Clinical improvements due to specific effects and placebo effects in conservative interventions and changes observed with no treatment in randomized controlled trials of patients with chronic nonspecific low back pain: a systematic review and meta-analysis

Review written by Todd Hargrove info

Key Points

  1. In 16 RCTs involving a wide variety of mostly passive interventions for nonspecific low back pain, about half of the changes in pain, function and quality of life would have occurred in the absence of treatment.
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BACKGROUND & OBJECTIVE

When patients with non-specific low back pain improve, it is often unknown whether such improvements are due to specific treatments effects, placebo effects, or time-based effects like natural course of history and/or regression to the mean.

This systematic review attempted to shed light on this issue by analyzing randomized controlled trials (RCTs) in patients with nonspecific low back pain.

It is often unknown whether improvements in non-specific low back pain are due to specific treatments effects, placebo effects, or time-based effects like natural course of history and/or regression to the mean.
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Approximately half of the changes seen after treatment would have occurred without any treatment at all, and that specific and nonspecific effects accounted for the rest of the changes in varying amounts.

METHODS

  • This review covered 16 RCTs on low back pain treatment that had three arms: a treatment group, a placebo group, and a group who received no treatment.
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