Studies of Nonoperative Tx for Discogenic Back Pain Lacking
(HealthDay News) — High-quality studies evaluating nonoperative treatments for reducing discogenic low back pain are lacking, according to a review published in the July 15 issue of Spine.
Young Lu, from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a systematic literature review to identify prospective randomized controlled trials (RCTs) evaluating nonoperative methods of treating discogenic back pain versus sham or placebo therapy (published between 2000–2012).
The researchers identified 11 eligible studies which investigated traction therapy, injections, and ablative techniques. Intervention was favored based on results from five studies investigating methylene blue injection, steroid injection, ramus communicans ablation, intradiscal electrothermal therapy, and biacuplasty, compared to sham therapy. Methylene blue injection study results have not been replicated in other RCTs. There is doubt as to whether the conclusions from some of the studies can be applied to the general population due to selection criteria used in the studies on ramus communicans ablation and intradiscal biacuplasty and a stratified analysis of results from the RCTs on intradiscal electrothermal therapy.
"Although conclusions from several studies favor intervention over sham, it is unclear whether these interventions confer stable long-term benefit," the authors write.
Relevant financial activities outside the submitted work were disclosed: consultancy, grants, royalties, board membership.