Eur Spine J. 2014 Jul 29. [Epub ahead of print]
Low back pain in children and adolescents: a systematic review and meta-analysis evaluating the effectiveness of conservative interventions.
Michaleff ZA1, Kamper SJ, Maher CG, Evans R, Broderick C, Henschke N.
Author information
1The George Institute for Global Health and Sydney Medical School, The University of Sydney, Kent Street, Sydney, 2000, Australia, zmichaleff@georgeinstitute.org.au.
Abstract
PURPOSE:
To identify and evaluate the effectiveness of conservative treatment approaches used in children and adolescents to manage and prevent low back pain (LBP).
METHODS:
Five electronic databases and the reference lists of systematic reviews were searched for relevant studies. Randomised controlled trials (RCTs) were considered eligible for inclusion if they enrolled a sample of children or adolescents
RESULTS:
Four RCTs on intervention and eleven RCTs on prevention of LBP were included. All included studies had a high risk of bias scoring ≤7 on the PEDro scale. For the treatment of LBP, a supervised exercise program compared to no treatment improved the average pain intensity over the past month by 2.9 points (95 % CI 1.6-4.1) measured by a 0-10 scale (2 studies; n = 125). For the prevention of LBP, there was moderate quality evidence to suggest back education and promotion programs are not effective in reducing LBP prevalence in children and adolescents.
CONCLUSIONS:
While exercise interventions appear to be promising to treat LBP in children and adolescents, there is a dearth of research data relevant to paediatric populations. Future studies conducted in children and adolescents with LBP should incorporate what has been learnt from adult LBP research and be of rigorous methodological quality.
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