Non-Pharmacological Interventions for Middle-Aged People with Chronic Non-Specific Low Back Pain: A Systematic Review

Abstract

Non-pharmacological therapies have greater emphasis and consideration of management of chronic non-specific LBP (CNLBP) because of its safety and effectiveness without significant side effects. However, there are few studies on CLBP in the middle-aged, and the intervention effect is controversial. Objective: This review aimed to evaluate the effects of non-pharmacological therapies for management of CNLBP in the middle-aged people. Methods: Five databases namely Science Direct, Google Scholar, Pubmed, Wiley, and ProQuest Central were searched for qualitative studies published from January 2018 to December 31, 2023. The publication languages were English. Randomized controlled trials (RCTs) of non-pharmacological intervention in the middle-aged people (mean age 40-60) with CNLBP were included. Two reviewers independently extracted the data and evaluated them using the Revised Cochrane Risk of Bias Tool for Randomized Trials 2 (RoB2). The pooled effect sizes on different aspects of outcome measures were calculated. Results: Nineteen articles (19 RCTs) were included, comprising a total of 1895 participants. The quality of included studies was relatively high. The review showed that the most common outcome measurements used were pain intensity, disability, and quality of life. The most investigated interventions were from the group of exercise programs, others were multimodal intervention, manual therapy and acupuncture. Conclusion: Non-pharmacological interventions for low back pain were associated with lower pain intensity, improvement disability and better quality of life. Studies highlighted the effectiveness of exercise therapy and multimodal intervention, but there was a high heterogeneity across the studies. Hence, more high quality researches are needed in future to identify the most effective combination of multidisciplinary treatments for non-specific CLBP.