+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review



The efficacy, safety, effectiveness, and cost-effectiveness of ultrasound and shock wave therapies for low back pain: a systematic review



Spine Journal 11(10): 966-977



Shock wave and especially ultrasound are commonly used to treat low back pain (LBP) in routine practice. To assess the evidence on the efficacy, effectiveness, cost-effectiveness, and safety of ultrasound and shock wave to treat LBP. Systematic review. An electronic search was performed in MEDLINE, EMBASE, and the Cochrane Library databases up to July 2009 to identify randomized controlled trials (RCTs) comparing vibrotherapy with placebo or with other treatments for LBP. No language restrictions were applied. Additional data were requested from the authors of the original studies. The risk of bias of each study was assessed following the criteria recommended by the Cochrane Back Review Group. Thirteen studies were identified. The four RCTs complying with the inclusion criteria included 252 patients. Two of the three RCTs on ultrasound had a high risk of bias. For acute patients with LBP and leg pain attributed to disc herniation, ultrasound, traction, and low-power laser obtained similar results. For chronic LBP patients without leg pain, ultrasound was less effective than spinal manipulation, whereas a shock wave device and transcutaneous electrical nerve stimulation led to similar results. Results from the only study comparing ultrasound versus a sham procedure are unreliable because of the inappropriateness of the sham procedure, low sample size, and lack of adjustment for potential confounders. No study assessed cost-effectiveness. No adverse events were reported. The available evidence does not support the effectiveness of ultrasound or shock wave for treating LBP. High-quality RCTs are needed to assess their efficacy versus appropriate sham procedures, and their effectiveness and cost-effectiveness versus other procedures shown to be effective for LBP. In the absence of such evidence, the clinical use of these forms of treatment is not justified and should be discouraged.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056327659

Download citation: RISBibTeXText

PMID: 21482199

DOI: 10.1016/j.yspm.2011.12.011


Related references

Efficacy, Effectiveness, Safety, and Cost-effectiveness of Epidural Adhesiolysis for Treating Failed Back Surgery Syndrome. A Systematic Review. Pain Medicine 20(4): 692-706, 2019

A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evidence-BasedComplementaryandAlternativeMedicine2012:953139, 2012

Effectiveness of extracorporeal shock wave for low back pain: A protocol of systematic review. Medicine 98(7): E14511, 2019

Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review. Global Spine Journal 8(8): 872-886, 2018

Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disability and Rehabilitation 32(8): 607-621, 2010

Cost Effectiveness of Multidisciplinary Pain Management Services for Chronic Back Pain: Systematic Review. Value in Health 18(7): A661, 2015

Cost-effectiveness of general practice care for low back pain: a systematic review. European Spine Journal 20(7): 1012-1023, 2011

Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review. European Spine Journal 20(7): 1024-1038, 2011

Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis. British Journal of Sports Medicine 53(3): 172-181, 2019

The Effectiveness and Safety of Manual Therapy on Pain and Disability in Older Persons With Chronic Low Back Pain: A Systematic Review. Journal of Manipulative and Physiological Therapeutics 40(7): 527-534, 2017

Cost-Effectiveness of Non-Invasive and Non-Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Applied Health Economics and Health Policy 15(2): 173-201, 2017

The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis. Medicine 95(38): E4723, 2016

The clinical effectiveness and cost-effectiveness of ablative therapies in the management of liver metastases: systematic review and economic evaluation. Health Technology Assessment 18(7): Vii-Viii 1-283, 2014

A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry's disease and mucopolysaccharidosis type 1. Health Technology Assessment 10(20): Iii-Iv Ix-113, 2006

Safety, efficacy, and cost effectiveness of evidence-based guidelines for the management of acute low back pain in primary care. Spine 26(23): 2615-2622, 2001