Table 27Utility of conventional medicine for low back pain: Use of medication

Author, Year (ID)Intervention (sample size)Control (sample size)Region, Cause, duration of PainHealthcare Utilization- end pointResults CAMResults ControlCAM vs. Control
Acupuncture
Brinkhaus 200622Acupuncture (147)Placebo (minimal acupuncture); waiting list (154)LBP, N-SDays with analgesics in last 4 week-immediately post intervention (8 weeks)2.0 (4.8)4.9 (8.3);
6.2 (1.6)
Acupuncture vs. minimal acupuncture -2.9 (95%CI: -5.0, -0.8)

Acupuncture vs. waiting list -4.3 (95%CI: -6.5, -2.0)
Cherkin 200129Acupuncture (94)Self care (90)LBP, NS, ChronicNumber of pain medication fills- 1 year4.4 (8.9)4.0 (8.6)NS
Kennedy, 2008202Acupuncture (24)Placebo (24)LBP, NS, AcuteMean (SD) tablets/day at end of tx1.0 (0.3)4.2 (0.6)S
Thomas 2006111Acupuncture (160)Usual care (81)LBP, N-S, MixedPts using any medication in past 4 weeks- 2 years40%59%S (-19, 95% CI:-35.0, -3.0)
Grant 199953Acupuncture (32)TENS (28)LBP, N-S, Chronic (elderlyMedian (IQ range) tablets consumed in last week-immediate post tx (B); 3 months (C)B) 15 (5-37)
C) 14 (0-38)
B) 28 (7-42)
C) 24 (2-42)
S
Sator- Katzenschlager 2004143Acupuncture (electrical/auricular) (31)Acupuncture (manual/auricular) (30)LBP, N-S, ChronicConsumption of rescue medication (Tramadol), number of tablets used-6150S
Spinal manipulation
Childs 200431Spinal manipulation + exercise (70)Exercise alone (61)LBP, NS, Mixed% of pts taking any medication in past week – 6 mo fu9.6%25%S
Hurwitz 200666Spinal manipulation (169)Medical care (170)LBP, N-S, Mixed% of pts using prescription pain medication- 6 months (D), 1 year (E1), 18 months (E2)D) 24%
E1) 20%
E2) 19%
D) 32%
E1) 29%
E2) 27%
NS (also pts in Spinal manipulation were more likely to use over the counter pain medication at D than pts in medical care, but not at E1-2, 56% vs.49%, respectively)
Meade 199195Spinal manipulation (treated by chiropractor) (384)Hospital outpatient management (357)LBP, N-S, Unknown/MixedPts using analgesics and anti inflammatory drugs- 6 months (D); 1 year (E1); 2 years (E2)D) 33%

E1) 30%

E2) 30%
D) 35%

E1) 29%

E2) 36%
-1.8 (95% CI: -9.3, 5.7)

0.7 (95% CI: - 7.6, 9.0)

-6.0 (95% CI: -19.1, 7.1)
Santilli 2006391Spinal manipulation (53)Placebo manipulation (simulated Spinal manipulation) (49)LBP and Sciatica, Specific, Acute/subacuteNumber of days onanti inflammatory drugs (NSAIDs)1.8 (2.9)3.7 (7.1)NS
Santilli 2006391Spinal manipulation (53)Placebo manipulation (simulated Spinal manipulation) (49)LBP and Sciatica, Specific, AcuteNumber of drug prescriptions-2.6 (4.0)4.6 (8.9)NS
Niemistö 2003385Spinal manipulation (102)Physician consultation (102)LBP, N-S, chronicPts using analgesics for LBP- 1 year23%26%NS
Nordaren, WU 1992346Spinal mobilization (18)Placebo (massage) (21)LBP, and Sciatica, Specific Acute/subacuteNumber of analgesic pills (median, range)0(0-132)3.5 (0.5)S (p< 0.05)
Massage
Cherkin 200129Massage (94)Self care (90)LBP, NS, ChronicNumber of pain medication fills- 1 year2.5 (3.6)4.0 (8.6)S
Poole 2007369Massage (77)Relaxation; (82)LBP, NS, ChronicPts using prescribed medication for LBP- 6 months43.1%52.6%;
55.8%
NR
Poole 2007369Massage (77)Relaxation; (82)LBP, N-S, ChronicPts using over the counter medication for LBP- 6 months18.5%15.8%;
18.6%
NS

Data are given as mean(SD) when not indicated

End point= denotes the last follow up in which the data was reported

NS= not significant; N-S=nonspecific; pt/s= patient/s; tx=treatment/intervention; LBP= low back pain; TENS= transcutaneous electrical stimulation; B=immediately post treatment; C= short term follow up (up to 3 months post treatment); D=intermediate follow up (up to 6 months post treatment); E=long term follow up (over 6 months post treatment)

From: 3, Results

Cover of Complementary and Alternative Therapies for Back Pain II
Complementary and Alternative Therapies for Back Pain II.
Evidence Reports/Technology Assessments, No. 194.
Furlan AD, Yazdi F, Tsertsvadze A, et al.

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