Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 257-263 , December 2009

Effective Conservative Treatment for Chronic Low Back Pain

  • James Rainville, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
    • New England Baptist Hospital, Boston, MA
    • Corresponding Author InformationAddress reprint requests to James Rainville, MD, The Spine Center, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120
    • ,
  • Rosalyn Nguyen, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
    • ,
  • Pradeep Suri, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
    • New England Baptist Hospital, Boston, MA

References 

  1. Brox JI, Sorensen R, Friis A, et al. Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercise in patients with chronic low back pain and disc degeneration. Spine. 2003;28:1913–1921
  2. Fairbank J, Frost H, Wilson-MacDonald J, et al. Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ. 2005;330:1233–1239
  3. Fritzell P, Hagg O, Wessberg P, et al: Volvo award winner in clinical studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 26:2521-2532
  4. O'Sullivan PB, Phyty GD, Twomey LT, et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22:2959–2967
  5. Keller A, Brox JI, Gunderson R, et al. Trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain randomized to lumbar fusion or cognitive intervention and exercises. Spine. 2004;29:3–8
  6. Brox JI, Reikeras O, Nygaard O, et al. Lumbar instrumented fusion compared with cognitive intervention and exercises in patients with chronic back pain after previous surgery for disc herniation: a prospective randomized controlled study. Pain. 2006;122:145–155
  7. Ostelo RW, Deyo RA, Stratford P, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33:90–94
  8. Smeets RJ, Vlaeyen JW, Kester AD, et al. Reduction of pain catastrophizing mediates the outcomes of both physical and cognitive-behavioral treatment in chronic low back pain. J Pain. 2006;7:261–271
  9. Roche G, Ponthieux A, Parot-Shinkel E, et al. Comparison of a functional restoration program with active individual physical therapy for patients with chronic low back pain: a randomized controlled trial. Arch Phys Med Rehabil. 2007;88:1229–1235
  10. Koumantakis GA, Watson PJ, Oldham JA. Supplementation of general endurance exercise with stabilization training versus general exercise only (Physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain). Clin Biomech. 2005;20:474–482
  11. Goldby LJ, Moore AP, Doust J, et al. A randomized controlled trial investigating the efficiency of musculoskeletal physiotherapy on chronic low back disorder. Spine. 2006;31:1083–1093
  12. McKenzie RA. The Lumbar Spine: Mechanical Diagnosis and Therapy. Waikanae, New Zealand: Spinal Publications; 1981;
  13. Petersen T, Kryger P, Ekdahl C, et al. The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: a randomized controlled trial. Spine. 2002;27:1702–1709
  14. Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. J Orthop Sports Phys Ther. 2006;36:472–484
  15. Chatzitheodorou D, Kabitsis C, Malliou P, et al. A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain. Phys Ther. 2007;87:304–312

 Dr Suri is supported by the Rehabilitation Medicine Scientist Training K12 Program (RMSTP) and the National Institutes of Health (K12 HD 01097).

 None of the authors have any conflict of interest regarding the contents of this article.

PII: S1040-7383(09)00073-2

doi: 10.1053/j.semss.2009.08.009

Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 257-263 , December 2009

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