Table H1, Strength of evidence - Noninvasive Treatments for Low Back Pain

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Chou R, Deyo R, Friedly J, et al. Noninvasive Treatments for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. (Comparative Effectiveness Reviews, No. 169.)

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Noninvasive Treatments for Low Back Pain [Internet].

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Table H1Strength of evidence

Key Question Outcome	Study Design Number of Studies	Study Limitations	Consistency	Directness	Precision	Reporting Bias	Strength of Evidence
1. What are the comparative benefits and harms of different pharmacological therapies for acute or chronic nonradicular low back pain, radicular low back pain, or spinal stenosis? (Including NSAIDs, acetaminophen, opioids, muscle relaxants, antiseizure medications, antidepressants, corticosteroids, and topicals/patch-delivered medications)

Acetaminophen
Acetaminophen vs. Placebo, acute LBP : Pain and function	1 RCT	Low	Unable to determine	Direct	Precise	Undetected	Low
Acetaminophen vs. NSAID, acute LBP: Pain and global improvement	3 RCTs	High	Consistent	Direct	Precise	Undetected	Low
Acetaminophen vs. Placebo, chronic LBP	No studies	-	-	-	-	-	Insufficient
Acetaminophen vs. NSAID, chronic LBP	1 RCT	High	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Acetaminophen vs. other interventions, acute LBP	4 RCTs	High	Consistent	Direct	Imprecise	Undetected	Insufficient
Acetaminophen vs. placebo: Adverse events (serious adverse events)	1 RCT	Low	Consistent	Direct	Imprecise	Undetected	Moderate
Acetaminophen vs. NSAIDs : Adverse events	3 RCTs in systematic revie	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Acetaminophen vs. Placebo, NSAID or Other intervention, radicular LBP	No studies	-	-	-	-	-	Insufficient
NSAIDs
NSAIDs vs. Placebo, acute LBP : Pain, function	4 RCTs in systematic review and 1 RCT for pain; 1 RCT for function	Moderate	Consistent for pain Unable to determine for function	Direct	Precise for pain Imprecise for function	Undetected	Moderate for pain, low for function
NSAIDs vs. Placebo, chronic LBP : Pain, function	4 RCTs in systematic review for pain 2 RCTs for function	Moderate	Consistent	Direct	Precise for pain Imprecise for function	Undetected	Moderate for pain, low for function
NSAIDs vs. Placebo, radicular LBP : Pain	2 RCTs in systemtic review	Moderate	Inconsistent	Direct	Imprecise	Undetected	Low
NSAID plus another intervention vs. Other intervention alone	2 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
NSAIDs vs. Interventions other than acetaminophen and opioids	2 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
NSAID vs. NSAID, acute or chronic LBP : Pain	27 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
NSAIDs vs. Placebo : Adverse events	10 RCTs	Moderate	C onsistent	Direct	Precise	Undetected	Moderate
COX-2-selective NSAIDs vs. nonselective NSAIDs : Adverse events	4 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Opioids, Tramadol and Tapentadol
Opioids vs. Placebo, chronic LBP : Pain and function	6 RCTs in systematic review and 3 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Tramadol vs. Placebo, chronic LBP : Pain and function	5 RCTs in systematic review and 2 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Buprenorphine patch vs. Placebo, subacute or chronic LBP : Pain and function	2 RCTs in systematic review	Moderate	Consistent for pain Inconsistent for function	Direct	Imprecise	Undetected	Low for pain Insufficient for function
Opioids vs. NSAIDs, chronic LBP : Pain relief, function	3 RCTs for pain 1RCT for function	Moderate	Inconsistent for pain Unable to determine for function	Direct	Imprecise	Undetected	Insufficient
Opioids vs. Acetaminophen, acute LBP : Days to return to work, pain	1 RCT for return to work No studies for pain	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Long acting opioids vs. Long acting opioids : Pain, function	4 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Long acting opioids vs. Short acting opioids : Pain	6 RCTs	Moderate	Inconsistent	Direct	Precise	Undetected	Low
Opioids vs. Placebo: Adverse events	16 RC Ts in systematic review	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Skeletal Muscle Relaxants (SMR)
SMRs vs. Placebo, acute LBP : Pain	4 RCTs in a systematic review and 1 RCT	Moderate	Consistent	Direct	Precise	Undetected	Moderate
SMR plus NSAID vs. NSAID alone, acute LBP : Pain	2 RCTs in systematic review and 1 RCT	Moderate	Consistent	Direct	Imprecise	Undetected	Low
SMR vs. Placebo, chronic LBP : Pain	3 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
SMR vs. SMR, acute or chronic LBP : Pain	3 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
SMR vs. Placebo, acute LBP : Adverse events	8 RCTs in systematic review and 1 RCT	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Benzodiazepines
Benzodiazepines vs. Placebo, acute LBP : Pain, function	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Tetrazepam vs. Placebo, chronic LBP:Pain, overall improvement	2 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Diazepam vs. Placebo, acute or subacute radicular pain : Pain, function	1 RCT	Low	Unable to determine	Direct	Precise	Undetected	Low
Benzodiazepines vs. Skeletal muscle relaxants, chronic LBP: Pain, function	2 RCTs	Low	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Diazepam vs. Cyclobenzaprine, chronic LBP : Muscle spasms	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Benzodiazepines vs. Placebo: Adverse events	8 RCTs in systematic review and 1 RCT	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Antidepressants
Tricyclic antidepressants or SSRI vs. Placebo, chronic LBP : Pain, function	4 RCTs of tricyclics and 3 RCTs of SSRIs in systematic review for pain; 2 RCTs evaluated function	Moderate	Consistent	Direct	Imprecise	Undetected	Moderate for pain, low for function
Duloxetine vs. Placebo, chronic LBP : Pain, Function	3 RCTs	Low	Consistent	Direct	Precise	Undetected	Moderate
Duloxetine vs. Tricyclic antidepressants	No studies	-	-	-	-	-	Insufficient
Antidepressants vs. Placebo : Adverse events, Serious adverse events	9 RCTs in systematic review and 3 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Antiseizure medications
Antiseizure medications, acute non-radicular LBP	No studies	-	-	-	-	-	Insufficient
Gabapentin vs. Placebo, chronic non-radicular LBP	1 RCT (abstract only, excluded)	-	-	-	-	Suspected	Insufficient
Gabapentin vs. Placebo, chronic radicular LBP: Pain and function	3 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Topiramate vs. Placebo, chronic radicular or mixed radicular and non-radicular LBP: Pain	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Pregabalin vs. Placebo, chronic radicular LBP : pain, function	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Pregabalin plus transdermal buprenorphine vs. transdermal buprenorphine, chronic non-radicular LBP : Pain	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Pregabalin plus another anaglesic vs. the other analgesica alone: Pain	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Gabapentin vs. Placebo : Adverse events	2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Topiramate vs. Placebo : Withdrawal due to adverse events, sedation, diarrhea	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Pregabalin vs. Placebo : Withdrawal due to adverse events, somnolence, dizziness	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Corticosteroids
Systemic corticosteroids vs. Placebo, acute non-radicular LBP : Pain, function	2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Systematic corticosteroids vs. Placebo, radicular LBP : Pain, function	5 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Systemic corticosteroids vs. Placebo, spinal stenosis: Pain, function	1 RCT	Moderate	Unable to determine	Direct	Precise	Undetected	Low
Systemic corticosteroids : Adverse events	12 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
2. What are the comparative benefits and harms of different nonpharmacological, noninvasive therapies for acute or chronic nonradicular low back pain, radicular low back pain, or spinal stenosis?
Exercise
Exercise vs. Usual care, acute to subacute LBP : Pain, function	8 RCTs in systematic review and 3 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Exercise vs. Usual care, chronic LBP: Pain, Function	19 RCTs in systematic review 3 RCTs in another systematic review, and 20 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
MCE vs. Minimal intervention, chronic LBP : Pain, function	2 RCTs for pain and 3 RCTs for function in systematic review	Modeate	Consistent	Direct	Imprecise	Undetected	Low
Exercise vs. Usual care, non- acute LBP: Work disability	8 RCTs in systematic review	Moderate	Consistent	Direct	Precise	Undetected`	Moderate
Exercise vs. Usual care, radicular LBP: Pain, function	3 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Exercise vs. Exercise, acute or chronic LBP	>20 RCTs	Moderate	Consistent	Direct	Precise	Suspected	Moderate
Exercise : Adverse events							Low
MCE vs. General exercise, chronic LBP : Pain, function	6 RCTs in systematic review and 2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
MCE vs. Multimodal PT, chronic LBP : Pain, function	4 RCTs for pain and 2 RCTs for function in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
MCE plus exercise vs. Exercise alone	2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
MCE : Adverse events	6 RCTs	Moderate	Consistent	Direct	Precise	Suspected	Low
Pilates
Pilates vs. usual care plus physical activity, chronic LBP: Pain, function	7 RCTs in systematic review	Moderate	Inconsistent	Direct	Precise	Undetected	Low
Pilates vs. other exercise, chronic LBP: Pain, function	3 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Tai Chi
Tai Chi vs. waitlist or no Tai Chi, chronic LBP : Pain, function	2 RCTs for pain, 1 RCT for function	Moderate	Consistent for pain Unable to determine for function	Direct	Imprecise	Undetected	Low
Tai Chi vs. other exercise, chronic LBP : Pain	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Tai Chi : Adverse events	2 RCTs	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Yoga
Yoga vs. Usual care, chronic LBP :Pain, Function	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Yoga vs. Exercise, chronic LBP : Pain, Function	5 RCTs in sytematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Yoga vs. Education, chronic LBP : Pain, function	5 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Yoga : Adverse events	5 RC Ts	Moderate	Consistent	Direct	Imprecise	Suspected	Low
Psychological Therapies
Progressive relaxation vs. wait list control, chronic LBP : Pain, Function	3 RCTs in systematic review	Moderate	Inconsistent	Direct	Precise	Undetected	Low
EMG biofeedback, chronic LBP : Pain, Function	3 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Operant therapy, chronic LBP : Pain, Function	3 RCTs for pain, 2 RCTs for function in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Cognitive therapy vs. Wait list control, chronic LBP	2 RCTs in systematic review	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Cognitive-behavioral and other combined therapy vs. Wait list control, chronic LBP : Pain, Function	5 RCTs for pain, 4 RCTs for function in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Psychological therapies vs. exercise or physical therapy, chronic LBP : Pain	8 RCTs	Moderate	Inconsistent	Direct	Precise	Undetected	Low
Psychological therapies vs. Psychological therapies : Pain, Function	10 RCTs	Modeate	Inconsistent	Direct	Precise	Undetected	Moderate
Psychological therapies : Adverse events	28 RCTs in systematic review	High	Consisent	Direct	Imprecise	Suspected	Low
Multidisciplinary rehabilitation
Multidisciplinary rehabilitation vs. Usual care, chronic LBP : Pain, function, return to work	9 RCTs in systematic review	Moderate	Inconsistent	Direct	Precise	Undetected	Moderate
Multidisciplinary rehabilitation vs. No multidisciplinary rehabilitation, chronic LBP : Pain, function	3 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Multidisciplinary rehabilitation vs. Physical therapy, chronic LBP : Pain, function	13 RCTs in systematic review	Moderate	Inconsistent	Direct	Precise	Undetected	Moderate
Multidisciplinary rehabilitation, acute LBP, radicular LBP	No studies						Insufficient
Multidisciplinary rehabilitation : Adverse events	2 RCTs	High	Consistent	Direct	Imprecise	Suspected	Low
Acupuncture
Acupuncture vs. Sham acupuncture, subacute LBP : Pain	3 RCTs in systematic review and 2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Acupuncture vs. Sham acupuncture, chronic LBP : Pain, function	7 RCTs in systematic review and 1 RCT	Moderate	Inconsistent	Direct	Precise	Undetected	Moderate
Acupuncture vs. No acupuncture, chronic low back pain	5 RCTs in systematic review	Moderate	Inconsistent	Direct	Precise	Undetected	Moderate
Acupuncture vs. NSAIDs, acute LBP : Overall improvement	5 RCTs in systematic review	Moderate	Consistent	Direc t	Imprecise	Undetected	Low
Acupuncture vs. Medications, chronic LBP : Pain, Function	3 RCTs in systematic review	High	Consistent	Direct	Precise	Undetected	Low
Acupuncture : Adverse events	3 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Massage
Massage vs. Sham massage, acute LBP: Pain, function	2 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Massage vs. Usual care, chronic LBP: Pain, function	2 RCTs	Moderate	Inconsistent	Direct	Precise	Undetected	Low
Massage vs. Other interventions, subacute to chronic LBP: Pain, function	9 RCTs for pain and 4 RCTs for function in systematic review	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Massage plus another active intervention vs. the Other intervention alone, subacute to chronic low back pain: Pain, function	5 RCTs in systematic review and 2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Massage vs. massage: Pain, function	6 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Massage: Adverse events	12 RCTs	High	Consistent	Direct	Prec ise	Suspected	Low
Spinal manipulation
Spinal manipulation, acute LBP : Pain, function	1 RCT for pain and 2 RCTs for function	High	Unable to determine for pain Consistent for function	Direct	Imprecise	Undetected	Low for function Insufficient for pain
Spinal manipulation vs. Sham manipulation, chronic LBP : Pain, function	3 RCTs in systematic review and 1 RCT	Moderate	Inconsistent	Direct	Precise	Undetected	Low for pain Insufficient for function
Spinal manipulation vs. Intert treatment, acute LBP : Pain, Function	3 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Spinal manipulation vs. Inert treatment, chronic LBP	4 RCTs in systematic review and 3 RCTs	Modeate	Inconsistent	Direct	Precise	Undetected	Low
Spinal manipulation vs. Other active interventions, acute LBP : Pain, function	3 RCTS in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Moderate
Spinal manipulation vs. Other interventions, chronic LBP : Pain, function	6 RCTs in systematic review and 3 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Spinal manipulation plus exercise or advice vs. exercise or advice alone, acute LBP : Function	4 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Spinal manipulation plus another active treatment, chronic LBP : Pain, function	3 RCTS in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Spinal manipulation : Adverse events	55 RCTs	Moderate	Consistent	Direct	Precise	Suspected	Low
Ultrasound
Ultrasound vs. Sham ultrasound, chronic LBP : Pain, function	5 RCTs	Moderate	Consistent for pain Inconsistent for function	Direct	Imprecise	Undetected	Low for pain Insufficient for function
Ultrasound vs. No ultrasound, chronic LBP : Pain, function	2 RCTs	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Ultrasound plus exercise vs. Exercise, chronic LBP : Pain, Function	2 RCTs	High	Consistent	Direct	Imprecise	Undetected	Insufficient
Ultrasound plus exercise vs. Exercise, Radicular LBP: Back pain, leg pain	1 RCT	Moderate	Unable to determine	Direct	Precise	Undetected	Moderate
Ultrasound vs. Other interventions	3 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Ultrasound vs. Other interventions, radiculopathy	2 RCT	High	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Ultrasound, acute non-radicular LBP	No studies						Insufficient
Spinal manipulation plus home exercise and advice, radicular LBP	1 RCT	Moderate	Unable to determine	Direct	Precise	Suspected	Low
Ultrasound vs. Sham ultrasound : Adverse events	1 RCT	Low	Unable to determine	Direct	Imprecise	Suspected	Low
Transcutaneous electrical nerve stimulation [TENS]
TENS vs. Sham TENS, acute or subacute LBP: Pain, function	2 RCTs	High	Unable to determine	Direct	Imprecise	Undetected	Insufficient
TENS vs. Sham TENS, chronic LBP : Pain, function	4 RCTs for pain and 2 RCTs for function in systematic review	Moderate	Consistent	Direct	Iimprecise	Undetected	Low
TENS vs. Acupuncture, chronic LBP : Pain	4 RCTs for pain and 2 RCTs for function in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
TENS : Adverse events	8 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Suspected	Low
Electrical muscle stimulation [EMS]
EMS plus exercise vs. Exercise, EMS vs. Other interventions, acute or chronic LBP: Pain, function	5 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
EMS: Adverse events	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Suspected	Insufficient
Percutaneous Electrical Nerve Stimulation [PENS]
PENS vs. Sham PENS, PENS plus exercise vs. exercise, PENS vs. other interventions, chronic LBP (with or without radiculopathy)	7 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
PENS : Adverse events	1 RCT	High	Unable to determine	Direct	--	Suspected	Insufficient
Interferential therapy [IFT]
IFT vs. other interventions, IFT plus another intervention vs. the other intervention,subacute to chronic LBP: Pain, function	4 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
IFT : Adverse events	No studies					Suspected	Insufficient
Superficial Heat or Cold
Heat wrap vs. Placebo, acute or subacute LBP : Pain, function	2 RCTs in systematic review and 2 RCTs	Moderate	Consistent	Direct	Precise	Undetected	Moderate
Heat plus exercise vs. exercise alone, acute LBP : Pain, function	1 RCT	Low	Unable to determine	Direct	Imprecise	Undetected	Low
Heat plus NSAID vs. NSAID alone, acute LBP:Pain	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Heat vs. Simple analgesics, acute or subacute LBP : Pain, function	1 RCT in systematic review	Low	Unable to determine	Direct	Imprecise	Undetected	Low
Heat vs. Exercise, acute LBP : Pain, Function	1 RCT in systematic review	Low	Unable to determine	Direct	Imprecise	Undetected	Low
Cold plus naproxen vs. naproxen alone, acute LBP: Pain	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Superficial Cold vs. Placebo	No studies						Insufficient
Heat vs. Cold	3 RCTs	High	Consistent	Direct	Imprecise	Undetected	Insufficient
Heat vs. No heat or placebo : Adverse events, flushing	2 RCTs	Low	Consistent	Direct	Imprecise	Suspected	Low
Low Level Laser Therapy [LLLT]
LLLT vs. Sham laser, acute LBP	1 RCT	High	Unable to determine	Direct	Imprecise	Undetected	Insufficient
LLLT vs. Sham laser, chronic LBP : Pain, Function	3 RCTs for pain, 1 RCT for function	Moderate	Consistent	Direct	Imprecise	Undetected	Low
LLLT plus NSAID vs. Sham plus NSAID, acute or subacute LBP : Pain, function	1 RCT	Low	Unable to determine	Direct	Imprecise	Undetected	Low
LLLT plus another intervention vs. the other intervention alons, chronic LBP: Pain, function	3 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
LLLT vs. anotehr intervention: Pain, function	2 RCTs	High	Unable to determine	Direct	Imprecise	Undetected	Insufficient
LLLT differing wavelengths or doses	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
LLLT : Adverse events	10 RCTs	High	Consistent	Direct	Imprecise	Suspected	Low
Short-wave Diathermy
Short-wave diathermy vs. Sham diathermy, mixed duration LBP : Effectiveness, Adverse events	4 RCTs	High	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Short-wave diathermy: Adverse events	No studies					Suspected	Insufficient
Lumbar Supports
Lumbar supports vs. no lumbar supports or an inactive treatment, acute or subacute LBP: Pain, function	4 RCTs in systematic review and 1 RCT	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Lumbar supports vs. no lumbar supports, chronic LBP	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Lumbar supports vs. no lumbar supports, mixed duration LBP: Pain and function	1 RCT	Moderate	Unable to determine	Direct	Precise	Undetected	Low
Lumbar support plus education vs. education, acute or subacute LBP : Pain, function	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Lumbar support plus exercise vs. exercise alone, chronic LBP : Pain, function	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Low
Lumbar support vs. other active treaatments : Pain, Function	3 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Low
Lumbar supports vs. Lumbar supports: Pain, function	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Lumbar supports : Adverse events	8 RCTs in systematic review and 3 RCTs	Moderate	Consistent	Direct	Imprecise	Suspected	Low
Traction
Traction vs. placebo, sham or no treatment, LBP with or without radicular symptoms : Pain, function	13 RCTs in systematic review and 2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Insufficient
Traction vs. physiotherapy, LBP with or without radicular symptoms: Pain, function	5 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Traction vs. other interventions, LBP with or without radicular symptoms : Pain, function	15 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Traction vs. Traction: Pain, function	5 RCTs in systematic review	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Traction : Adverse events	11 RCTs in systematic reviews	Moderate	Consistent	Direct	Imprecise	Undetected	Low
Taping
Kinesio Taping vs. Sham taping, chronic LBP : Pain, Function	2 RCTs	Low	Inconsistent for pain Consistent for function	Direct	Imprecise	Undetected	Insufficient for pain Low for function
Functional Fascial Taping plus exercise vs. Sham taping plus exercise, chronic LBP: Pain, function	1 RCT	Moderate	Unable to determine	Direct	Imprecise	Undetected	Insufficient
Kinesio Taping vs. exercise therapy, chronic LBP : Pain, Function	2 RCTs	Moderate	Inconsistent	Direct	Imprecise	Undetected	Low
Taping : Adverse events							Insufficient

From: Appendix H, Strength of Evidence

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Chou R, Deyo R, Friedly J, et al. Noninvasive Treatments for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. (Comparative Effectiveness Reviews, No. 169.) Table H1, Strength of evidence.
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