Low Back Pain: A Comprehensive Review on the Diagnosis, Treatment Options, and the Role of Other Contributing Factors

Mohamed Ali Seyed; Shahul Hameed Pakkir Mohamed

doi:10.3889/oamjms.2021.6877

Authors

Mohamed Ali Seyed Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, Kingdom of Saudi Arabia https://orcid.org/0000-0003-4469-1221
Shahul Hameed Pakkir Mohamed Department of Physical Therapy, Faculty of Applied Medical Science, University of Tabuk, Tabuk, Kingdom of Saudi Arabia

DOI:

https://doi.org/10.3889/oamjms.2021.6877

Keywords:

Low back pain, Physiotherapy, Spinal manipulation, Posture correction, Core stability, Hydrotherapy

Abstract

BACKGROUND: In recent years, low back pain (LBP) is a growing major health issue around the world and mostly addressed in primary healthcare settings. This may be due to changing work environment including the nature of long sitting work hours, especially in the booming information and technology (IT) and Business Process Outsourcing (BPO) industry. LBP is normally considered as a combination of various types of pain and its related conditions, which eventually lead to disabilities.

AIM: In this article, the aim is to discuss the current and future perspectives of LBP mainly on diagnosis and therapeutic front of LBP.

METHODS: A search was performed using electronic databases, which include PubMed Central and Google Scholar, using the related key words “back pain and low back pain.” All related peer reviewed published articles were included regardless of the language, region, or the publication date.

RESULTS: Although the management of LBP both in terms of diagnosis as well as in the therapeutic options has witnessed considerable progress but challenges are still exist not only within countries but also in the regions and continents among various medical professionals. However, in the past few years, a huge array of coordinated but randomized multi-center clinical studies were performed and various detailed insight investigations have been done, and substantial clinical guidelines have become available. Hence, a new view on evidence-based management approach for LBP has significantly improved recently and discussed here.

CONCLUSION: Based on the available evidence and literature, this comprehensive review discusses the present and future perspectives of LBP mainly on diagnosis and therapeutic front for LBP. In addition, current intervention and prevention plans have failed to lessen the considerable burden of LBP and hence several areas which require more details, which deserves additional discussion to augment us through an understanding of this very important topic on improvements of multi tasked outcomes to benefit the affected patients.

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References

Vlaeyen, JW, Maher CG, Wiech K, Zundert JV, Meloto CB, Diatchenko L, et al. Low back pain. Nat Rev Dis Primers. 2018;4(1):52. https://doi.org/10.1038/s41572-018-0052-1 PMid:30546064 DOI: https://doi.org/10.1038/s41572-018-0052-1

Refshauge KM, Maher CG. Low back pain investigations and prognosis: A review. Br J Sports Med. 2006;40(6):494-8. PMid:16720885 DOI: https://doi.org/10.1136/bjsm.2004.016659

Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101-7. PMid:24688341

Gordon R, Bloxham SA. Systematic review of the effects of exercise and physical activity on non-specific chronic low back pain. Healthcare (Basel). 2016;4(2):22. https://doi.org/10.3390/healthcare4020022 PMid:27417610 DOI: https://doi.org/10.3390/healthcare4020022

Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: Estimates from the global burden of disease study 2017. Ann Transl Med. 2020;8(6):299. https://doi.org/10.21037/atm.2020.02.175 PMid:32355743 DOI: https://doi.org/10.21037/atm.2020.02.175

Last AR, Hulbert K. Chronic low back pain: Evaluation and management. Am Fam Physician. 2019;79(12):1067-74. PMid:19530637

Kiran M, Suryawanshi SP, Gandhi N. Management of low back pain in computer users: A multidisciplinary approach. J Craniovertebr Junction Spine. 2012;3(1):7-10. https://doi.org/10.4103/0974-8237.110117 PMid:23741122 DOI: https://doi.org/10.4103/0974-8237.110117

Wong AY, Karppinen A, Samartzis D. Low back pain in older adults: Risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14. https://doi.org/10.1186/s13013-017-0121-3 PMid:28435906 DOI: https://doi.org/10.1186/s13013-017-0121-3

de Souza IM, Sakaguchi TF, Yuan SL, Matsutani LA, Espírito-Santo AS, Pereira CA, et al. Prevalence of low back pain in the elderly population: A systematic review. Clinics (Sao Paulo). 2019;74:e789. https://doi.org/10.6061/clinics/2019/e789 PMid:31664424 DOI: https://doi.org/10.6061/clinics/2019/e789

Lim YZ, Chou L, Rebecca TM, Au, KL Seneviwickrama MD, Cicuttini FM, et al. People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: A systematic review. J Physiother. 2019;65(3):124-35. https://doi.org/10.1016/j.jphys.2019.05.010 PMid:31227280 DOI: https://doi.org/10.1016/j.jphys.2019.05.010

Fares MY, Fares J, Salhab HA, Khachfe HH, Bdeir A, Fares Y. Low back pain among weightlifting adolescents and young adults. Cureus. 2020;12(7):e9127. https://doi.org/10.7759/cureus.9127 PMid:32789068 DOI: https://doi.org/10.7759/cureus.9127

Casazza BA. Diagnosis and treatment of acute low back pain. Am Fam Physician. 2012;85(4):343-50. PMid:22335313

Masic I, Miokovic M, Muhamedagic B. Evidence based medicinenew approaches and challenges. Acta Inform Med.2008;16(4):219-25. https://doi.org/10.5455/aim.2008.16.219-225 PMid:24109156 DOI: https://doi.org/10.5455/aim.2008.16.219-225

Hartvigsen J, Lings S, Leboeuf-Yde C, Bakketeig L. Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies. Occup Environ Med. 2004;61(1):e2. PMid:14691283

Omoigui S. The biochemical origin of pain: The origin of all pain is inflammation and the inflammatory response. Part 2 of 3-inflammatory profile of pain syndromes. Med Hypotheses. 2007;69(6):1169-78. https://doi.org/10.1016/j.mehy.2007.06.033 PMid:17728071 DOI: https://doi.org/10.1016/j.mehy.2007.06.033

Battié MC, Videman T, Levalahti E, Gill K, Kaprio J. Heritability of low back pain and the role of disc degeneration. Pain. 2007;131(3):272-80. https://doi.org/10.1016/j.pain.2007.01.0101 PMid:17335977 DOI: https://doi.org/10.1016/j.pain.2007.01.010

Chan D, Song Y, Sham P, Kenneth M, Cheung C. Genetics of disc degeneration. Eur Spine J. 2006;15(3):317-25. https://doi.org/10.1007/s00586-006-0171-3 PMid:16819621 DOI: https://doi.org/10.1007/s00586-006-0171-3

Amin RM, Andrade NS, Neuman BS. Lumbar disc herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-16. https://doi.org/10.1007/s12178-017-9441-4 PMid:28980275 DOI: https://doi.org/10.1007/s12178-017-9441-4

Foulkes T, Wood JN. Pain genes. PLoS Genet. 2008;4(7):e1000086. https://doi.org/10.1371/journal.pgen.1000086 PMid:18654615 DOI: https://doi.org/10.1371/journal.pgen.1000086

Solovieva S, Leino-Arjas P, Saarela J, Luoma K, Raininko R, Riihimäki H, et al. Possible association of interleukin 1 gene locus polymorphisms with low back pain. Pain. 2004;109(1-2):8-19. https://doi.org/10.1016/j.pain.2003.10.020 PMid:15082121 DOI: https://doi.org/10.1016/j.pain.2003.10.020

Solovieva S, Pehkonen I, Kausto J, Miranda H, Shiri R, Kauppinen T, et al. Development and validation of a job exposure matrix for physical risk factors in low back pain. PLoS One. 2012;7(11):e48680. https://doi.org/10.1371/journal.pone.0048680 PMid:23152793 DOI: https://doi.org/10.1371/journal.pone.0048680

Kędra A, Plandowska M, Kędra P, Czaprowski D. Non-specific low back pain: cross-sectional study of 11,423 children and youth and the association with the perception of heaviness in carrying of schoolbags. Peer J. 2021;9:e11220. https://doi.org/10.7717/peerj.11220 PMid:33986989 DOI: https://doi.org/10.7717/peerj.11220

Verkerk K, Luijsterburg PA, Miedema HS, Pool-Goudzwaard A, Koes BW. Prognostic factors for recovery in chronic nonspecific low back pain: A systematic review. Phys Ther. 2012;92(9):1093-108. https://doi.org/10.2522/ptj.20110388 PMid:22595238 DOI: https://doi.org/10.2522/ptj.20110388

Wang L, Yin Z, Zhang Y, Sun M, Yu Y, Lin Y, et al. Optimal acupuncture methods for nonspecific low back pain: A systematic review and bayesian network meta-analysis of randomized controlled trials. J Pain Res. 2021;14:1097-112. https://doi.org/10.2147/jpr.s310385 PMid:33907457 DOI: https://doi.org/10.2147/JPR.S310385

van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW, et al. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010;24(2):193-204. https://doi.org/10.1016/j.berh.2010.01.002 PMid:20227641 DOI: https://doi.org/10.1016/j.berh.2010.01.002

Macedo LG, Bostick GP, Maher CG. Exercise for prevention of recurrences of nonspecific low back pain. Phys Ther. 2013;93(12):1587-91. https://doi.org/10.2522/ptj.20120464 PMid:23813085 DOI: https://doi.org/10.2522/ptj.20120464

Chung JW, Zeng Y, Wong TK. Drug therapy for the treatment of chronic nonspecific low back pain: Systematic review and meta-analysis. Pain Physician. 2013;16(6):E685-704. https://doi.org/10.36076/ppj.2013/16/e685 PMid:24284847 DOI: https://doi.org/10.36076/ppj.2013/16/E685

Jean-François C, Bernhard G, Bernd K, Frank P, Michael P, Susanne GS, et al. Non-specific low back pain. Dtsch Arztebl Int. 2017;114(51-52):883-90. PMid:29321099

Chang CG, Candido KD, Knezevic NN. Digital subtraction angiography does not reliably prevent paraplegia associated with lumbar transforaminal epidural steroid injection. Pain Physician. 2012;15(6):515-23. https://doi.org/10.36076/ppj.2012/15/515 PMid:23159970 DOI: https://doi.org/10.36076/ppj.2012/15/515

Almeida DC, Kraychete DC. Low back pain-a diagnostic approach. Rev Dor. 2017;18(2):173-7. https://doi.org/10.5935/1806-0013.20170034 DOI: https://doi.org/10.5935/1806-0013.20170034

AlMazrou SH, Elliott RA, Knaggs RD, AlAujan SS. Costeffectiveness of pain management services for chronic low back pain: A systematic review of published studies. BMC Health Serv Res. 2020;20(1):194. https://doi.org/10.1186/s12913-020-5013-1 PMid:32164720 DOI: https://doi.org/10.1186/s12913-020-5013-1

Dale R, Stacey B. Multimodal treatment of chronic pain. Med Clin North Am. 2016;100(1):55-64. https://doi.org/10.1016/j.mcna.2015.08.012 PMid:26614719 DOI: https://doi.org/10.1016/j.mcna.2015.08.012

Arnold JJ, Ehleringer SR. Is spinal manipulation an effective treatment for low back pain? Yes: evidence shows benefit in most patients. Am Fam Physician. 2012;85(8):756-8. PMid:22534384

Gibbons P, Tehan P. Patient positioning and spinal locking for lumbar spine rotation manipulation. Manual Ther. 2001;6(3):130-8. https://doi.org/10.1054/math.2001.0404 PMid:11527452 DOI: https://doi.org/10.1054/math.2001.0404

Rubinstein S, Middelkoop M, Assendelft W, Boer M, Tulder M. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: A systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:1689. https://doi.org/10.1136/bmj.l689 PMid:30867144 DOI: https://doi.org/10.1136/bmj.l689

Pickar J. Neurophysiological effects of spinal manipulation. Spine J. 2002;2(5):357-71. PMid:14589467 DOI: https://doi.org/10.1016/S1529-9430(02)00400-X

Williams N, Hendry M, Lews R, Russel I, Westmoreland A, Wilkinson C, et al. Psychological response in spinal manipulation (PRISM): A systematic review of psychological outcomes in randomised controlled trials. Complement Ther Med. 2007;15(4):271-83. https://doi.org/10.1016/j.ctim.2007.01.008 PMid:18054729 DOI: https://doi.org/10.1016/j.ctim.2007.01.008

Gera C, Malik M, Kaur J, Saini M. A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses. Hong Kong Physiother J. 2020;40(2):75-87. https://doi.org/10.1142/s1013702520500122 PMid:33005072 DOI: https://doi.org/10.1142/S1013702520500122

Honore M, Leboeuf-Yd C, Gagey O. The regional effects of spinal manipulation on the pressure pain threshold in asymptomatic subjects: A systematic review. Chiropractic Manuel Ther. 2018;26:11. https://doi.org/10.1186/s12998-018-0181-3 PMid:29713457 DOI: https://doi.org/10.1186/s12998-018-0181-3

Coronado R, Gay C, Bialosky J, Carnaby G, Bishop M, George S, et al. Changes in Pain sensitivity following spinal manipulation: A systematic review and meta-analysis. J Electromyograph Kinesiol. 2012;22(5):752-67. https://doi.org/10.1016/j.jelekin.2011.12.013 PMid:22296867 DOI: https://doi.org/10.1016/j.jelekin.2011.12.013

Coutaux A. Non-pharmacological treatments for pain relief: TENS and acupuncture. Joint Bone Spine. 2017;84(6):657-61. https://doi.org/10.1016/j.jbspin.2017.02.005 PMid:28219657 DOI: https://doi.org/10.1016/j.jbspin.2017.02.005

Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-analysis: Acupuncture for low back pain. Ann Int Med. 2005;142(8):651-63. https://doi.org/10.7326/0003-4819-142-8-200504190-00014 PMid:15838072 DOI: https://doi.org/10.7326/0003-4819-142-8-200504190-00014

Chliessbach J, Klift EV, Arendt-Nielsen L, Curatolo M, Streitberger K. The effect of brief electrical and manual acupuncture stimulation on mechanical experimental pain. Pain. 2011;12(2):278-75. https://doi.org/10.1111/j.1526-4637.2010.01051.x PMid:21276188 DOI: https://doi.org/10.1111/j.1526-4637.2010.01051.x

Li X, Wang R, Shi X, Su J, Pan Y, Tian J, et al. Reporting characteristics and quality of systematic reviews of acupuncture analgesia. Pain Pract. 2017;17(8):1066-74. https://doi.org/10.1111/papr.12555 PMid:28083991 DOI: https://doi.org/10.1111/papr.12555

Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: An overview of systematic reviews. Evid Base Complement Alternat Med. 2015;2015:328196. https://doi.org/10.1155/2015/328196 PMid:25821485 DOI: https://doi.org/10.1155/2015/328196

Langevin HM, Schnyer R, MacPherson H, Davis R, Harris RE, Napadow V, et al. Manual and electrical needle stimulation in acupuncture research: Pitfalls and challenges of heterogeneity. J Altern Complement Med. 2015;21(3):113-28. https://doi.org/10.1089/acm.2014.0186 PMid:25710206 DOI: https://doi.org/10.1089/acm.2014.0186

Kwon Y, Kang M, Son S, Kim J, Lee Y, Han H, et al. Different frequencies of electroacupuncture modified the cellular activity of serotonergic neurons in brainstem. Am J Chin Med. 2000;28(3-4):435-41. https://doi.org/10.1142/s0192415x00000519 PMid:11154058 DOI: https://doi.org/10.1142/S0192415X00000519

Han Z, Jiang Y, Wan Y, Wang Y, Chang JK, Han J. Endomorphin-1 mediates 2 Hz but not 100 Hz electroacupuncture analgesia in the rat. Neurosci Lett. 1999;274:75-8. https://doi.org/10.1016/s0304-3940(99)00670-9 PMid:10553941 DOI: https://doi.org/10.1016/S0304-3940(99)00670-9

Janke EA, Collins A, Kozak AT. Overview of the relationship between pain and obesity: What do we know? Where do we go next? J Rehabil Res Dev. 2007;44(2):245-62. https://doi.org/10.1682/jrrd.2006.06.0060 PMid:17551876 DOI: https://doi.org/10.1682/JRRD.2006.06.0060

Brox JI, Storheim K, Holm I, Friis A, Reikerås O. Disability, pain, psychological factors and physical performance in healthy controls, patients with sub-acute and chronic low back pain: A case-control study. J Rehabil Med. 2005;37(2):95-9. https://doi.org/10.1080/16501970410017738 PMid:15788344 DOI: https://doi.org/10.1080/16501970410017738

Teichtahl AJ, Urquhart DM, Wang Y, Wluka AE, O’Sullivan R, Jones G, et al. Physical inactivity is associated with narrower lumbar intervertebral discs, high fat content of paraspinal muscles and low back pain and disability. Arthritis Res Ther. 2015;17(1):114. https://doi.org/10.1186/s13075-015-0629-y PMid:25947906 DOI: https://doi.org/10.1186/s13075-015-0629-y

Steele J, Bruce-Low S, Smith D. A reappraisal of the deconditioning hypothesis in low back pain: Review of evidence from a triumvirate of research methods on specific lumbar extensor deconditioning. Curr Med Res Opin. 2014;30(5):865-911. https://doi.org/10.1185/03007995.2013.875465 PMid:24328452 DOI: https://doi.org/10.1185/03007995.2013.875465

McCaskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck-and low back pain rehabilitation: A systematic literature review. BMC Musculoskelet Disord. 2014;15:382. https://doi.org/10.1186/1471-2474-15-382 PMid:25409985 DOI: https://doi.org/10.1186/1471-2474-15-382

Hidalgo B, Detrembleur C, Hall T, Mahaudens P, Nielens H. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: An update of systematic reviews. J Man Manip Ther. 2014;22(2):59-74. https://doi.org/10.1179/2042618613y.0000000041 PMid:24976749 DOI: https://doi.org/10.1179/2042618613Y.0000000041

Standaert CJ, Friedly J, Erwin MW, Lee MJ, Rechtine G, Henrikson NB, et al. Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain. Spine. 2011;36(21):S120-30. https://doi.org/10.1097/brs.0b013e31822ef878 PMid:21952184 DOI: https://doi.org/10.1097/BRS.0b013e31822ef878

van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic nonspecific low back pain. Eur Spine J. 2011;20(1):19- 39. https://doi.org/10.1007/s00586-010-1518-3 PMid:20640863 DOI: https://doi.org/10.1007/s00586-010-1518-3

Chambers H. Physiotherapy and lumbar facet joint injections as a combination treatment for chronic low back pain. A narrative review of lumbar facet joint injections, lumbar spinal mobilizations, soft tissue massage and lower back mobility exercises. Musculoskeletal Care. 2013;11(2):106-20. https://doi.org/10.1002/msc.1045 PMid:23468052 DOI: https://doi.org/10.1002/msc.1045

Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, et al. Complementary and alternative therapies for back pain II. Evid Rep Technol Assess. 2010;194:1-764.

Zdziarski LA, Wasser JG, Vincent HK. Chronic pain management in the obese patient: A focused review of key challenges and potential exercise solutions. J Pain Res. 2015;8:63-77. https://doi.org/10.2147/jpr.s55360 PMid:25709495 DOI: https://doi.org/10.2147/JPR.S55360

Vincent HK, George SZ, Seay AN, Vincent KR, Hurley RW. Resistance exercise, disability, and pain catastrophizing in obese adults with back pain. Med Sci Sports Exerc. 2014;46:1693-701. https://doi.org/10.1249/mss.0000000000000294 PMid:25133997 DOI: https://doi.org/10.1249/MSS.0000000000000294

Palstam A, Larsson A, Löfgren M, Ernberg M, Bjersing J, Bileviciute-Ljungar I, et al. Decrease of fear avoidance beliefs following person-centered progressive resistance exercise contributes to reduced pain disability in women with fibromyalgia: Secondary exploratory analyses from a randomized controlled trial. Arthritis Res Ther. 2016;18(1):116. https://doi.org/10.1186/s13075-016-1007-0 PMid:27209068 DOI: https://doi.org/10.1186/s13075-016-1007-0

Valencia WM, Stoutenberg M, Florez H. Weight loss and physical activity for disease prevention in obese older adults: An important role for lifestyle management. Curr Diab Rep. 2014;14(10):539. https://doi.org/10.1007/s11892-014-0539-4 PMid:25183491 DOI: https://doi.org/10.1007/s11892-014-0539-4

Baena-Beato PÁ, Artero EG, Arroyo-Morales M, Robles-Fuentes A, Gatto-Cardia MC, Delgado-Fernández M. Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back 478 pain. A controlled clinical trial. Clin Rehabil. 2014;28(4):350-60. https://doi.org/10.1177/0269215513504943 PMid:24177712 DOI: https://doi.org/10.1177/0269215513504943

Kell RT, Asmundson GJ. A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res Natl Strength Cond Assoc. 2009;23(2):513-23. https://doi.org/10.1519/jsc.0b013e3181918a6e PMid:19209082 DOI: https://doi.org/10.1519/JSC.0b013e3181918a6e

Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344(5):363-70. PMid:11172169 DOI: https://doi.org/10.1056/NEJM200102013440508

Chou R. In the clinic Low back pain. Ann Intern Med. 2014;160(11):ITC6-1. https://doi.org/10.7326/0003-4819-160-11-201406030-01006 PMid:25009837 DOI: https://doi.org/10.7326/0003-4819-160-11-201406030-01006

Roelofs PD, Deyo RA, Koes BW, Scholten RJ, van Tulder MW. Non-steroidal anti-inflammatory drugs for low back pain. Cochrane Database Syst Rev. 2008;1:CD000396. https://doi.org/10.1002/14651858.cd000396.pub3 PMid:18253976 DOI: https://doi.org/10.1002/14651858.CD000396.pub3

Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, et al. Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American college of physicians and the American pain society. Ann Intern Med. 2007;147(7):478. https://doi.org/10.7326/0003-4819-147-7-200710020-00006 PMid:17909209 DOI: https://doi.org/10.7326/0003-4819-147-7-200710020-00006

van Tulder M, Becker A, Bekkering T, Breen A, Gil del Real MT, Hutchinson A, et al. Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2016;15(2):s169-91. https://doi.org/10.1007/s00586-006-1071-2 PMid:16550447 DOI: https://doi.org/10.1007/s00586-006-1071-2

Pereira S, Power C. Sedentary behaviours in mid-adulthood and subsequent body mass index. PLoS One. 2013 https://doi.org/10.1371/journal.pone.0065791 PMid:23762427 DOI: https://doi.org/10.1371/journal.pone.0065791

Aissaoui R, Lacoste M, Dansereau J. Analysis of sliding and pressure distribution during a repositioning of persons in a simulator chair. IEEE Trans Neural Sys Rehabil Eng. 2001;9(2):215-24. https://doi.org/10.1109/7333.928581 PMid:11474974 DOI: https://doi.org/10.1109/7333.928581

Schneider R. Pantograph for tilting trains. In: IEEE Current Collections for High-Speed Trains Seminar. United States: IEEE; 1998. https://doi.org/10.1049/ic:19981001 DOI: https://doi.org/10.1049/ic:19981001

Neville L. The Fundamental Principles of Seating and Positioning in Children and Young People with Physical Disabilities. Coleraine: University of Ulster; 2005.

Seperson S. Elder Care and Service Learning: A Handbook. Charlotte: Information Age Publishing; 2008.

Browder DA, Childs JD, Cleland JA, Fritz JM. Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: A randomized clinical trial. Phys Ther. 2007;87(12):1608-18. https://doi.org/10.2522/ptj.20060297 PMid:17895350 DOI: https://doi.org/10.2522/ptj.20060297

Nelson-Wong E, Howarth S, Callaghan J. Acute biomechanical responses to a prolonged standing exposure in a simulated occupational setting. Ergonomics. 2010;53(9):1117-28. https://doi.org/10.1080/00140139.2010.500400 PMid:20737337 DOI: https://doi.org/10.1080/00140139.2010.500400

Rahim AH, Omar AR, Halim I, Saman AM, Alina M, Othman I, et al. Analysis of muscle fatigue associated with prolonged standing tasks in manufacturing industry. In: International Conference on Science and Social Research (CSSR). Malaysia: Kuala Lumpur; 2010. p. 711-6. https://doi.org/10.1109/cssr.2010.5773875 DOI: https://doi.org/10.1109/CSSR.2010.5773875

Zander JE, King PM, Ezenwa BN. Influence of flooring conditions on lower leg volume following prolonged standing. Int J Ind Ergonom. 2004;34(4):279-88. https://doi.org/10.1016/j.ergon.2004.04.014 DOI: https://doi.org/10.1016/j.ergon.2004.04.014

Garcìa AN, Costa L, Hancock MJ, de Souza FS, de Oliveira Gomes GV, de Almeida MO, et al. McKenzie method of mechanical diagnosis and therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain: A randomised placebocontrolled trial with short-and longer-term follow-up. Br J Sports Med. 2018;52(9):594-600. https://doi.org/10.1136/bjsports-2016-097327 PMid:28701365 DOI: https://doi.org/10.1136/bjsports-2016-097327

Korovessis P, Stamatakis M, Baikousis A, Korovessis P. Segmental roentgenographic analysis of vertebral inclination on sagittal plane in asymptomatic vs chronic low back pain patients. J Spinal Disord. 1998;12(2):131-7. https://doi.org/10.1097/00002517-199904000-00009 DOI: https://doi.org/10.1097/00002517-199904000-00009

Qaseem A, Wilt TJ, McLean RM. Non-invasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American college of physicians. Ann Intern Med. 2017;166(7):514-30. https://doi.org/10.7326/m16-2367 PMid:28192789 DOI: https://doi.org/10.7326/M16-2367

National Institute for Health and Care Excellence. Clinical Guidelines. Low Back Pain and Sciatica in Over 16s: Assessment and Management. National Guideline Centre (UK). London: National Institute for Health and Care Excellence; 2016. https://doi.org/10.1093/ww/9780199540884.013.u13729 DOI: https://doi.org/10.1093/ww/9780199540884.013.U13729

Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou SJ, Liu J, et al. A metaanalysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. https://doi.org/10.1371/journal.pone.0052082 PMid:23284879 DOI: https://doi.org/10.1371/journal.pone.0052082

Searle A, Spink M, Ho A, Chuter V. Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomised controlled trials. Clin Rehabil. 2015;29(12):1155-67. https://doi.org/10.1177/0269215515570379 PMid:25681408 DOI: https://doi.org/10.1177/0269215515570379

Jeong UC, Sim JH, Kim CY, Hwang-Bo G, Nam CW. The effect of

gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. J Phys Ther Sci. 2015;27(12):3813-6. https://doi.org/10.1589/jpts.27.3813 PMid:26834359 DOI: https://doi.org/10.1589/jpts.27.3813

Ferreira ML, Ferreira PH, Latimer J, Herbert RD, Hodges PW, Jennings MD, et al. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial. Pain. 2007;131(1-2):31-7. https://doi.org/10.1016/j.pain.2006.12.008 PMid:17250965 DOI: https://doi.org/10.1016/j.pain.2006.12.008

Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord. 1992;5(4):383-9. https://doi.org/10.1097/00002517-199212000-00001 PMid:1490034 DOI: https://doi.org/10.1097/00002517-199212000-00001

van Dieen JH, Cholewicki J, Radebold A. Trunk muscle recruitment patterns in patients with low back pain enhance the stability of the lumbar spine. Spine. 2003;28(8):834-41. https://doi.org/10.1097/01.brs.0000058939.51147.55 PMid:12698129 DOI: https://doi.org/10.1097/01.BRS.0000058939.51147.55

Ferreira G, Costa LM, Stein A, Hartvigsen J, Buchbinder R, Maher CG. Tackling low back pain in Brazil: A wake-up call. Braz J Phys Ther. 2019;23(3):189-95. https://doi.org/10.1016/j.bjpt.2018.10.001 PMid:30337255 DOI: https://doi.org/10.1016/j.bjpt.2018.10.001

Coste J, Venot A. An epidemiologic approach to drug prescribing quality assessment: A study in primary care practice inFrance. Med Care. 1999;37(12):1294-307. https://doi.org/10.1097/00005650-199912000-00012 PMid:10599610 DOI: https://doi.org/10.1097/00005650-199912000-00012

Cherkin DC, Wheeler KJ, Barlow W, Deyo RA. Medication use for low back pain in primary care. Spine (Phila Pa 1976). 1998;23(5):607-14. https://doi.org/10.1097/00007632-199803010-00015 PMid:9530793 DOI: https://doi.org/10.1097/00007632-199803010-00015

Khadilkar A, Milne S, Brosseau L, Wells G, Tugwell P, Robinson V, et al. Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: A systematic review. Spine (Phila Pa 1976). 2005;30(23):2657-66. https://doi.org/10.1097/01.brs.0000188189.21202.0f PMid:16319752 DOI: https://doi.org/10.1097/01.brs.0000188189.21202.0f

French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. A cochrane review of superficial heat or cold for low back pain. Spine (Phila Pa 1976). 2003;31(9):998-1006. https://doi.org/10.1097/01.brs.0000214881.10814.64 PMid:16641776 DOI: https://doi.org/10.1097/01.brs.0000214881.10814.64

Levin MF, Hui-Chan CW. Conventional and acupuncturelike transcutaneous electrical nerve stimulation excite similar afferent fibers. Arch Phys Med Rehabil. 1993;74(1):54-60. PMid:8420521

Radhakrishnan R, Sluka KA. Deep tissue afferents, but not cutaneous afferents, mediate transcutaneous electrical nerve stimulation-induced anti-hyperalgesia. J Pain. 2005;6(10):673-80. https://doi.org/10.1016/j.jpain.2005.06.001 PMid:16202960 DOI: https://doi.org/10.1016/j.jpain.2005.06.001

Graven-Nielsen T, Arendt-Nielsen L. Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat Rev Rheumatol. 2010;6(10):599-606. https://doi.org/10.1038/nrrheum.2010.107 PMid:20664523 DOI: https://doi.org/10.1038/nrrheum.2010.107

O’Neill S, Manniche C, Graven-Nielsen T, Arendt-Nielsen L. Generalized deep-tissue hyperalgesia in patients with chronic low-back pain. Eur J Pain. 2007;11(4):415-20. https://doi.org/10.1016/j.ejpain.2006.05.009 PMid:16815054 DOI: https://doi.org/10.1016/j.ejpain.2006.05.009

Jarzem PF, Harvey EJ, Arcaro N, Kaczorowski J. Transcutaneous electrical nerve stimulation [TENS] for chronic low back pain. J Musculoskelet Pain. 2005;13(2):3-9. https://doi.org/10.1300/j094v13n02_02 DOI: https://doi.org/10.1300/J094v13n02_02

Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1995;150(3699):971-7. PMid:5320816 DOI: https://doi.org/10.1126/science.150.3699.971

Hughes GS Jr., Lichstein PR, Whitlock D, Harker C. Response of plasma beta-endorphins to transcutaneous electrical nerve stimulation in healthy subjects. Phys Ther. 1984;64(7):1062-6. https://doi.org/10.1093/ptj/64.7.1062 PMid:6330773 DOI: https://doi.org/10.1093/ptj/64.7.1062

Mckenzie R. The Lumbar Spine Mechanical Diagnosis and Therapy. 2nd ed., Vol. 1. Paraparaumu, New Zealand: Spinal Publications New Zealand Ltd.; 2003.

Levangie PK, Norkin CC. Joint Structure and Function. 5th ed. Philadelphia, PA: FA Davis; 2011.

Chaitow L. Hydrotherapy. Water Therapy for Health and Beauty. Boston, MA: Element Books; 1996.

Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V. Clinical effectiveness of aquatic exercise to treat chronic low back pain. Spine. 2009;34(14):1436-40. https://doi.org/10.1097/brs.0b013e3181a79618 PMid:19525833 DOI: https://doi.org/10.1097/BRS.0b013e3181a79618

Geytenbeek J. Evidence for effective hydrotherapy. Physiotherapy. 2005;88(9):514-29. https://doi.org/10.1016/s0031-9406(05)60134-4 DOI: https://doi.org/10.1016/S0031-9406(05)60134-4

Ariyoshi M, Sonoda K, Nagata K, Mashima T, Zenmyo M, Paku C, et al. Efficacy of aquatic exercises for patients with low-back pain. The Kurume Med J. 1998;46(2):91-6. https://doi.org/10.2739/kurumemedj.46.91 PMid:10410527 DOI: https://doi.org/10.2739/kurumemedj.46.91

Castro-Sanchez AM, Guillermo A, Lara-Palomo I, Saavedra-Hernández M, Arroyo-Morales M, Moreno-Lorenzo C. Hydrotherapy for the treatment of pain in people with multiple sclerosis: A randomized controlled trial. Evid Based Complement Alternat Med. 2012;2014:473963. DOI: https://doi.org/10.1155/2012/473963

Camilotti BM, Rodacki AL, Israel VL, Fowler NE. Stature recovery after sitting on land and in water. Man Ther. 2009;14(6):685-9. https://doi.org/10.1016/j.math.2009.03.007 PMid:19467912 DOI: https://doi.org/10.1016/j.math.2009.03.007

Skelton DA, Dinan SM. Exercise for falls management: Rationale for an exercise programme aimed at reducing postural instability. Physiother Theor Pract. 1999;15(2):105-20. https://doi.org/10.1080/095939899307801 DOI: https://doi.org/10.1080/095939899307801

Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48(4):297-302. https://doi.org/10.1016/s0004-9514(14)60169-0 PMid:12443524 DOI: https://doi.org/10.1016/S0004-9514(14)60169-0

Oliveira RF, Fandim JV, Fioratti I, Fernandes LG, Saragiotto BT, Costa LO. The contemporary management of nonspecific lower back pain. Pain Manage. 2019;9(5):475-82. https://doi.org/10.2217/pmt-2019-0016 PMid:31452452 DOI: https://doi.org/10.2217/pmt-2019-0016

Padayachy K, Vawda HM, Shaik J, McCarthy PW. The immediate effect of low back manipulation on serum cortisol levels in adult males with mechanical low back pain. Clin Chiropractic. 2010;13(4):246-52. https://doi.org/10.1016/j.clch.2010.05.002 DOI: https://doi.org/10.1016/j.clch.2010.05.002

Eichler J, Rachinger-Adam B, Kraft E, Azad SC. Efficacy of biofeedback in patients with chronic low back pain: Impact on pain intensity, psychological factors and stress markers. Schmerz. 2019;33(6):539-48. https://doi.org/10.1007/s00482-019-0393-z PMid:31346772 DOI: https://doi.org/10.1007/s00482-019-0393-z

Castro JB, Lima VP, Santos AO, Da Silva GC, De Oliveira JG, Da Silva JN, et al. Correlation analysis between biochemical markers, pain perception, low back functional disability, and muscle strength in postmenopausal women with low back pain. J Phys Educ Sport. 2020;20(1):24-30.

Paungmali A, Joseph LH, Punturee K, Sitilertpisan P, Pirunsan U, Uthaikhup S. Immediate effects of core stabilization exercise on β-endorphin and cortisol levels among patients with chronic nonspecific low back pain: A randomized crossover design. J. Manipulative Physiol. Ther. 2018;41(3):181-8. https://doi.org/10.1016/j.jmpt.2018.01.002 PMid:29459120 DOI: https://doi.org/10.1016/j.jmpt.2018.01.002

Sugano A, Nomura T. Influence of water exercise and land stretching on salivary cortisol concentrations and anxiety in chronic low back pain patients. J Physiol Anthropol Appl Hum Sci. 2000;19(4):175-80. https://doi.org/10.2114/jpa.19.175 PMid:11037691 DOI: https://doi.org/10.2114/jpa.19.175

Cho HK, Moon W, Kim J. Effects of yoga on stress and inflammatory factors in patients with chronic low back pain: A non-randomized controlled study. Eur J Integr Med. 2015;7(2):118-23. https://doi.org/10.1016/j.eujim.2014.10.008 DOI: https://doi.org/10.1016/j.eujim.2014.10.008

Coelho CM, Lessa TT, Carvalho RM, Coelho LA, da Silva Scari R, da Silva Fernandes N, et al. Quality of life in female practitioners of Hatha Yoga. Motriz Rev Ed Fisica. 2011;17(1):33-8. DOI: https://doi.org/10.5016/1980-6574.2011v17n1p33

Tekur P, Chametcha S, Hongasandra RN, Raghuram N. Effect of yoga on quality of life of CLBP patients: A randomized control study. Int J Yoga. 2010;3(1):10-7. https://doi.org/10.4103/0973-6131.66773 PMid:20948896 DOI: https://doi.org/10.4103/0973-6131.66773

Haldavnekar RV, Tekur P, Nagarathna R, Nagendra HR. Effect of yogic colon cleansing (laghu sankhaprakshalana kriya) on pain, spinal flexibility, disability and state anxiety in chronic low back pain. Int J Yoga. 2014;7(2):111-9. https://doi.org/10.4103/0973-6131.133884 PMid:25035620 DOI: https://doi.org/10.4103/0973-6131.133884

Chatzitheodorou D, Kabitsis C, Malliou P, Mougios V. A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain. Phys Ther. 2007;87(3):304-12. https://doi.org/10.2522/ptj.20060080 PMid:17284546 DOI: https://doi.org/10.2522/ptj.20060080

Bicici S, Karatas N, Baltaci G. Effect of athletic taping and kinesiotaping® on measurements of functional performance in basketball players with chronic inversion ankle sprains. Int J Sports Phys Ther. 2012;7(2):154-66. PMid:22530190

Paoloni M, Bernetti A, Fratocchi G, Mangone M, Parrinello L, Del Pilar Cooper M, et al. Kinesio taping applied to lumbar muscles influences clinical and electromyographic characteristics in chronic low back pain patients. Eur J Phys Rehabil Med. 2011;47(2):237-44. PMid:21430611

DeLeo JA. Basic science of pain. J Bone Joint Surg Am. 2006;88(2):58-62. PMid:16595445 DOI: https://doi.org/10.2106/JBJS.E.01286

Kelle B, Güzel R, Sakallı H. The effect of Kinesio taping application for acute non-specific low back pain: A randomized controlled clinical trial. Clin Rehabil. 2016;30(10):997-1003. https://doi.org/10.1177/0269215515603218 PMid:26316553 DOI: https://doi.org/10.1177/0269215515603218

Castro-Sánchez AM, Lara-Palomo IC, Matarán-Peñarrocha GA, Fernández-Sánchez M, Sánchez-Labraca N, Arroyo- Morales M. Kinesio Taping reduces disability and pain slightly in chronic non-specific low back pain: A randomised trial. J Physiother. 2011;58(2):89-95. https://doi.org/10.1016/s1836-9553(12)70088-7 PMid:22613238 DOI: https://doi.org/10.1016/S1836-9553(12)70088-7

Hwang-Bo G, Lee JH. Effects of kinesio taping in a physical therapist with acute low back pain due to patient handling: A case report. Int J Occup Med Environ Health. 2011;24(3):320-3. https://doi.org/10.2478/s13382-011-0029-8 PMid:21845524 DOI: https://doi.org/10.2478/s13382-011-0029-8

Inanoglu D, Baltacı G. Effects of different taping techniques on quality of life and pain in low back pain patients without any neurological deficits. J Exerc Ther Rehabil. 2014;1(1):26-34.

Kase K, Tatsuyuki H, Tomoko O. Development of kinesio tape. Kinesio taping perfect manual. Kinesio Taping Assoc. 1996;6:117-8.

Yoshida A, Kahanov L. The effect of kinesio taping on lower trunk range of motions. Res Sports Med. 2007;15(2):103-12. https://doi.org/10.1080/15438620701405206 PMid:17578750 DOI: https://doi.org/10.1080/15438620701405206

AlBahel F, Hafez RA, Zakaria RA, Al-Ahaideb A, Buragadda S, Melam RG. Kinesio taping for the treatment of mechanical low back pain. World Appl Sci J. 2013;22(1):78-84.

Hagen L, Hebert JJ, Dekanich J, Koppenhaver S. The effect of elastic therapeutic taping on back extensor muscle endurance in patients with low back pain: A randomized, controlled, crossover trial. J Orthop Sports Phys Ther. 2015;45(3):215-9. https://doi.org/10.2519/jospt.2015.5177 PMid:25679343 DOI: https://doi.org/10.2519/jospt.2015.5177

Castro-Mendez A, Munuera PV, Albornoz-Cabello M. The short-term effect of custom-made foot orthoses in subjects with excessive foot pronation and lower back pain: A randomized, double-blinded, clinical trial. Prosthet Orthot Int. 2013;37(5):384-90. https://doi.org/10.1177/0309364612471370 PMid:23327838 DOI: https://doi.org/10.1177/0309364612471370

Almeida J, Pastre C, Padovani C, Martins R. Comparison of plantar pressure and musculoskeletal symptoms with the use of custom and prefabricated insoles in the work environment. Rev Bras Fisioter. 2009;13:542-8. DOI: https://doi.org/10.1590/S1413-35552009005000063

Park K, Kim Y, Chung Y, Hwang S. Effects of the height of shoe heels on muscle activation of cervical and lumbar spine in healthy women. J Phys Ther Sci. 2016;28(3):956-9. https://doi.org/10.1589/jpts.28.956 PMid:27134392 DOI: https://doi.org/10.1589/jpts.28.956

Sun D, Gu Y, Mei Q, Shao Y, Sun J, Fernandez J. Effect of heel heights on female postural control during standing on a dynamic support surface with sinusoidal oscillations. J Mot Behav. 2017;49(3):281-7. https://doi.org/10.1080/00222895.2016.1191423 PMid:27588676 DOI: https://doi.org/10.1080/00222895.2016.1191423