Spinal manipulation therapy for low back pain: a meta-analysis of effectiveness relative to other therapies

Article Abstract:

Background: Low back pain is a costly illness for which spinal manipulative therapy is commonly recommended. Previous systematic reviews and practice guidelines have reached discordant results on the effectiveness of this therapy for low back pain. Purpose: To resolve the discrepancies related to use of spinal manipulative therapy and to update previous estimates of effectiveness by comparing spinal manipulative therapy with other therapies and then incorporating data from recent high-quality randomized, controlled trials (RCTs) into the analysis. Data Sources: MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trials Register, and previous systematic reviews. Study Selection: Randomized, controlled trials of patients with low back pain that evaluated spinal manipulative therapy with at least 1 day of follow-up and at least one clinically relevant outcome measure. Data Extraction: Two authors, who served as the reviewers for all stages of the meta-analysis, independently extracted data from unmasked articles. Comparison treatments were classified into the following seven categories: sham, conventional general practitioner care, analgesics, physical therapy, exercises, back school, or a collection of therapies judged to be ineffective or even harmful (traction, corset, bed rest, home care, topical gel, no treatment, diathermy, and minimal massage). Data Synthesis: Thirty-nine RCTs were identified. Meta-regression models were developed for acute or chronic pain and short-term and long-term pain and function. For patients with acute low back pain, spinal manipulative therapy was superior only to sham therapy (10-mm difference [95% CI, 2 to 17 mm] on a 100-mm visual analogue scale) or therapies judged to be ineffective or even harmful. Spinal manipulative therapy had no statistically or clinically significant advantage over general practitioner care, analgesics, physical therapy, exercises, or back school. Results for patients with chronic low back pain were similar. Radiation of pain, study quality, profession of manipulator, and use of manipulation alone or in combination with other therapies did not affect these results. Conclusions: There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain.

Care and treatment, Backache, Back pain, Spinal adjustment, Author Abstract

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Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis

Article Abstract:

Products containing ephedra or ephedrine may cause weight loss in the short term but there is no long-term evidence that the weight loss can be maintained for long periods of time. There is also little evidence that these products can improve athletic performance. However, they can have severe side effects on the heart, gastrointestinal tract, brain, and nervous system.

Methods, Complications and side effects, Weight loss, Ergogenic aids, Ephedra

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Effects of omega-3 fatty acids on cancer risk

Article Abstract:

Study is conducted to synthesize published and unpublished evidence to determine estimates of the effect of omega-3 fatty acids on cancer risk in perspective cohort studies with 10 different types of cancer across 7 countries. Result shows that there were no evidence to suggest a significant association between omega-3 fatty acid consumption and cancer incidence.

United States, Health aspects, Risk factors, Cancer, Omega-3 fatty acids, Omega 3 fatty acids

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