Background & Aims

Non-specific low back pain, which currently represents a significant public health challenge on a global scale, affects approximately 11.9% of the world’s population. This condition transcends several age groups and stands out as one of the main causes of years lived with disability, exerting considerable adverse impacts on quality of life. Treatment of this condition is primarily aimed at reducing pain and restoring functional capacity. The integrated management of non-specific low back pain includes strategies such as education, medication, and non-pharmacological therapies, with exercise and Transcutaneous Electrical Nerve Stimulation (TENS) being relevant interventions.
To evaluate the effectiveness of the additional use of analgesic currents to practice physical exercises in individuals with chronic low back pain, compared to isolated use of exercise related to pain and disability.

Methods

Searches were conducted on five electronic databases (MEDLINE, Embase, Cochrane Library, Physiotherapy Evidence Database, and Scielo). The search was carried out from September 2022 to July 2023. The study protocol was registered in PROSPERO under the identification CRD42022360741. Randomized clinical trials comparing exercise alone and exercise and placebo to exercise associated with electroanalgesia for treating individuals with non-specific low back pain. Two independent researchers performed the data extraction and assessed the risk of bias using a predefined form and the Cochrane Collaboration of Risk of Bias, respectively. The quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.

Results

Eight studies were identified for the systematic review and four for the meta-analysis with a standardized mean difference, 95% confidence interval, and fixed effect model. Common outcomes involved pain and disability. There was no significant difference between treatments in reducing pain and disability.

Conclusions

There needs to be evidence to support the associated use of analgesic currents and exercise, considering the different current application protocols and types of exercise and the lack of information in clinical trials.

References

Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-781. doi:10.1016/j.berh.2010.10.002;
Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;2017(1). doi:10.1002/14651858.CD011279.PUB2
Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi:10.7326/M16-2367
Dias LV, Cordeiro MA, Schmidt de Sales R, et al. Immediate analgesic effect of transcutaneous electrical nerve stimulation (TENS) and interferential current (IFC) on chronic low back pain: Randomised placebo-controlled trial. J Bodyw Mov Ther. 2021;27:181-190. doi:10.1016/J.JBMT.2021.03.005
Almeida CC de, Silva VZM da, Júnior GC, Liebano RE, Durigan JLQ. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis. Braz J Phys Ther. 2018;22(5):347. doi:10.1016/J.BJPT.2017.12.005

Presenting Author

Jocassia Silva Pinheiro

Poster Authors

Jocassia Pinheiro

Universidade de São Paulo (USP)

Lead Author

E-mail

Marina Figueiredo Magalhães

Ribeirão Preto Medical School, University of São Paulo

Lead Author

E-mail

Almir Vieira Dibai-Filho

Ph.D.

Federal University of Maranhão

Lead Author

E-mail

Rinaldo Roberto de Jesus Guirro

Universidade de São Paulo

Lead Author

E-mail

Topics

  • Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science