Ultrasound, Shock Wave Not Effective for Low Back Pain

Available evidence shows that different treatments of acute low back pain give similar results

FRIDAY, Oct. 21 (HealthDay News) -- The available evidence does not support the effectiveness of ultrasound or shock wave for treating low back pain (LBP), according to a review published in the October issue of The Spine Journal.

Jesús Seco, M.D., Ph.D., from the University of León in Ponferrada, Spain, and colleagues reviewed available literature to July 2009 to assess the evidence for efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and a shock wave device in treating LBP. A total of 13 randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP were identified, of which four complied with the inclusion criteria and included 252 patients. Additional data were obtained from authors of original studies and the risk of bias of each study was assessed using Cochrane Back Review Group criteria.

The investigators found that ultrasound, traction, and low-power laser gave similar results for acute patients with LBP and leg pain due to disc herniation. Ultrasound was less effective than spinal manipulation in chronic LBP patients without leg pain. In these patients, a shock wave device and transcutaneous electrical nerve stimulation produced similar results. Of the three RCTs on ultrasound, two had a high risk of bias. Only one study compared ultrasound versus a sham procedure, but results were unreliable due to inappropriate sham procedure, low sample size, and no adjustment for potential confounders.

"The available trials do not demonstrate the efficacy or effectiveness of ultrasound and shock wave for treating LBP, whether acute or chronic, with or without leg pain," the authors write.

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