/non-surgical interventions for managing pain and function in people with LBP.

Objectives: To provide accessible, high-quality evidence on the effects of non-pharmacological and non-surgical interventions for people with LBP and to highlight areas of remaining uncertainty and gaps in the evidence regarding the effects of these interventions for people with LBP.

Methods: We searched the Cochrane Database of Systematic Reviews from inception to 15 April 2023, to identify Cochrane reviews of randomised controlled trials testing the effect of non-pharmacological/non-surgical interventions, unrestricted by language. Major outcomes were pain intensity, function and safety. Two authors independently assessed eligibility, extracted data and assessed the quality of the reviews using AMSTAR 2 (A MeaSurement Tool to Assess Systematic Reviews) and the certainty of the evidence using GRADE. The primary comparison was placebo/sham.

Main results: We included 31 Cochrane reviews of 644 trials that randomised 97,183 adults with LBP. We have high confidence in the findings of 19 reviews, moderate confidence in the findings of two reviews, and low confidence in the findings of 10 reviews. We present results for non-pharmacological/non-surgical interventions compared to placebo/sham or no treatment/usual care at short-term (≤ three months) follow-up. Placebo/sham comparisons Acute/subacute LBP Compared to placebo, there is probably no difference in function (at one-week follow-up) for spinal manipulation (standardised mean difference (SMD) -0.08, 95% confidence interval (CI) -0.37 to 0.21; 2 trials, 205 participants; moderate-certainty evidence). Data for safety were reported only for heated back wrap. Compared to placebo, heated back wrap may result in skin pinkness (6/128 participants versus 1/130; 2 trials; low-certainty evidence). Chronic LBP Compared to sham acupuncture, acupuncture probably provides a small improvement in function (SMD -0.38, 95% CI -0.69 to -0.07; 3 trials, 957 participants; moderate-certainty evidence). Compared to sham traction, there is probably no difference in pain intensity for traction (0 to 100 scale, mean difference (MD) -4, 95% CI -17.7 to 9.7; 1 trial, 60 participants; moderate-certainty evidence). Data for safety were reported only for acupuncture. There may be no difference between acupuncture and sham acupuncture for safety outcomes (risk ratio (RR) 0.68, 95% CI 0.42 to 1.10; I2 = 0%; 4 trials, 465 participants; low-certainty evidence). No treatment/usual care comparisons Acute/subacute LBP Compared to advice to rest, advice to stay active probably provides a small reduction in pain intensity (SMD -0.22, 95% CI -0.02 to -0.41; 2 trials, 401 participants; moderate-certainty evidence). Compared to advice to rest, advice to stay active probably provides a small improvement in function (SMD -0.29, 95% CI -0.09 to -0.49; 2 trials, 400 participants; moderate-certainty evidence). Data for safety were reported only for massage. There may be no difference between massage and usual care for safety (risk difference 0, 95% CI -0.07 to 0.07; 1 trial, 51 participants; low-certainty evidence). Chronic LBP Compared to no treatment, acupuncture probably provides a medium reduction in pain intensity (0 to 100 scale, mean difference (MD) -10.1, 95% CI -16.8 to -3.4; 3 trials, 144 participants; moderate-certainty evidence), and a small improvement in function (SMD -0.39, 95% CI -0.72 to -0.06; 3 trials, 144 participants; moderate-certainty evidence). Compared to usual care, acupuncture probably provides a small improvement in function (MD 9.4, 95% CI 6.15 to 12.65; 1 trial, 734 participants; moderate-certainty evidence). Compared to no treatment/usual care, exercise therapies probably provide a small to medium reduction in pain intensity (0 to 100 scale, MD -15.2, 95% CI -18.3 to -12.2; 35 trials, 2746 participants; moderate-certainty evidence), and probably provide a small improvement in function (0 to 100 scale, MD -6.8, 95% CI -8.3 to -5.3; 38 trials, 2942 participants; moderate-certainty evidence). Compared to usual care, multidisciplinary therapies probably provide a medium reduction in pain intensity (SMD -0.55, 95% CI -0.83 to -0.28; 9 trials, 879 participants; moderate-certainty evidence), and probably provide a small improvement in function (SMD -0.41, 95% CI -0.62 to -0.19; 9 trials, 939 participants; moderate-certainty evidence). Compared to no treatment, psychological therapies using operant approaches probably provide a small reduction in pain intensity (SMD -0.43, 95% CI -0.75 to -0.11; 3 trials, 153 participants; moderate-certainty evidence). Compared to usual care, psychological therapies (including progressive muscle relaxation and behavioural approaches) probably provide a small reduction in pain intensity (0 to 100 scale, MD -5.18, 95% CI -9.79 to -0.57; 2 trials, 330 participants; moderate-certainty evidence), but there is probably no difference in function (SMD -0.2, 95% CI -0.41 to 0.02; 2 trials, 330 participants; moderate-certainty evidence). It is uncertain whether there is a difference between non-pharmacological/non-surgical interventions and no treatment/usual care for safety (very low-certainty evidence).

Authors' conclusions: Spinal manipulation probably makes no difference to function compared to placebo for people with acute/subacute LBP. Acupuncture probably improves function slightly for people with chronic LBP, compared to sham acupuncture. There is probably no difference between traction and sham traction for pain intensity in people with chronic LBP. Compared to advice to rest, advice to stay active probably reduces pain intensity slightly and improves function slightly for people with acute LBP. Acupuncture probably reduces pain intensity, and improves function slightly for people with chronic LBP, compared to no treatment. Acupuncture probably improves function slightly for people with chronic LBP, compared to usual care. Exercise therapies probably reduce pain intensity, and improve function slightly for people with chronic LBP, compared to no treatment/usual care. Multidisciplinary therapies probably reduce pain intensity, and improve function slightly for people with chronic LBP, compared to usual care. Compared to usual care, psychological therapies probably reduce pain intensity slightly, but probably make no difference to function for people with chronic LBP.

PubMed Disclaimer

Conflict of interest statement

CGM has received competitive grants from government agencies and industry to support his research. As an invited speaker at conferences, he has had his expenses covered and also received small gifts, such as a box of chocolates or a bottle of wine. He has received honoraria for marking theses, reviewing grants and preparing talks. CGM has published multiple papers on low back pain, some of which were referenced in the overview, and is on the Editorial Board of the Cochrane Back and Neck Review group. Mitigation of conflict of interest: CGM was not involved in editorial decisions on this review.

ADF was co‐ordinating Editor of the Cochrane Back and Neck Review group until December 2020. Mitigation of conflict of interest: ADF was not involved in decisions to approve or reject this review. She has published multiple papers on low back pain, some of which were referenced in the review. ADF has a monetised YouTube channel for people with chronic pain, including low back pain, and there are videos about non‐pharmacological and non‐surgical interventions. The institutions where ADF works have received various grants from external organisations, including government and public institutions in Ontario, Canada and the UK.

MWvT is on the Editorial Board of the Cochrane Back and Neck Review group. MWvT was co‐ordinating Editor until September 2017. Mitigation of conflict of interest: MWvT was not involved in editorial decisions on this review. MWvT has published multiple papers on low back pain, some of which were referenced in the review. MWvT has no additional competing interest; all research funding comes from non‐profit governmental funding agencies, and all funding (including travel and stay expenses) was paid to VU University.

HL has consulted for Cancer Council Australia and has received funding from the Australian Health and Medical Research Council (grant no. APP1126767), and Center for Effective Global Action (CEGA) & Berkeley Initiative for Transparency in the Social Sciences (BITSS).

BMW has received speaker fees for talks on non‐pharmacological care for people with low back pain.

SS is supported by the John J. Bonica Postdoctoral Fellowship from the International Association for the Study of Pain.

RRNR, AGC, MCF, EOH, and JHM have no known conflicts of interest.

This research project did not receive any specific grant from funding agencies in the public, commercial or not‐for‐profit sectors.

Update of

  • doi: 10.1002/14651858.CD014691

Similar articles

See all similar articles

Cited by

References

References to included reviews

Almeida 2023
    1. Almeida MO, Narciso Garcia A, Menezes Costa LC, Van Tulder MW, Lin CC, Machado LA. The McKenzie method for (sub)acute non-specific low back pain. Cochrane Database of Systematic Reviews 2023, Issue 4. Art. No: CD009711. [DOI: 10.1002/14651858.CD009711.pub2] - DOI - PMC - PubMed
Dahm 2010
    1. Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No: CD007612. [DOI: 10.1002/14651858.CD007612.pub2] - DOI - PMC - PubMed
Ebadi 2020
    1. Ebadi S, Henschke N, Forogh B, Nakhostin Ansari N, Tulder MW, Babaei-Ghazani A, et al. Therapeutic ultrasound for chronic low back pain. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No: CD009169. [DOI: 10.1002/14651858.CD009169.pub3] - DOI - PMC - PubMed
Engers 2008
    1. Engers A, Jellema P, Wensing M, Van der Windt DA, Grol R, Van Tulder MW. Individual patient education for low back pain. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No: CD004057. [DOI: 10.1002/14651858.CD004057.pub3] - DOI - PMC - PubMed
Franke 2015
    1. Franke H, Fryer G, Ostelo RW, Kamper SJ. Muscle energy technique for non-specific low-back pain. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No: CD009852. [DOI: 10.1002/14651858.CD009852.pub2] - DOI - PMC - PubMed
French 2006
    1. French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. Superficial heat or cold for low back pain. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No: CD004750. [DOI: 10.1002/14651858.CD004750.pub2] - DOI - PMC - PubMed
Furlan 2005
    1. Furlan AD, Van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, et al. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No: CD001351. [DOI: 10.1002/14651858.CD001351.pub2] - DOI - PMC - PubMed
Furlan 2015
    1. Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No: CD001929. [DOI: 10.1002/14651858.CD001929.pub3] - DOI - PMC - PubMed
Hayden 2005
    1. Hayden JA, Van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No: CD011674. [DOI: 10.1002/14651858.CD011674.pub2] - DOI - PMC - PubMed
Hayden 2021a
    1. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, Van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No: CD009790. [DOI: 10.1002/14651858.CD009790.pub2] - DOI - PMC - PubMed
Henschke 2010
    1. Henschke N, Ostelo RW, Van Tulder MW, Vlaeyen JW, Morley S, Assendelft WJ, et al. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No: CD002014. [DOI: 10.1002/14651858.CD002014.pub3] - DOI - PMC - PubMed
Kamper 2014
    1. Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No: CD000963. [DOI: 10.1002/14651858.CD000963.pub3] - DOI - PMC - PubMed
Khadilkar 2008
    1. Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No: CD003008. [DOI: 10.1002/14651858.CD003008.pub3] - DOI - PMC - PubMed
Macedo 2016
    1. Macedo LG, Saragiotto BT, Yamato TP, Costa LO, Menezes Costa LC, Ostelo RW, et al. Motor control exercise for acute non-specific low back pain. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No: CD012085. [DOI: 10.1002/14651858.CD012085] - DOI - PMC - PubMed
Marin 2017
    1. Marin TJ, Van Eerd D, Irvin E, Couban R, Koes BW, Malmivaara A, et al. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No: CD002193. [DOI: 10.1002/14651858.CD002193.pub2] - DOI - PMC - PubMed
Mu 2020
    1. Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database of Systematic Reviews 2020, Issue 12. Art. No: CD013814. [DOI: 10.1002/14651858.CD013814] - DOI - PMC - PubMed
Oltean 2014
    1. Oltean H, Robbins C, Van Tulder MW, Berman BM, Bombardier C, Gagnier JJ. Herbal medicine for low-back pain. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No: CD004504. [DOI: 10.1002/14651858.CD004504.pub4] - DOI - PMC - PubMed
Parreira 2017
    1. Parreira P, Heymans MW, Van Tulder MW, Esmail R, Koes BW, Poquet N, et al. Back Schools for chronic non-specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No: CD011674. [DOI: 10.1002/14651858.CD011674.pub2] - DOI - PMC - PubMed
Parry 2019
    1. Parry SP, Coenen P, Shrestha N, O'Sullivan PB, Maher CG, Straker LM. Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No: CD012487. [DOI: 10.1002/14651858.CD012487.pub2] - DOI - PMC - PubMed
Poquet 2016
    1. Poquet N, Lin CW, Heymans MW, Van Tulder MW, Esmail R, Koes BW, et al. Back schools for acute and subacute non-specific low-back pain. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No: CD008325. [DOI: 10.1002/14651858.CD008325.pub2] - DOI - PMC - PubMed
Rubinstein 2011
    1. Rubinstein SM, Van Middelkoop M, Assendelft WJ, De Boer MR, Van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No: CD008112. [DOI: 10.1002/14651858.CD008112.pub2] - DOI - PMC - PubMed
Rubinstein 2012
    1. Rubinstein SM, Terwee CB, Assendelft WJ, De Boer MR, Van Tulder MW. Spinal manipulative therapy for acute low-back pain. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No: CD008880. [DOI: 10.1002/14651858.CD008880.pub2] - DOI - PMC - PubMed
Saragiotto 2016
    1. Saragiotto BT, Maher CG, Yamato TP, Costa LO, Menezes Costa LC, Ostelo RW, et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No: CD012004. [DOI: 10.1002/14651858.CD012004] - DOI - PMC - PubMed
Schaafsma 2013
    1. Schaafsma FG, Whelan K, Van der Beek AJ, Van der Es-Lambeek LC, Ojajarvi A, Verbeek JH. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No: CD001822. [DOI: 10.1002/14651858.CD001822.pub3] - DOI - PMC - PubMed
Urrutia 2004
    1. Urrutia G, Burton AK, Morral A, Bonfill X, Zanoli G. Neuroreflexotherapy for non-specific low-back pain. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No: CD003009. [DOI: 10.1002/14651858.CD003009.pub2] - DOI - PMC - PubMed
Van Duijvenbode 2008
    1. Van Duijvenbode IC, Jellema P, Van Poppel MN, Van Tulder MW. Lumbar supports for prevention and treatment of low back pain. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No: CD001823. [DOI: 10.1002/14651858.CD001823.pub3] - DOI - PMC - PubMed
Walker 2010
    1. Walker BF, French SD, Grant W, Green S. Combined chiropractic interventions for low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 4. Art. No: CD005427. [DOI: 10.1002/14651858.CD005427.pub2] - DOI - PMC - PubMed
Wegner 2013
    1. Wegner I, Widyahening IS, Van Tulder MW, Blomberg SE, De Vet HC, Bronfort G, et al. Traction for low-back pain with or without sciatica. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No: CD003010. [DOI: 10.1002/14651858.CD003010.pub5] - DOI - PMC - PubMed
Wieland 2022
    1. Wieland LS, Skoetz N, Pilkington K, Harbin S, Vempati R, Berman BM. Yoga for chronic non-specific low back pain. Cochrane Database of Systematic Reviews 2022, Issue 11. Art. No: CD010671. [DOI: 10.1002/14651858.CD010671.pub3] - DOI - PMC - PubMed
Yamato 2015
    1. Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM, et al. Pilates for low back pain. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No: CD010265. [DOI: 10.1002/14651858.CD010265.pub2] - DOI - PMC - PubMed
Yousefi‐Nooraie 2008
    1. Yousefi-Nooraie R, Schonstein E, Heidari K, Rashidian A, Pennick V, Akbari-Kamrani M, et al. Low level laser therapy for nonspecific low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No: CD005107. [DOI: 10.1002/14651858.CD005107.pub4] - DOI - PMC - PubMed

References to excluded reviews

Assendelft 2013
    1. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. WITHDRAWN: Spinal manipulative therapy for low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No: CD000447. [DOI: 10.1002/14651858.CD000447.pub3] - DOI - PMC - PubMed
Bleakley 2012
    1. Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No: CD008262. [DOI: 10.1002/14651858.CD008262.pub2] - DOI - PMC - PubMed
Choi 2010
    1. Choi BK, Verbeek JH, Tam WW, Jiang JY. Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No: CD006555. [DOI: 10.1002/14651858.CD006555.pub2] - DOI - PMC - PubMed
Costello 2015
    1. Costello JT, Baker PR, Minett GM, Bieuzen F, Stewart IB, Bleakley C. Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No: CD010789. [DOI: 10.1002/14651858.CD010789.pub2] - DOI - PMC - PubMed
Eccleston 2014
    1. Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Psychological therapies (Internet-delivered) for the management of chronic pain in adults. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No: CD010152. [DOI: 10.1002/14651858.CD010152.pub2] - DOI - PMC - PubMed
Eccleston 2017
    1. Eccleston C, Fisher E, Thomas KH, Hearn L, Derry S, Stannard C, et al. Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No: CD010323. [DOI: 10.1002/14651858.CD010323.pub3] - DOI - PMC - PubMed
French 2010
    1. French SD, Green S, Buchbinder R, Barnes H. Interventions for improving the appropriate use of imaging in people with musculoskeletal conditions. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No: CD006094. [DOI: 10.1002/14651858.CD006094.pub2] - DOI - PMC - PubMed
Gadsby 2007
    1. Gadsby JG, Flowerdew MW. WITHDRAWN: Transcutaneous electrical nerve stimulation and acupuncture-like transcutaneous electrical nerve stimulation for chronic low back pain. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No: CD000210. [DOI: 10.1002/14651858.CD000210.pub2] - DOI - PMC - PubMed
Hagen 2010
    1. Hagen KB, Hilde G, Jamtvedt G, Winnem M. WITHDRAWN: Bed rest for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2010, Issue 6. Art. No: CD001254. [DOI: 10.1002/14651858.CD001254.pub3] - DOI - PMC - PubMed
Hayden 2019
    1. Hayden JA, Wilson MN, Riley RD, Iles R, Pincus T, Ogilvie R. Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review. Cochrane Database of Systematic Reviews 2019, Issue 11. Art. No: CD011284. [DOI: 10.1002/14651858.CD011284.pub2] - DOI - PMC - PubMed
Henschke 2013
    1. Henschke N, Maher CG, Ostelo RW, De Vet HC, Macaskill P, Irwig L. Red flags to screen for malignancy in patients with low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No: CD008686. [DOI: 10.1002/14651858.CD008686.pub2] - DOI - PMC - PubMed
Heymans 2004
    1. Heymans MW, Van Tulder MW, Esmail R, Bombardier C, Koes BW. Back schools for non-specific low-back pain. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No: CD000261. [DOI: 10.1002/14651858.CD000261.pub2] - DOI - PubMed
Hilde 2007
    1. Hilde G, Hagen KB, Jamtvedt G, Winnem M. WITHDRAWN: Advice to stay active as a single treatment for low-back pain and sciatica. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No: CD003632. [DOI: 10.1002/14651858.CD003632.pub2] - DOI - PMC - PubMed
Jordan 2010
    1. Jordan JL, Holden MA, Mason EE, Foster NE. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No: CD005956. [DOI: 10.1002/14651858.CD005956.pub2] - DOI - PMC - PubMed
Karjalainen 2000
    1. Karjalainen K, Malmivaara A, Van Tulder M, Roine R, Jauhiainen M, Hurri H, et al. Multidisciplinary rehabilitation for fibromyalgia and musculoskeletal pain in working age adults. Cochrane Database of Systematic Reviews 2000, Issue 2. Art. No: CD001984. [DOI: 10.1002/14651858.CD001984] - DOI - PMC - PubMed
Nnoaham 2014
    1. Nnoaham KE, Kumbang J. WITHDRAWN: Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No: CD003222. [DOI: 10.1002/14651858.CD003222.pub3] - DOI - PubMed
O'Connell 2018
    1. O'Connell NE, Marston L, Spencer S, DeSouza LH, Wand BM. Non-invasive brain stimulation techniques for chronic pain. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No: CD008208. [DOI: 10.1002/14651858.CD008208.pub4] - DOI - PMC - PubMed
Sahar 2007
    1. Sahar T, Cohen MJ, Ne'eman V, Kandel L, Odebiyi DO, Lev I, et al. Insoles for prevention and treatment of back pain. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No: CD005275. [DOI: 10.1002/14651858.CD005275.pub2] - DOI - PubMed
Verbeek 2011
    1. Verbeek JH, Martimo KP, Karppinen J, Kuijer PP, Viikari-Juntura E, Takala EP. Manual material handling advice and assistive devices for preventing and treating back pain in workers. Cochrane Database of Systematic Reviews 2011, Issue 6. Art. No: CD005958. [DOI: 10.1002/14651858.CD005958.pub3] - DOI - PubMed
Wieland 2017
    1. Wieland LS, Skoetz N, Pilkington K, Vempati R, D'Adamo CR, Berman BM. Yoga treatment for chronic non-specific low back pain. Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No: CD010671. [DOI: 10.1002/14651858.CD010671.pub2] - DOI - PMC - PubMed
Williams 2020
    1. Williams AC, Fisher E, Hearn L, Eccleston C. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No: CD007407. [DOI: 10.1002/14651858.CD007407.pub4] - DOI - PMC - PubMed

Additional references

Aas 2009
    1. Aas RW, Tuntland H, Holte KA, Røe C, Labriola M. Workplace interventions for low-back pain in workers. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No: CD008159. [DOI: 10.1002/14651858.CD008159] [CD008159] - DOI - PMC - PubMed
Abbafati 2020
    1. Abbafati C, Machado DB, Cislaghi B, Salman OM, Karanikolos M, Mckee M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;10258:1204-22. - PMC - PubMed
Ahern 2019
    1. Ahern M, Dean CM, Dear BF, Willcock SM, Hush JM. The experiences and needs of people seeking primary care for low-back pain in Australia. Pain Reports 2019;4(4):e756. - PMC - PubMed
Ahern 2020
    1. Ahern MM, Dean LV, Stoddart CC, Agrawal A, Kim K, Cook CE, et al. The effectiveness of virtual reality in patients with spinal pain: a systematic review and meta-analysis. Pain Practice 2020;20(6):656-75. - PubMed
Algafly 2007
    1. Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British Journal of Sports Medicine 2007;41(6):365-9. - PMC - PubMed
Almeida 2020
    1. Almeida L, Costa LO, Maher CG, Yamato TP, Fandim JV, Dear B, et al. Telerehabilitation for acute, subacute and chronic low back pain. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No: CD013704. [DOI: 10.1002/14651858.CD013704] - DOI
Andersson 1995
    1. Andersson S, Lundeberg T. Acupuncture from empiricism to science: functional background to acupuncture effects in pain and disease. Medical Hypotheses 1995;45(3):271-81. - PubMed
Ashar 2021
    1. Ashar YK, Gordon A, Schubiner H, Uipi C, Knight K, Anderson Z, et al. Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: a randomized clinical trial. JAMA Psychiatry 2022;79(1):13-23. - PMC - PubMed
Bagg 2018
    1. Bagg MK, Salanti SG, McAuley JH. Comparing interventions with network meta-analysis. Journal of Physiotherapy 2018;64:128-32. - PubMed
Bagg 2022
    1. Bagg MK, Wand BM, Cashin AG, Lee H, Hübscher M, Stanton TR, et al. Effect of graded sensorimotor retraining on pain intensity in patients with chronic low back pain: a randomized clinical trial. JAMA 2022;28(5):430-9. - PMC - PubMed
Balagué 2012
    1. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain Epidemiology and natural history. Lancet 2012;379(379):482-91. - PubMed
Balshem 2011
    1. Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology 2011;64:401-6. - PubMed
Bialosky 2009
    1. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Manual Therapy 2009;14(5):531-8. - PMC - PubMed
Binny 2019
    1. Binny J, Wong NLJ, Garga S, Lin C-WC, Maher CG, McLachlan AJ, et al. Transcutaneous electric nerve stimulation (TENS) for acute low back pain: systematic review. Scandinavian Journal of Pain 2019;19(2):225-33. - PubMed
Bishop 2015
    1. Bishop MD, Torres-Cueco R, Gay CW, Lluch-Girbés E, Beneciuk JM, Bialosky JE. What effect can manual therapy have on a patient's pain experience? Pain Management 2015;5(6):455-64. - PMC - PubMed
Borrell‐Carrio 2004
    1. Borrell-Carrio F. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Annals of Family Medicine 2004;2(6):576-82. - PMC - PubMed
Braithwaite 2020
    1. Braithwaite FA, Walters JL, Moseley GL, Williams MT, McEvoy MP. Towards more homogenous and rigorous methods in sham-controlled dry needling trials: two Delphi surveys. Physiotherapy 2020;106:12-23. - PubMed
Buchbinder 2018
    1. Buchbinder R, Van Tulder M, Öberg B, Costa LM, Woolf A, Schoene M, et al. Low back pain: a call for action. Lancet 2018;391:2384-8. - PubMed
Burns 2016
    1. Burns JW. Mechanisms, mechanisms, mechanisms: it really does all boil down to mechanisms. Pain 2016;157(11):2393-4. - PMC - PubMed
Cashin 2021b
    1. Cashin AG, McAuley JH, Lamb SE, Lee H. Disentangling contextual effects from musculoskeletal treatments. Osteoarthritis and Cartilage 2021;29(3):297-9. - PubMed
Caspersen 1985
    1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports 1985;100(2):126-31. - PMC - PubMed
Chiarotto 2018
    1. Chiarotto A, Boers M, Deyo RA, Buchbinder R, Corbin TP, Costa LO, et al. Core outcome measurement instruments for clinical trials in nonspecific low back pain. Pain 2018;159(3):481-95. - PMC - PubMed
Chou 2017
    1. Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Annals of Internal Medicine 2017;166:493-505. - PubMed
Chou 2018
    1. Chou L, Ranger TA, Peiris W, Cicuttini FM, Urquhart DM, Sullivan K, et al. Patients' perceived needs of health care providers for low back pain management: a systematic scoping review. Spine Journal 2018;18(4):691-711. - PubMed
Cieza 2020
    1. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10267):2006-17. - PMC - PubMed
Clarke 2006
    1. Clarke J, Van Tulder M, Blomberg S, De Vet H, Van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane Collaboration. Spine 2006;31(14):1591-9. - PubMed
Coppieters 2008
    1. Coppieters MW, Butler DS. Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic techniques and considerations regarding their application. Manual Therapy 2008;13(3):213-21. - PubMed
Costa 2012
    1. Costa LC, Maher C, Hancock M, McAuley J, Herbert R, Costa L. The prognosis of acute and persistent low back pain: a meta analysis. Canadian Medical Association Journal 2012;184(11):613-24. - PMC - PubMed
Covidence [Computer program]
    1. Covidence. Version accessed prior to 3 February 2025. Melbourne, Australia: Veritas Health Innovation, 2025. Available at covidence.org.
Da Silva 2017
    1. Da Silva T, Mills K, Brown BT, Herbert R, Maher C, Hancock M. Risk of recurrence of low back pain: A systematic review. Journal of Orthopaedic and Sports Physical Therapy 2017;47(5):305-13. - PubMed
Dieleman 2020
    1. Dieleman JL, Cao J, Chapin A, Chen C, Li Z, Liu A, et al. US health care spending by payer and health condition, 1996-2016. JAMA 2020;323(9):863-84. - PMC - PubMed
Dworkin 2005
    1. Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 2005;113:9-19. - PubMed
Edwards 2022
    1. Edwards RR, Schreiber KL, Dworkin RH, Turk DC, Baron R, Freeman R, et al. Optimizing and accelerating the development of precision pain treatments for chronic pain: IMMPACT review and recommendations. Journal of Pain 2022;22:00415-1. - PMC - PubMed
Efthimiou 2016
    1. Efthimiou O, Debray TP, Valkenhoef G, Trelle S, Panayidou K, Moons KG, et al, GetReal Methods Review Group. GetReal in network meta-analysis: a review of the methodology. Research Synthesis Methods 2016;7(3):236-63. - PubMed
Foster 2018
    1. Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet 2018;391(10137):2368-83. - PubMed
Furlan 2009
    1. Furlan AD, Pennick V, Bombardier C, Van Tulder M, Editorial Board, Cochrane Back Review Group. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine 2009;34(18):1929-41. - PubMed
Furlan 2011
    1. Furlan AD, Yazdi F, Tsertsvadze A, Lao L, Sherman K, Ammendolia C, et al. Acupuncture for (sub)acute non‐specific low‐back pain. Cochrane Database of Systematic Reviews 2011;(8). [DOI: 10.1002/14651858.CD009265] [CD009265] - DOI
Furlan 2015a
    1. Furlan AD, Malmivaara A, Chou R, Maher CG, Deyo RA, Schoene M, et al, Editorial Board of the Cochrane Back and Neck Group. 2015 updated method guideline for systematic reviews in the Cochrane Back and Neck Group. Cochrane Database of Systematic Reviews 2015;40(21):1660-73. - PubMed
Furlong 2020
    1. Furlong B, Aubrey-Bassler K, Etchegary H, Pike A, Darmonkow G, Swab M, et al. Patient education materials for non-specific low back pain and sciatica: a protocol for a systematic review and meta-analysis. BMJ Open 2020;10(9):e039530. - PMC - PubMed
Gao 2019
    1. Gao Y, Ge L, Ma X, Shen X, Liu M, Tian J. Improvement needed in the network geometry and inconsistency of Cochrane network meta-analyses: a cross-sectional survey. Journal of Clinical Epidemiology 2019;113:214-27. - PubMed
Garland 2020
    1. Garland EL, Brintz CE, Hanley AW, Roseen EJ, Atchley RM, Gaylord SA, et al. Mind-body therapies for opioid-treated pain: a systematic review and meta-analysis. JAMA Internal Medicine 2020;180(1):91-105. - PMC - PubMed
Gilanyi 2023
    1. Gilanyi YL, Wewege MA, Shah B, Cashin AG, Williams CM, Davidson SR, et al. Exercise increases pain self-efficacy in adults with nonspecific chronic low back pain: a systematic review and meta-analysis. Journal of Orthopaedic and Sports Physical Therapy 2023;0(6):1-8. - PubMed
Goldkuhle 2018
    1. Goldkuhle M, Narayan VM, Weigl A, Dahm P, Skoetz N. A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer. BMJ Open 2018;8(3):e020869. - PMC - PubMed
Gopalakrishnan 2013
    1. Gopalakrishnan S, Ganeshkumar P. Systematic reviews and meta-analysis: Understanding the best evidence in primary healthcare. Journal Family Medicine and Primary Care 2013;2(1):9-9. - PMC - PubMed
Grey 2020
    1. Grey A, Bolland MJ, Avenell A, Klein AA, Gunsalus CK. Check for publication integrity before misconduct. Nature 2020;577:167-9. - PubMed
Grooten 2022
    1. Grooten WJ, Boström C, Dedering Å, Halvorsen M, Kuster RP, Nilsson-Wikmar L, et al. Summarizing the effects of different exercise types in chronic low back pain - a systematic review of systematic reviews. BMC Musculoskeletal Disorders 2022;23(1):801. - PMC - PubMed
Hancock 2007
    1. Hancock MJ, Maher CG, Latimer J, Spindler MF, McAuley JH, Laslett M, et al. Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. European Spine Journal 2007;16(10):1539-50. - PMC - PubMed
Hansen 2010
    1. Hansen Z, Daykin A, Lamb SE. A cognitive-behavioural programme for the management of low back pain in primary care: a description and justification of the intervention used in the Back Skills Training Trial. Physiotherapy 2010;96(2):87-94. - PubMed
Hartvigsen 2018
    1. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet 2018;391(10137):2356-67. - PubMed
Hayden 2021b
    1. Hayden JA, Ellis J, Ogilvie R, Stewart SA, Bagg MK, Stanojevic S, et al. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. Journal of Physiotherapy 2021;67:252-62. [DOI: 10.1016/j.jphys.2021.09.004] - DOI - PubMed
Hennessy 2020
    1. Hennessy EA, Johnson BT. Examining overlap of included studies in meta-reviews: Guidance for using the corrected covered area index. Research Synthesis Methods 2020;11(1):134-45. - PMC - PubMed
Henschke 2008
    1. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ (Clinical Research Ed.) 2008;337(jul07 1):a171. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al, Cochrane Bias Methods Group, Cochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ (Clinical Research Ed.) 2011;343:d5928. - PMC - PubMed
Higgins 2024
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch V, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 6.5 (updated August 2024). Cochrane, 2024. Available from https://training.cochrane.org/handbook. - PMC - PubMed
Ho 2022
    1. Ho EK, Chen L, Simic M, Ashton-James CE, Comachio J, Wang DX, et al. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ (Clinical Research Ed.) 2022;376:e067718. - PMC - PubMed
Hodges 2003
    1. Hodges PW. Core stability exercise in chronic low back pain. Orthopedic Clinics of North America 2003;34(2):245-54. - PubMed
Hoffman 2007
    1. Hoffman BM, Papas RK, Chatkoff DK, Kerns RD. Meta-analysis of psychological interventions for chronic low back pain. Health Psychology 2007;26(1):1-9. - PubMed
Hoffmann 2014
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: Template for Intervention Description and Replication (TIDieR) checklist and guide. BMJ (Clinical Research Ed.) 2014;348:g1687. - PubMed
Hohenschurz‐Schmidt 2022
    1. Hohenschurz-Schmidt D, Draper-Rodi J, Vase L, Scott W, McGregor A, Soliman N, et al. Blinding and sham control methods in trials of physical, psychological, and self-management interventions for pain (article I): a systematic review and description of methods. Pain 2022;164(3):469-84. - PMC - PubMed
Hunt 2018
    1. Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G. An introduction to overviews of reviews: planning a relevant research question and objective for an overview. Systematic Reviews 2018;7(1):1-9. - PMC - PubMed
IJzelenberg 2011
    1. IJzelenberg W, Rubinstein SM, Hayden J, Koes BW, Van Tulder MW. Exercise therapy for acute non‐specific low‐back pain. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No: CD009365. [DOI: 10.1002/14651858.CD009365] - DOI - PMC - PubMed
Jesus‐Moraleida 2016
    1. Jesus‐Moraleida FR, Silva JP, Pereira DS, Domingues Dias JM, Correa Dias R, Ferreira ML, et al. Exercise therapy for older adults with low‐back pain. Cochrane Database of Systematic Reviews 2016;(4). [DOI: 10.1002/14651858.CD012140] [CD012140] - DOI
Kaptchuk 2006
    1. Kaptchuk TJ, Stason WB, Davis RB, Legedza AR, Schnyer RN, Kerr CE, et al. Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ (Clinical Research Ed.) 2006;332(7538):391-7. - PMC - PubMed
Karlsson 2020
    1. Karlsson M, Bergenheim A, Larsson ME, Nordeman L, Van Tulder M, Bernhardsson S. Effects of exercise therapy in patients with acute low back pain: a systematic review of systematic reviews. Systematic Reviews 2020;9(1):182. - PMC - PubMed
Kent 2023
    1. Kent P, Haines T, O'Sullivan P, Smith A, Campbell A, Schutze R, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial. Lancet 2023;401:1866-77. - PubMed
Koes 2007
    1. Koes BW, Van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ (Clinical Research Ed.) 2007;334(7607):1313-7. - PMC - PubMed
Lao 1996
    1. Lao L. Acupuncture techniques and devices. Journal of Alternative and Complementary Medicine (New York, N.Y.) 1996;2(1):23-5. - PubMed
Lee 2016
    1. Lee H, Mansell G, McAuley JH, Kamper SJ, Hübscher M, Moseley GL, et al. Causal mechanisms in the clinical course and treatment of back pain. Best Practice & Research Clinical Rheumatology 2016;30(6):1074-83. - PubMed
Lewis 2012
    1. Lewis SE, Holmes PS, Woby SR, Hindle J, Fowler NE. Short-term effect of superficial heat treatment on paraspinal muscle activity, stature recovery, and psychological factors in patients with chronic low back pain. Archives of Physical Medicine and Rehabilitation 2012;93(2):367-72. - PubMed
Lim 2019
    1. Lim YZ, Chou L, Au RT, Seneviwickrama KM, Cicuttini FM, Briggs AM, et al. People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: a systematic review. Journal of Physiotherapy 2019;65(3):124-35. - PubMed
Liu 2013
    1. Liu H, Yao K, Zhang J, Li L, Wu T, Brox JI, et al. Sling exercise therapy for chronic low‐back pain. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No: CD010689. [DOI: 10.1002/14651858.CD010689] - DOI
Machado 2012
    1. Machado L, Van Tulder MW, Lin CW, Clare H, Hayden JA. The McKenzie method for chronic non‐specific low‐back pain. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No: CD009712. [DOI: 10.1002/14651858.CD009712] - DOI
Maher 2017
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet 2017;389(10070):736-47. - PubMed
McClurg 2016
    1. McClurg D, Pollock A, Campbell P, Hazelton C, Elders A, Hagen S, et al. Conservative interventions for urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No: CD012337. [DOI: 10.1002/14651858.CD012337] - DOI - PMC - PubMed
Meader 2014
    1. Meader N, King K, Llewellyn A, Norman G, Brown J, Rodgers M, et al. A checklist designed to aid consistency and reproducibility of GRADE assessments: development and pilot validation. Systematic Reviews 2014;3(1):82. - PMC - PubMed
Melzack 1981
    1. Melzack R. Myofascial trigger points: relation to acupuncture and mechanisms of pain. Archives of Physical Medicine and Rehabilitation 1981;62(3):114-7. - PubMed
Milne 2001
    1. Milne S, Welch V, Brosseau L, Saginur M, Shea B, Tugwell P, et al. Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No: CD003008. [DOI: 10.1002/14651858.CD003008] - DOI - PubMed
Moore 2015
    1. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ (Clinical Research Ed.) 2015;350:h1258. - PMC - PubMed
Moseley 2009
    1. Moseley AM, Elkins MR, Herbert RD, Maher CG, Sherrington C. Cochrane reviews used more rigorous methods than non-Cochrane reviews: survey of systematic reviews in physiotherapy [Cochrane reviews used more rigorous methods than non-Cochrane reviews: survey of systematic reviews in physiotherapy]. Journal of Clinical Epidemiology 2009;62(10):1021-30. - PubMed
Moseley 2015
    1. Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. Journal of Pain 2015;16(9):807-13. - PubMed
NICE 2016
    1. National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59]; November 2016; last updated December 2020. https://www.nice.org.uk/guidance/ng59 (accessed prior to 5 March 2025).
NICE 2021
    1. National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline [NG193]; April 2021. https://www.nice.org.uk/guidance/ng193 (accessed prior to 5 March 2025). - PubMed
Nuesch 2010
    1. Nuesch E, Trelle S, Reichenbach S, Rutjes AW, Tschannen B, Altman DG, et al. Small study effects in meta-analyses of osteoarthritis trials: meta-epidemiological study [Small study effects in meta-analyses of osteoarthritis trials: meta-epidemiological study]. BMJ (Clinical Research Ed.) 2010;341:c3515. - PMC - PubMed
O'Connell 2010
    1. O'Connell NE, Wand BM, Marston L, Spencer S, DeSouza LH. Non-invasive brain stimulation techniques for chronic pain. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No: CD008208. [DOI: 10.1002/14651858.CD008208.pub5] - DOI - PubMed
O'Connell 2013
    1. O'Connell NE, Wand BM, McAuley J, Marston L, Moseley GL. Interventions for treating pain and disability in adults with complex regional pain syndrome. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No: CD009416. [DOI: 10.1002/14651858.CD009416.pub2] - DOI - PMC - PubMed
Odebiyi 2013
    1. Odebiyi DO, Henschke N, Ferreira ML, Tella A. Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No: CD010500. [DOI: 10.1002/14651858.CD010500] [CD010500] - DOI
Oliveira 2018
    1. Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CW, Chenot JF, et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. European Spine Journal 2018;27(11):2791-803. - PubMed
Owen 2020
    1. Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine 2020;54:1279-87. - PMC - PubMed
Parker 2022
    1. Parker L, Boughton S, Lawrence R, Bero L. Experts identified warning signs of fraudulent research: a qualitative study to inform a screening tool. Journal of Clinical Epidemiology 2022;151:1-17. - PubMed
Pascoe 2022
    1. Pascoe SC, Spoonemore SL Jr, Young JL, Rhon DI. Proposing six criteria to improve reproducibility of "usual care" interventions in back pain trials: a systematic review. Journal of Clinical Epidemiology 2022;149:227-35. - PubMed
Pieper 2014
    1. Pieper D, Antoine SL, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. Journal of Clinical Epidemiology 2014;67:368-75. - PubMed
Pincus 2013
    1. Pincus T, Holt N, Vogel S, Underwood M, Savage R, Walsh DA, et al. Cognitive and affective reassurance and patient outcomes in primary care: a systematic review. Pain 2013;154(11):2407-16. - PubMed
Poder 2019
    1. Poder TG, Beffarat M, Benkhalti M, Ladouceur G, Dagenais P. A discrete choice experiment on preferences of patients with low back pain about non-surgical treatments: identification, refinement and selection of attributes and levels. Patient Preference and Adherence 2019;13:933-40. - PMC - PubMed
Pérez‐Bracchiglione 2022
    1. Pérez-Bracchiglione J, Meza N, Bangdiwala SI, Niño de Guzmán E, Urrútia G, Bonfill X, et al. Graphical Representation of Overlap for OVErviews: GROOVE tool. Research Synthesis Methods 2022;13(3):381-8. - PubMed
Qaseem 2020
    1. Qaseem A, McLean RM, O'Gurek D, Batur P, Lin K, Kansagara DL, et al, Clinical Guidelines Committee of the American College of Physicians, Commission on Health of the Public and Science of the American Academy of Family Physicians. Nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults: a clinical guideline from the American College of Physicians and American Academy of Family Physicians. Annals of Internal Medicine 2020;173:739-48. [DOI: 10.7326/M19-3602] - DOI - PubMed
Rainville 2004
    1. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine Journal 2004;4(1):106-15. - PubMed
Rubinstein 2019
    1. Rubinstein SM, De Zoete A, Van Middelkoop M, Assendelft WJ, De Boer MR, Van Tulder MW. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ (Clinical Research Ed.) 2019;364:l689. - PMC - PubMed
Santesso 2020
    1. Santesso N, Glenton C, Dahm P, Garner P, Akl EA, Alper B, et al, GRADE Working Group. GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. Journal of Clinical Epidemiology 2020;119:126-35. - PubMed
Schulz 2010
    1. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 2010;8(18):1-9. [DOI: ] - PMC - PubMed
Shea 2017
    1. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Clinical Research Ed.) 2017;358:j4008. - PMC - PubMed
Sluka 2018
    1. Sluka KA, Frey-Law L, Hoeger Bement A. Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain 2018;159:S91-7. - PMC - PubMed
Smith 2019
    1. Smith BE, Hendrick P, Bateman M, Holden S, Littlewood C, Smith TO, et al. Musculoskeletal pain and exercise - Challenging existing paradigms and introducing new. British Journal of Sports Medicine 2019;53(14):907-12. - PMC - PubMed
Sridhar 2021
    1. Sridhar S, Haas R, Docking S, Buchbinder R, O'Connor D. Models of care for managing non-specific low back pain. Cochrane Database of Systematic Reviews 2021, Issue 12. Art. No: CD015083. [DOI: 10.1002/14651858.CD015083] - DOI - PMC - PubMed
Traeger 2015
    1. Traeger AC, Hübscher M, Henschke N, Moseley GL, Lee H, McAuley JH. Effect of primary care based education on reassurance in patients with acute low back pain systematic review and meta-analysis. JAMA Internal Medicine 2015;175(5):733-43. - PubMed
Useem 2015
    1. Useem J, Brennan A, LaValley M, Vickery M, Ameli O, Reinen N, et al. Systematic differences between Cochrane and non-Cochrane meta-analyses on the same topic: a matched pair analysis. PloS One 2015;10(12):e0144980. - PMC - PubMed
Van Middelkoop 2011
    1. Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal 2011;20(1):19-39. - PMC - PubMed
Van Tulder 1997
    1. Van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine 1997;22(18):2128-56. - PubMed
Van Tulder 2003
    1. Van Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board of the Cochrane Collaboration Back Review Group. Updated method guidelines for systematic reviews in The Cochrane Collaboration Back Review Group. Spine 2003;28(12):1290-9. - PubMed
Van Tulder 2006
    1. Van Tulder M, Becker A, Bekkering T, Breen A, Real MT, Hutchinson A, et al. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal 2006;15:169-91. [DOI: 10.1007/s00586-006-1071-2] - DOI - PMC - PubMed
Vance 2014
    1. Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Management 2014;4(3):197-209. - PMC - PubMed
Widerström 2019
    1. Widerström B, Rasmussen-Barr E, Boström C. Aspects influencing clinical reasoning and decision-making when matching treatment to patients with low back pain in primary healthcare. Musculoskeletal Science Practice 2019;41:6-14. - PubMed
Wood 2019
    1. Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-and long-term outcomes of pain and disability. European Journal of Pain (London, England) 2019;23(2):234-49. - PubMed
Wun 2021
    1. Wun A, Kollias P, Jeong H, Rizzo RR, Cashin AG, Bagg MK, et al. Why is exercise prescribed for people with chronic low back pain? A review of the mechanisms of benefit proposed by clinical trialists. Musculoskeletal Science and Practice 2021;51:102307. - PubMed

References to other published versions of this review

Cashin 2021a
    1. Cashin AG, Rizzo RR, Wand BM, O'Connell NE, Lee H, Bagg MK, et al. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2021, Issue 8. Art. No: CD014691. [DOI: 10.1002/14651858.CD014691] - DOI - PMC - PubMed

LinkOut - more resources