Non Specific Lbp

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In adult patients (ages 18 and older) with non-specific low back pain (LBP), does the use of muscle energy technique (MET) improve pain and functional status compared to control interventions?

This study is a meta-analysis which included individual studies that were only randomized controlled trials (RCTs). The individual studies included both acute low back pain (6 weeks). The individual studies also must only have used isometric muscle energy as the form of treatment.

Strengths: The strengths of this study are that it only selected RCTs and allowed for studies around the world to be included. An additional strength is that the authors only considered individual studies where an effect due to MET only could be found. Additionally, the authors …show more content…
MET plus any intervention vs. other therapies plus that intervention for acute non-specific LBP.1

Performing a meta-analysis is difficult because of the need for evaluation of the individual factors from each individual study, but I feel that the authors adequately measured what they set out to prove and applied the needed statistical calculations to make the results meaningful. Furthermore, the primary outcomes were measured utilizing reliable pain and functional status tools, so I feel this area was adequately assessed as well.

This study looked at seven different primary outcomes, which I feel objectively covered all aspects to determine if MET is efficacious as a sole technique to improve LBP. The authors clearly depicted how they screened for inclusion of articles in an easy to understand flow chart. They also clearly listed the mean difference (MD) and 95% confidence intervals (CI) for each primary outcome, but did not include p-values. The risk of bias was also neatly listed with a color-coded bar graph. As for the primary outcome that included the most studies (6 studies total, MET plus any intervention versus other therapies plus that intervention for chronic non-specific LBP), the authors listed two different Forest plots (one for an outcome of pain and the other for an outcome of function) which displayed the individual studies and the corresponding MD and 95% CI for the MET and the control. While this intervention had the largest amount of pooled studies, it …show more content…
Most often, the patients are prescribed a combination of anti-inflammatory medications, x-rays and physical therapy. Many times, patients are non-compliant with physical therapy and end up back in the office to seek additional “treatment.” As Osteopathic providers, we have the useful and proven modality of OMT. Numerous studies have proven the efficacy of OMT in treating low back pain, but often, this treatment benefit is based on the patient’s individual somatic dysfunctions and treatment is based upon whatever technique the OMT provider feels is best fit for the patient. This approach makes most sense to me since I feel that you (as the OMT provider) shouldn’t be limited to just one technique, as is the case with ME in this meta-analysis. As evidenced by the findings in this study, by limiting yourself to just one area of the body and with only one treatment modality, you are bound to achieve sub-optimal results. However, as with any OMT procedure, I do feel you will gain some benefit, whether that is in a reduction of pain or an increased ROM, but whether that benefit is measurable and lasting is up for debate. From this study, I learned that as OMT providers, we should utilize our full arsenal of OMT skills and we should do our best to treat the patient most holistically by addressing all
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