Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 20 (7), 1024-38

Cost-effectiveness of Guideline-Endorsed Treatments for Low Back Pain: A Systematic Review

Affiliations
Review

Cost-effectiveness of Guideline-Endorsed Treatments for Low Back Pain: A Systematic Review

Chung-Wei Christine Lin et al. Eur Spine J.

Abstract

Healthcare costs for low back pain (LBP) are increasing rapidly. Hence, it is important to provide treatments that are effective and cost-effective. The purpose of this systematic review was to investigate the cost-effectiveness of guideline-endorsed treatments for LBP. We searched nine clinical and economic electronic databases and the reference list of relevant systematic reviews and included studies for eligible studies. Economic evaluations conducted alongside randomised controlled trials investigating treatments for LBP endorsed by the guideline of the American College of Physicians and the American Pain Society were included. Two independent reviewers screened search results and extracted data. Data extracted included the type and perspective of the economic evaluation, the treatment comparators, and the relative cost-effectiveness of the treatment comparators. Twenty-six studies were included. Most studies found that interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation or cognitive-behavioural therapy were cost-effective in people with sub-acute or chronic LBP. Massage alone was unlikely to be cost-effective. There were inconsistent results on the cost-effectiveness of advice, insufficient evidence on spinal manipulation for people with acute LBP, and no evidence on the cost-effectiveness of medications, yoga or relaxation. This review found evidence supporting the cost-effectiveness of the guideline-endorsed treatments of interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation and cognitive-behavioural therapy for sub-acute or chronic LBP. There is little or inconsistent evidence for other treatments endorsed in the guideline.

Figures

Fig. 1
Fig. 1
Flow of study

Similar articles

See all similar articles

Cited by 52 articles

See all "Cited by" articles

References

    1. Hestbaek L, Leboeuf-Yde C, Manniche C. Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J. 2003;12:149–165. - PMC - PubMed
    1. Koes BW, Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332(7555):1430–1434. doi: 10.1136/bmj.332.7555.1430. - DOI - PMC - PubMed
    1. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Jr, Shekelle P, Owens DK, Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–491. - PubMed
    1. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, York J, Das A, McAuley JH. Prevalence of and screening for serious spinal pathology in patients presenting to primary care with acute low back pain. Arthritis Rheum. 2009;60(10):3072–3080. doi: 10.1002/art.24853. - DOI - PubMed
    1. Koes B, van Tulder M, Lin C, Macedo L, McAuley JH, Maher C (Accepted 16 June 2010) An updated overview of clinical guidelines for the management of nonspecific low back pain in primary care. Eur Spine J 19(12):2075–2094 - PMC - PubMed

LinkOut - more resources

Feedback