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Papers of the Week


Papers: 27 Mar 2021 - 2 Apr 2021

RESEARCH TYPE:
Psychology


2021 Mar 24


Pain

Effectiveness of placebo interventions for patients with non-specific low back pain: a systematic review.

Authors

Wilhelmus Strijkers R H, Schreijenberg M, Gerger H, Koes BW, Chiarotto A
Pain. 2021 Mar 24.
PMID: 33769366.

Abstract

Little is known about the effectiveness of placebo interventions in patients with non-specific low back pain (LBP). This systematic review assessed the magnitude of the effects of placebo interventions as compared to no intervention in randomized controlled trials(RCTs) including patients with LBP. Embase, Medline(Ovid) and Cochrane CENTRAL databases were searched from inception to December 5th, 2019. RCTs comparing placebo intervention versus no intervention in adult patients with non-specific LBP were included. Pain intensity, physical functioning and health-related quality of life (hrQoL) measured at short-, medium- and long-term follow-up were the outcomes of this review. Twenty-one RCTs were included; one concerning acute LBP and one sub-acute LBP, while 19 studies reported on chronic LBP. In chronic LBP, placebo interventions were more effective than no intervention at short-term for pain intensity [standardized mean difference (SMD) = -0.37, 95% CI = -0.55 to -0.18, moderate quality evidence], physical functioning (SMD -0.19, 95% CI = -0.39 to 0.01, moderate quality evidence), and physical quality of life (Mean Difference = -2.71, 95% CI = -4.71 to 0.71, high quality evidence), respectively. These effects were not significant at medium-term follow-up and no data was available at long-term follow-up. These results show placebo interventions are more effective than no intervention at short-term in patients with chronic LBP. However, the magnitude of the effects is probably not clinically relevant (approximately 8 points on a 0-100 pain scale). Future research should identify effect modifiers and causal mechanisms explaining the short-term effects of placebo interventions in patients with chronic LBP. (PROSPERO Registration number CRD42019127465).