Last week, as part of their “Your Health” segment, NPR aired a piece about the effectiveness of various treatments for low back pain, with a focus on spinal manipulation. Lower back pain is a common complaint to physicians, and, as the article states, a common reason for the prescription of addictive narcotic painkillers. Other interventions can include:
- Physical therapy
- Massage therapy
- Nonsteroidal anti-inflammatory drugs (NSAIDS)
- Chiropractic treatment
A recent publication appearing in the Journal of the American Medical Association (JAMA) analyzed results from 26 randomized clinical trials. The key takeaway from this article is that spinal manipulation, an act of mobilizing the joints of the spine, provides modest pain relief of 1 point on a 0- to 10-point rating scale. This is approximately equivalent to the pain reduction achieved with the use of NSAIDS.
“Low back pain can often be debilitating, leading to missed work, a decreased ability to participate in social and family activities, and chronic conditions. This says nothing of the side effects of medications prescribed.”
This represents an important finding. You can quickly become overwhelmed by the number of interventions available that claim to aid or alleviate low back pain, and very few of them are backed by evidence. But low back pain can often be debilitating, leading to missed work, a decreased ability to participate in social and family activities, and chronic conditions. This says nothing of the side effects of medications prescribed, from ones as benign as gastric irritation to those as dangerous as opioid dependency. Because of this risk, a number of conservative treatments, such as spinal manipulation, need to be considered. Also worth examination is an intervention known as percutaneous electrical nerve stimulation (PENS).
See a sample report, Percutaneous Electrical Nerve Stimulation for Treatment of Low Back Pain
PENS is a conservative, minimally invasive treatment for pain in which acupuncture-like needles connected through a cable to an external power source are inserted into the skin. Needle placement is near the area of pain and are percutaneous instead of cutaneous, as in transcutaneous electrical nerve stimulation (TENS). PENS electrodes are not permanently implanted as in spinal cord stimulation. The mechanism of action of PENS is theorized to modulate the hypersensitivity of nerves from which the persistent pain arises, potentially involving endogenous opioid-like substances.
Hayes produced a Health Technology Brief on this therapy in February of this year. You can click on the link below to see a sample of the report. After you read it, schedule a demo to see what the unbiased evidence assessments contained within the Hayes Knowledge Center can do for you.