Lombalgie - Lombosciatalgie
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14.
Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Chou R, Deyo R, Friedly J, Skelly A, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S. Ann Intern Med. 2017 Apr 4;166(7):480-492. doi: 10.7326/M16-2458. Epub 2017 Feb 14. PMID: 28192790.
PEER systematic review of randomized controlled trials: Management of chronic low back pain in primary care. Kolber MR, Ton J, Thomas B, Kirkwood J, Moe S, Dugré N, Chan K, Lindblad AJ, McCormack J, Garrison S, Allan GM, Korownyk CS, Craig R, Sept L, Rouble AN, Perry D. Can Fam Physician. 2021 Jan;67(1):e20-e30. doi: 10.46747/cfp.6701e20. PMID: 33483410; PMCID: PMC7822613
Prevention and treatment of low back pain: evidence, challenges, and promising directions. Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Lancet. 2018 Jun 9;391(10137):2368-2383. doi: 10.1016/S0140-6736(18)30489-6. Epub 2018 Mar 21. PMID: 29573872.
“Aide décisionnelle simplifiée de PEER : options de traitement des maux de dos chroniques en soins primaires.” Kirkwood, Jessica et al. Canadian family physician Medecin de famille canadien vol. 67,1 (2021): e15-e19. doi:10.46747/cfp.6701e15
Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials, BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1225 (Published 31 March 2015)
Conclusions: Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.
Conclusions: NSAIDs are effective for spinal pain, but the magnitude of the difference in outcomes between the intervention and placebo groups is not clinically important. At present, there are no simple analgesics that provide clinically important effects for spinal pain over placebo. There is an urgent need to develop new drug therapies for this condition.
InterpretatIon: There is moderate- to high-quality evidence that anticonvulsants are ineffective for treatment of low back pain or lumbar radicular pain. There is high-quality evidence that gabapentinoids have a higher risk for adverse events.
Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials.Shanthanna H, Gilron I, Rajarathinam M, AlAmri R, Kamath S, Thabane L, Devereaux PJ, Bhandari M. PLoS Med. 2017 Aug 15;14(8):e1002369. doi: 10.1371/journal.pmed.1002369. eCollection 2017 Aug. Review.
CONCLUSIONS AND RELEVANCE: Existing evidence on the use of gabapentinoids in CLBP is limited and demonstrates significant risk of adverse effects without any demonstrated benefit. Given the lack of efficacy, risks, and costs associated, the use of gabapentinoids for CLBP merits caution. There is need for large high-quality trials to more definitively inform this issue.
Conclusions: Treatment with pregabalin did not significantly reduce the intensity of leg pain associated with sciatica and did not significantly improve other outcomes, as compared with placebo, over the course of 8 weeks. The incidence of adverse events was significantly higher in the pregabalin group than in the placebo group.
Conclusions and relevance: Existing evidence on the use of gabapentinoids in CLBP is limited and demonstrates significant risk of adverse effects without any demonstrated benefit.
Conclusions: Among patients with acute low back pain, spinal manipulation therapy was associated with modest improvements in pain and function at up to 6 weeks, with transient minor musculoskeletal harms. However, heterogeneity in study results was large.
Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain, A Systematic Review and Meta-analysis, JAMA Intern Med. 2016;176(7):958-968. doi:10.1001/jamainternmed.2016.1251
Conclusions: In people with chronic low back pain, opioid analgesics provide short and/or intermediate pain relief, though the effect is small and not clinically important even at higher doses. Many trial patients stopped taking the medicine because they did not tolerate or respond to the medicine. There is no evidence on opioid analgesics for acute low back pain or to guide prolonged use of these medicines in the treatment of people with chronic low back pain.
Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis, A.G. Cashin et al, BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1446 (Published 08 July 2021)
Conclusions: Considerable uncertainty exists about the clinical efficacy and safety of muscle relaxants. Very low and low certainty evidence shows that non-benzodiazepine antispasmodics might provide small but not clinically important reductions in pain intensity at or before two weeks and might increase the risk of an adverse event in acute low back pain, respectively. Large, high quality, placebo controlled trials are urgently needed to resolve uncertainty.
A Randomized, Placebo-Controlled Trial of Ibuprofen Plus Metaxalone, Tizanidine, or Baclofen for Acute Low Back Pain. Friedman BW, Irizarry E, Solorzano C, Zias E, Pearlman S, Wollowitz A, Jones MP, Shah PD, Gallagher EJ. Ann Emerg Med. 2019 Apr 5. pii: S0196-0644(19)30139-8. doi: 10.1016/j.annemergmed.2019.02.017. [Epub ahead of print]
CONCLUSION: Adding baclofen, metaxalone, or tizanidine to ibuprofen does not appear to improve functioning or pain any more than placebo plus ibuprofen by 1 week after an ED visit for acute low back pain.
Conclusion: Among ED patients with acute, nontraumatic, nonradicular low back pain, naproxen+diazepam did not improve functional outcomes or pain compared with naproxen+placebo 1 week and 3 months after ED discharge.
Conclusion: Among ED patients with acute, nontraumatic, nonradicular low back pain, combining naproxen with either orphenadrine or methocarbamol did not improve functional outcomes compared with naproxen+placebo
A Prospective Observational Study of Emergency Department–Initiated Physical Therapy for Acute Low Back Pain, Howard S Kim, MD MS, Jody D Ciolino, PhD, Nicola Lancki, MPH, Kyle J Strickland, PT DPT, Daniel Pinto, PT PhD, Christine Stankiewicz, PT DPT, D Mark Courtney, MD MSCI, Bruce L Lambert, PhD, Danielle M McCarthy, MD MS, Physical Therapy, , pzaa219, https://doi-org.acces.bibl.ulaval.ca/10.1093/ptj/pzaa219