Evolution of treatment for unspecific back pain: From past to future.

Unspecific back pain (UBP) has long puzzled medical professionals. Historically, back pain (BP) was often attributed to mystical causes, treated with incantations or herbal concoctions. The Middle Ages shifted towards empirical practices, though still intertwined with superstition, using methods like leeches and bloodletting. The Renaissance introduced systematic healthcare approaches, laying the foundation for modern medicine. The 20th century saw significant advancements with diagnostic imaging, pharmacotherapy, physical therapy, and surgical interventions, though UBP remained elusive. Recent decades have seen a paradigm shift towards multidisciplinary approaches, addressing BP's multifactorial nature through holistic methods considering biomechanical, psychosocial, and lifestyle factors. This shift integrates quantitative research with hermeneutic interpretation, emphasizing evidence-based guidelines. Non-pharmacological interventions such as exercise therapy, electrotherapy, cognitive behavioral therapy, and mindfulness-based stress reduction have gained prominence, empowering individuals in their recovery. Technological innovations like virtual reality and artificial intelligence offer personalized treatment plans, optimizing outcomes. The future of BP treatment holds promise with advancements in regenerative medicine, neuromodulation, telemedicine, and remote monitoring platforms, enhancing accessibility and continuity of care, especially in underserved communities. However, challenges such as the opioid epidemic and healthcare disparities remain, necessitating judicious prescribing practices and equitable resource distribution. The evolving treatment landscape for UBP reflects the dynamic interplay between scientific progress, clinical innovation, and societal needs, aiming to alleviate the burden of back pain and improve quality of life.

Electromagnetic Induction for Treatment of Unspecific Back Pain: A Prospective Randomized Sham-Controlled Clinical Trial.

OBJECTIVE: To evaluate the effects of high-energy pulsed electromagnetic fields on unspecific back pain. METHODS: A prospective, randomized, sham-controlled clinical trial with repeated measurements was performed. The study included 5 visits (V0 to V4) with 3 interventions during V1, V2 and V3. Sixty-one patients aged between 18 and 80 years with unspecific back pain (acute inflammatory diseases and specific causes were reasons for exclusion) were included. The treatment group (n = 31) received 1-2 pulses/s, with an intensity of 50 mT, and an electric field strength of at least 20 V/m on 3 consecutive weekdays for 10 min each time. The control group (n = 30) received a comparable sham therapy. Pain intensity (visual analogue scale), local oxyhaemoglobin saturation, heart rate, blood pressure, and perfusion index were evaluated before (b) and after (a) V1 and V3 interventions. Change in visual analogue scale for V1 (ChangeV1a-b) and V3 (ChangeV3a-b), and ChangeData between V3a and V1b (ChangeV3a-V1b) for the remaining data were calculated (results were mean (standard deviation) (95% confidence interval; 95% CI)). RESULTS: Concerning the visual analogue scale: (i) compared with the control group, the treatment group had higher ChangeV1a-b (-1.25 (1.76) (95% CI -1.91 to -0.59) vs -2.69 (1.74) (95% CI -3.33 to -2.06), respectively), and comparable Change V3a-b (-0.86 (1.34) (95% CI -1.36 to -0.36) vs -1.37 (1.03) (95% CI -1.75 to 0.99), respectively); and (ii) there was a significant marked decrease in Change V3a-1b in the treatment group compared with the control group (-5.15 (1.56) (95% CI -5.72 to -4.57) vs -2.58 (1.68) (95% CI -3.21 to -1.96), p = 0.001, respectively). There was no significant ChangeV3a-V1b in local oxyhaemoglobin saturation, heart rate, blood pressure or perfusion index between the 2 groups and for the same group (before vs after). CONCLUSION: Non-thermal, non-invasive electromagnetic induction therapy had a significant and rapid influence on unspecific back pain in the treatment group.

Sex-specific response to whole-body vibration training: a randomized controlled trial.

A few studies have indicated that males and females respond differently to whole-body vibration (WBV) training. However, the existing insights are still insufficient and they cannot be transferred to sex-specific practice planning. To evaluate the effect of 5-week WBV training on neuromuscular [countermovement jump (CMJ), squat jump (SJ)] and cardiovascular [heart rate and blood pressure] data, taking into account sex-specific effects. This is a comparative experimental study including 96 healthy adults, divided into two groups: a WBV group (25 females and 24 males) and a control group (27 females and 20 males). The participants attended nine to ten training sessions (twice a week for 5 weeks), each lasting approximately 30 min. Both groups performed the same exercise routine on the vibration training device. For the WBV group, the training device was vibrating during the whole training session, including the breaks. For the control group, it was turned off. Maximum jump height (H, cm) and maximum relative power (MRP, kW/kg) were noted during CMJ and SJ performed on a force plate. Resting (sitting) heart rate (bpm) and blood pressure (mmHg) were measured twice, before and after the intervention. For each parameter, Δdata (= before - after) was calculated. Interactive effects of sex (2) vs group (2) vs session (2) were noted only in males and they only concerned ΔSJMPR and ΔCMJH: compared to the control group, the WBV group had better ΔSJMPR (1.39 ± 3.05 vs -2.69 ± 4.49 kW/kg, respectively) and ΔCMJH (0.50 ± 6.14 vs -4.42 ± 5.80 cm, respectively). No sex-specific effect of WBV on neuromuscular (CMJ and SJ) or cardiovascular (heart rate and blood pressure) data was found.