Cost-effectiveness of guideline-endorsed treatments for low back pain: A systematic review

Chung Wei Christine Lin*, Marion Haas, Chris G. Maher, Luciana A C MacHado, Maurits W. Van Tulder

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

118 Citations (Scopus)

Abstract

Healthcare costs for low back pain (LBP) are increasing rapidly. Hence, it is important to provide treatments that are effective and cost-effective. The purpose of this systematic review was to investigate the cost-effectiveness of guideline-endorsed treatments for LBP. We searched nine clinical and economic electronic databases and the reference list of relevant systematic reviews and included studies for eligible studies. Economic evaluations conducted alongside randomised controlled trials investigating treatments for LBP endorsed by the guideline of the American College of Physicians and the American Pain Society were included. Two independent reviewers screened search results and extracted data. Data extracted included the type and perspective of the economic evaluation, the treatment comparators, and the relative costeffectiveness of the treatment comparators. Twenty-six studies were included. Most studies found that interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation or cognitive-behavioural therapy were costeffective in people with sub-acute or chronic LBP. Massage alone was unlikely to be cost-effective. There were inconsistent results on the cost-effectiveness of advice, insufficient evidence on spinal manipulation for people with acute LBP, and no evidence on the cost-effectiveness of medications, yoga or relaxation. This review found evidence supporting the cost-effectiveness of the guidelineendorsed treatments of interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation and cognitivebehavioural therapy for sub-acute or chronic LBP. There is little or inconsistent evidence for other treatments endorsed in the guideline.

Original languageEnglish
Pages (from-to)1024-1038
Number of pages15
JournalEuropean Spine Journal
Volume20
Issue number7
DOIs
Publication statusPublished - Jul 2011
Externally publishedYes

Keywords

  • Cost-effectiveness analysis
  • Low back pain
  • Systematic review

Fingerprint

Dive into the research topics of 'Cost-effectiveness of guideline-endorsed treatments for low back pain: A systematic review'. Together they form a unique fingerprint.

Cite this