[Acute low back pain: activity, NSAID's and muscle relaxants effective; bedrest and targeted exercise not effective; results of systematic reviews].
OBJECTIVE
To inventory the current state of the art regarding the effectiveness of conservative treatment of acute low back pain.


METHODS
Systematic reviews.


METHODS
The relevant literature from the period January 1966-September 1999 was retrieved via Medline, Embase, Psychlit and the Cochrane Library and via reference lists in the articles found. The methodological quality of the studies was assessed using criteria for internal validity. On the basis of the number of examinations, their quality and the consistency of the findings, conclusions were subdivided into four levels of strength of scientific evidence.


RESULTS
Approximately two-thirds of the randomised trials in the field of back pain were of poor methodological quality. There was strong evidence that advice to stay active, non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants were effective in acute low back pain. There was also strong evidence that bed rest and specific exercises were not effective in acute low back pain. Strong evidence for effectiveness of many other commonly used interventions was lacking.
van Tulder
M W
MW
Vrije Universiteit, Instituut voor Extramuraal Geneeskundig Onderzoek, BT Amsterdam. mw.van_tulder.emgo@med.vu.nl
Koes
B W
BW
Assendelft
W J
WJ
Bouter
L M
LM
Daams
J
J
van der Laan
J R
JR
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001510:Bed Rest; D005081:Exercise Therapy; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000628:therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009465:Neuromuscular Agents