Effectiveness of self-management of low back pain: Systematic review with meta-analysis
Arthritis Care & Research ,  Evidence Based Medicine  Clinical Article

Oliveira VC et al. – There is moderate quality evidence that self–management has small effects on pain and disability in people with low back pain (LBP). These results challenge the endorsement of self–management in treatment guidelines.

Methods
  • The authors performed a systematic review searching MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, PEDro, AMED, SportDiscus and Cochrane databases from earliest record to April 2011.
  • Randomised controlled trials evaluating self–management for non–specific LBP and assessing pain and disability were included.
  • The PEDro scale was used to assess methodological quality of included trials.
  • Data were pooled where studies were sufficiently homogenous.
  • Analyses were conducted separately for short (less than 6 months after randomization) and long (at least 12 months after randomization) term follow–ups. Six criteria for self–management were used to assess content of the intervention.

Results
  • The search identified 2325 titles, of which 13 original trials were included.
  • Moderate quality evidence showed that self–management is effective for improving pain and disability for people with LBP.
  • The weighted mean difference for pain was –3.2 points on a 0–100 scale (95% confidence interval: –5.1 to –1.3) and for disability –2.3 points (–3.7 to –1.0) at short–term follow–up.
  • The long–term effects were –4.8 (–7.1 to –2.5) for pain and –2.1 (–3.6 to –0.6) for disability.

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