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草药治疗下腰痛

Appendices

Appendix 1. Current search strategy

MEDLINE

  1. randomized controlled trial.pt.

  2. controlled clinical trial.pt.

  3. Randomized Controlled Trials/

  4. Random Allocation/

  5. Double‐Blind Method/

  6. Single‐Blind Method/

  7. or/1‐6

  8. Animals/ not Human/

  9. 7 not 8

  10. clinical trial.pt.

  11. exp Clinical Trial/

  12. (clin$ adj25 trial$).tw.

  13. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).tw.

  14. Placebos/

  15. placebo$.tw.

  16. random$.tw.

  17. Research Design/

  18. (latin adj square).tw.

  19. or/10‐18

  20. 19 not 18

  21. 20 not 9

  22. Comparative Study/

  23. exp Evaluation Studies/

  24. Follow‐Up Studies/

  25. Prospective Studies/

  26. (control$ or prospective$ or Volunteer$).tw.

  27. Cross‐Over Studies/

  28. or/22‐27

  29. 28 not 8

  30. 29 not (9 or 21)

  31. 9 or 21 or 30

  32. dorsalgia.ti,ab.

  33. exp Back Pain/

  34. backache.ti,ab.

  35. (lumbar adj pain).ti,ab.

  36. coccyx.ti,ab.

  37. coccydynia.ti,ab.

  38. sciatica.ti,ab.

  39. sciatic neuropathy/

  40. spondylosis.ti,ab.

  41. lumbago.ti,ab.

  42. or/32‐41

  43. 31 and 42

  44. Drugs, Chinese Herbal/

  45. herbal.mp.

  46. Plants, Medicinal/

  47. phytomedicine.mp.

  48. herb$.mp.

  49. weed.mp.

  50. algae.mp.

  51. cryptophyta/ or haptophyta/ or exp glaucophyta/ or exp rhodophyta/ or exp viridiplantae/ or exp chlorophyta/ or exp streptophyta/ or exp stramenopiles/

  52. exp Fungi/

  53. exp Medicine, Traditional/

  54. exp Phytotherapy/

  55. exp Pharmacognosy/

  56. (oriental adj traditional).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  57. (Camphora adj molmol).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  58. Capsicum/

  59. exp Salicaceae/

  60. (Maleluca adj alternifolia).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  61. Angelica sinensis/

  62. Aloe/

  63. (Thymus adj officinalis).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  64. Menthe piperita.mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  65. Arnica Montana.mp. or Arnica/

  66. Curcuma longa.mp. or Curcuma/

  67. Tanacetum parthenium.mp. or Tanacetum parthenium/

  68. feverfew.mp.

  69. Harpagophytum procumbens.mp. or exp Harpagophytum/

  70. Zingiber officii.mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier]

  71. plant preparations/ or plant extracts/ or plant oils/

  72. or/44‐71

  73. 43 and 72

  74. 31 and 42 and 72

  75. limit 74 to yr=2013‐Current

  76. limit 74 to ed=20130806‐20140911

  77. 75 or 76

EMBASE

From the 2013 strategy, line 31 was changed from 14 and 30 to 14 or 30

  1. Clinical Article/

  2. exp Clinical Study/

  3. Clinical Trial/

  4. Controlled Study/

  5. Randomized Controlled Trial/

  6. Major Clinical Study/

  7. Double Blind Procedure/

  8. Multicenter Study/

  9. Single Blind Procedure/

  10. Phase 3 Clinical Trial/

  11. Phase 4 Clinical Trial/

  12. crossover procedure/

  13. placebo/

  14. or/1‐13

  15. allocat$.mp.

  16. assign$.mp.

  17. blind$.mp.

  18. (clinic$ adj25 (study or trial)).mp.

  19. compar$.mp.

  20. control$.mp.

  21. cross?over.mp.

  22. factorial$.mp.

  23. follow?up.mp.

  24. placebo$.mp.

  25. prospectiv$.mp.

  26. random$.mp.

  27. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).mp.

  28. trial.mp.

  29. (versus or vs).mp.

  30. or/15‐29

  31. 14 or 30

  32. exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/

  33. human/ or normal human/ or human cell/

  34. 32 and 33

  35. 32 not 34

  36. 31 not 35

  37. dorsalgia.mp.

  38. back pain.mp.

  39. exp BACKACHE/

  40. (lumbar adj pain).mp.

  41. coccyx.mp.

  42. coccydynia.mp.

  43. sciatica.mp.

  44. exp ISCHIALGIA/

  45. spondylosis.mp.

  46. lumbago.mp.

  47. exp Low back pain/

  48. or/37‐47

  49. exp herbaceous agent/

  50. herbal.mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]

  51. exp medicinal plant/

  52. exp phytotherapy/

  53. exp herbal medicine/

  54. phytomedicine.mp.

  55. exp plant extract/

  56. herb*.mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]

  57. weed.mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]

  58. exp alga/

  59. exp fungus/

  60. exp traditional medicine/

  61. exp pharmacognosy/

  62. (oriental adj traditional).mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]

  63. exp Chinese medicine/

  64. exp pepper/

  65. capsicum.mp.

  66. exp willow/

  67. salix.mp.

  68. exp Angelica sinensis/

  69. exp Aloe/

  70. exp Arnica montana/

  71. exp Curcuma longa/

  72. tanacetum/ or exp tanacetum parthenium/

  73. exp harpagophytum/ or exp harpagophytum extract/ or exp harpagophytum procumbens extract/

  74. or/49‐73

  75. 36 and 48 and 74

  76. limit 75 to yr="2013‐Current"

  77. limit 75 to em=201331‐201436

  78. 76 or 77

CENTRAL

#1 MeSH descriptor: [Low Back Pain] this term only

#2 MeSH descriptor: [Back Pain] this term only

#3 backache

#4 lumbago

#5 #1 or #2 or #3 or #4

#6 MeSH descriptor: [Drugs, Chinese Herbal] explode all trees

#7 MeSH descriptor: [Plants, Medicinal] explode all trees

#8 herbal

#9 phytomedicine

#10 herb*

#11 weed

#12 MeSH descriptor: [Algae] explode all trees

#13 MeSH descriptor: [Fungi] explode all trees

#14 MeSH descriptor: [Medicine, Traditional] explode all trees

#15 MeSH descriptor: [Phytotherapy] this term only

#16 MeSH descriptor: [Pharmacognosy] explode all trees

#17 Oriental next traditional

#18 MeSH descriptor: [Medicine, Chinese Traditional] this term only

#19 Camphora next molmo

#20 MeSH descriptor: [Capsicum] this term only

#21 MeSH descriptor: [Salix] this term only

#22 Maleluca next alternifolia

#23 MeSH descriptor: [Angelica sinensis] this term only

#24 MeSH descriptor: [Aloe] this term only

#25 Thymus next officinalis

#26 Menthe next piperita

#27 MeSH descriptor: [Arnica] this term only

#28 Arnica next Montana

#29 Curcuma next longa

#30 MeSH descriptor: [Curcuma] this term only

#31 MeSH descriptor: [Tanacetum parthenium] this term only

#32 MeSH descriptor: [Harpagophytum] this term only

#33 Harpagophytum next procumbens

#34 Zingiber next officii

#35 MeSH descriptor: [Plant Preparations] this term only

#36 MeSH descriptor: [Plant Oils] explode all trees

#37 MeSH descriptor: [Plant Extracts] explode all trees

#38 #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37

#39 #5 and #38

#40 #39 Publication Year from 2013 to 2014, in Trials

CINAHL

S75 S73 OR S74

S74 S73 and EM 20130806‐20140911

S73 S49 and S71 Limiters ‐ Published Date: 20130801‐20140931

S72 S49 and S71

S71 S50 or S51 or S52 or S53 or S54 or S55 or S56 or S57 or S58 or S59 or S60 or S61 or S62 or S63 or S64 or S65 or S66 or S67 or S68 or S69 or S70

S70 (MH "Devil's Claw")

S69 (MH "Feverfew")

S68 Curcuma longa

S67 (MH "Arnica")

S66 (MH "Aloe")

S65 (MH "Dong Quai")

S64 (MH "Willow Bark")

S63 ("Capsicum") or (MH "Cayenne Pepper")

S62 Camphora W1 molmol

S61 (MH "Medicine, Traditional")

S60 oriental W1 traditional

S59 Pharmacognosy

S58 ("Phytotherapy") or (MH "Medicine, Herbal")

S57 (MH "Medicine, Chinese Traditional")

S56 (MH "Fungi+")

S55 (MH "Algae+")

S54 "weed"

S53 herb*

S52 phytomedicine

S51 (MH "Plants, Medicinal+")

S50 (MH "Drugs, Chinese Herbal")

S49 S28 and S48

S48 S35 or S43 or S47

S47 S44 or S45 or S46

S46 "lumbago"

S45 (MH "Spondylolisthesis") OR (MH "Spondylolysis")

S44 (MH "Thoracic Vertebrae")

S43 S36 or S37 or S38 or S39 or S40 or S41 or S42

S42 lumbar N2 vertebra

S41 (MH "Lumbar Vertebrae")

S40 "coccydynia"

S39 "coccyx"

S38 "sciatica"

S37 (MH "Sciatica")

S36 (MH "Coccyx")

S35 S29 or S30 or S31 or S32 or S33 or S34

S34 lumbar N5 pain

S33 lumbar W1 pain

S32 "backache"

S31 (MH "Low Back Pain")

S30 (MH "Back Pain+")

S29 "dorsalgia"

S28 S26 NOT S27

S27 (MH "Animals")

S26 S7 or S12 or S19 or S25

S25 S20 or S21 or S22 or S23 or S24

S24 volunteer*

S23 prospectiv*

S22 control*

S21 followup stud*

S20 follow‐up stud*

S19 S13 or S14 or S15 or S16 or S17 or S18

S18 (MH "Prospective Studies+")

S17 (MH "Evaluation Research+")

S16 (MH "Comparative Studies")

S15 latin square

S14 (MH "Study Design+")

S13 (MH "Random Sample")

S12 S8 or S9 or S10 or S11

S11 random*

S10 placebo*

S9 (MH "Placebos")

S8 (MH "Placebo Effect")

S7 S1 or S2 or S3 or S4 or S5 or S6

S6 triple‐blind

S5 single‐blind

S4 double‐blind

S3 clinical W3 trial

S2 "randomi?ed controlled trial*"

S1 (MH "Clinical Trials+")

ClinicalTrials.gov

Condition: back pain

AND Intervention: herbal OR botanical

Received on or after 08/06/2013

WHO ICTRP

Condition: back pain

AND Intervention: herbal OR botanical

Date of registration between 06/08/2013‐(no date limit)

PubMed

((((herbal or botanical))) AND back pain) AND ((pubstatusaheadofprint OR publisher[sb] or pubmednotmedline[sb]))

Appendix 2. Previous search strategies

August 2013

Embase

The animal study filter was updated from 2010

  1. Clinical Article/

  2. exp Clinical Study/

  3. Clinical Trial/

  4. Controlled Study/

  5. Randomized Controlled Trial/

  6. Major Clinical Study/

  7. Double Blind Procedure/

  8. Multicenter Study/

  9. Single Blind Procedure/

  10. Phase 3 Clinical Trial/

  11. Phase 4 Clinical Trial/

  12. crossover procedure/

  13. placebo/

  14. or/1‐13

  15. allocat$.mp.

  16. assign$.mp.

  17. blind$.mp.

  18. (clinic$ adj25 (study or trial)).mp.

  19. compar$.mp.

  20. control$.mp.

  21. cross?over.mp.

  22. factorial$.mp.

  23. follow?up.mp.

  24. placebo$.mp.

  25. prospectiv$.mp.

  26. random$.mp.

  27. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).mp.

  28. trial.mp.

  29. (versus or vs).mp.

  30. or/15‐29

  31. 14 and 30

  32. exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/

  33. human/ or normal human/ or human cell/

  34. 32 and 33

  35. 32 not 34

  36. 31 not 35

January 2011

Medline

Back terms and herbal medicine terms were updated from 2009

  1. randomized controlled trial.pt.

  2. controlled clinical trial.pt.

  3. Randomized Controlled Trials/

  4. Random Allocation/

  5. Double‐Blind Method/

  6. Single‐Blind Method/

  7. or/1‐6

  8. Animals/ not Human/

  9. 7 not 8

  10. clinical trial.pt.

  11. exp Clinical Trials/

  12. (clin$ adj25 trial$).tw.

  13. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).tw.

  14. Placebos/

  15. placebo$.tw.

  16. random$.tw.

  17. Research Design/

  18. (latin adj square).tw.

  19. or/10‐18

  20. 19 not 18

  21. 20 not 9

  22. Comparative Study/

  23. exp Evaluation Studies/

  24. Follow‐Up Studies/

  25. Prospective Studies/

  26. (control$ or prospective$ or Volunteer$).tw.

  27. Cross‐Over Studies/

  28. or/22‐27

  29. 28 not 8

  30. 29 not (9 or 21)

  31. 9 or 21 or 30

  32. dorsalgia.ti,ab.

  33. exp Back Pain/

  34. backache.ti,ab.

  35. (lumbar adj pain).ti,ab.

  36. coccyx.ti,ab.

  37. coccydynia.ti,ab.

  38. sciatica.ti,ab.

  39. sciatic neuropathy/

  40. spondylosis.ti,ab.

  41. lumbago.ti,ab.

  42. or/32‐41

  43. 31 and 42

  44. Drugs, Chinese Herbal/

  45. herbal.mp.

  46. Plants, Medicinal/

  47. phytomedicine.mp.

  48. herb$.mp.

  49. weed.mp.

  50. algae.mp.

  51. cryptophyta/ or haptophyta/ or exp glaucophyta/ or exp rhodophyta/ or exp viridiplantae/ or exp chlorophyta/ or exp streptophyta/ or exp stramenopiles/

  52. exp Fungi/

  53. exp Medicine, Traditional/

  54. exp Phytotherapy/

  55. exp Pharmacognosy/

  56. (oriental adj traditional).mp.

  57. (Camphora adj molmol).mp.

  58. Capsicum/

  59. exp Salicaceae/

  60. (Maleluca adj alternifolia).mp.

  61. Angelica sinensis/

  62. Aloe/

  63. (Thymus adj officinalis).mp.

  64. Menthe piperita.mp.

  65. Arnica Montana.mp. or Arnica/

  66. Curcuma longa.mp. or Curcuma/

  67. Tanacetum parthenium.mp. or Tanacetum parthenium/

  68. feverfew.mp.

  69. Harpagophytum procumbens.mp. or exp Harpagophytum/

  70. Zingiber officii.mp.

  71. plant preparations/ or plant extracts/ or plant oils/

  72. or/44‐71

  73. 43 and 72

  74. limit 73 to yr="2003 ‐ 2011"

CINAHL

The strategy was updated from 2009

S73 S49 and S71 Limiters ‐ Published Date from: 20030101‐20111231

S72 S49 and S71

S71 S50 or S51 or S52 or S53 or S54 or S55 or S56 or S57 or S58 or S59 or S60 or S61 or S62 or S63 or S64 or S65 or S66 or S67 or S68 or S69 or S70

S70 (MH "Devil's Claw")

S69 (MH "Feverfew")

S68 Curcuma longa

S67 (MH "Arnica")

S66 (MH "Aloe")

S65 (MH "Dong Quai")

S64 (MH "Willow Bark")

S63 ("Capsicum") or (MH "Cayenne Pepper")

S62 Camphora W1 molmol

S61 (MH "Medicine, Traditional")

S60 oriental W1 traditional

S59 Pharmacognosy

S58 ("Phytotherapy") or (MH "Medicine, Herbal")

S57 (MH "Medicine, Chinese Traditional")

S56 (MH "Fungi+")

S55 (MH "Algae+")

S54 "weed"

S53 herb*

S52 phytomedicine

S51 (MH "Plants, Medicinal+")

S50 (MH "Drugs, Chinese Herbal")

S49 S28 and S48

S48 S35 or S43 or S47

S47 S44 or S45 or S46

S46 "lumbago"

S45 (MH "Spondylolisthesis") OR (MH "Spondylolysis")

S44 (MH "Thoracic Vertebrae")

S43 S36 or S37 or S38 or S39 or S40 or S41 or S42

S42 lumbar N2 vertebra

S41 (MH "Lumbar Vertebrae")

S40 "coccydynia"

S39 "coccyx"

S38 "sciatica"

S37 (MH "Sciatica")

S36 (MH "Coccyx")

S35 S29 or S30 or S31 or S32 or S33 or S34

S34 lumbar N5 pain

S33 lumbar W1 pain

S32 "backache"

S31 (MH "Low Back Pain")

S30 (MH "Back Pain+")

S29 "dorsalgia"

S28 S26 NOT S27

S27 (MH "Animals")

S26 S7 or S12 or S19 or S25

S25 S20 or S21 or S22 or S23 or S24

S24 volunteer*

S23 prospectiv*

S22 control*

S21 followup stud*

S20 follow‐up stud*

S19 S13 or S14 or S15 or S16 or S17 or S18

S18 (MH "Prospective Studies+")

S17 (MH "Evaluation Research+")

S16 (MH "Comparative Studies")

S15 latin square

S14 (MH "Study Design+")

S13 (MH "Random Sample")

S12 S8 or S9 or S10 or S11

S11 random*

S10 placebo*

S9 (MH "Placebos")

S8 (MH "Placebo Effect")

S7 S1 or S2 or S3 or S4 or S5 or S6

S6 triple‐blind

S5 single‐blind

S4 double‐blind

S3 clinical W3 trial

S2 "randomi?ed controlled trial*"

S1 (MH "Clinical Trials+")

CENTRAL

New intervention terms were added from 2009

#1 MeSH descriptor Low Back Pain, this term only

#2 MeSH descriptor Back Pain, this term only

#3 backache

#4 lumbago

#5 (#1 OR #2 OR #3 OR #4)

#6 MeSH descriptor Drugs, Chinese Herbal explode all trees

#7 MeSH descriptor Plants, Medicinal explode all trees

#8 herbal

#9 phytomedicine

#10 herb*

#11 weed

#12 MeSH descriptor Algae explode all trees

#13 MeSH descriptor Fungi explode all trees

#14 MeSH descriptor Medicine, Traditional explode all trees

#15 MeSH descriptor Phytotherapy, this term only

#16 MeSH descriptor Pharmacognosy explode all trees

#17 Oriental NEXT traditional

#18 MeSH descriptor Medicine, Chinese Traditional, this term only

#19 Camphora NEXT molmo

#20 MeSH descriptor Capsicum, this term only

#21 MeSH descriptor Salix, this term only

#22 Maleluca NEXT alternifolia

#23 MeSH descriptor Angelica sinensis, this term only

#24 MeSH descriptor Aloe, this term only

#25 Thymus NEXT officinalis

#26 Menthe NEXT piperita

#27 MeSH descriptor Arnica, this term only

#28 Arnica NEXT Montana

#29 Curcuma NEXT longa

#30 MeSH descriptor Curcuma, this term only

#31 MeSH descriptor Tanacetum parthenium, this term only

#32 MeSH descriptor Harpagophytum, this term only

#33 Harpagophytum NEXT procumbens

#34 Zingiber NEXT officii

#35 MeSH descriptor Plant Preparations, this term only

#36 MeSH descriptor Plant Oils explode all trees

#37 MeSH descriptor Plant Extracts explode all trees

#38 (#6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34 OR #35 OR #36 OR #37)

#39 (#5 AND #38), from 2003 to 2011

April 2010

EMBASE

The strategy was updated from 2009

  1. Clinical Article/

  2. exp Clinical Study/

  3. Clinical Trial/

  4. Controlled Study/

  5. Randomized Controlled Trial/

  6. Major Clinical Study/

  7. Double Blind Procedure/

  8. Multicenter Study/

  9. Single Blind Procedure/

  10. Phase 3 Clinical Trial/

  11. Phase 4 Clinical Trial/

  12. crossover procedure/

  13. placebo/

  14. or/1‐13

  15. allocat$.mp.

  16. assign$.mp.

  17. blind$.mp.

  18. (clinic$ adj25 (study or trial)).mp.

  19. compar$.mp.

  20. control$.mp.

  21. cross?over.mp.

  22. factorial$.mp.

  23. follow?up.mp.

  24. placebo$.mp.

  25. prospectiv$.mp.

  26. random$.mp.

  27. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).mp.

  28. trial.mp.

  29. (versus or vs).mp.

  30. or/15‐29

  31. 14 and 30

  32. human/

  33. Nonhuman/

  34. exp ANIMAL/

  35. Animal Experiment/

  36. 33 or 34 or 35

  37. 32 not 36

  38. 31 not 36

  39. 37 and 38

  40. 38 or 39

  41. dorsalgia.mp.

  42. back pain.mp.

  43. exp BACKACHE/

  44. (lumbar adj pain).mp.

  45. coccyx.mp.

  46. coccydynia.mp.

  47. sciatica.mp.

  48. exp ISCHIALGIA/

  49. spondylosis.mp.

  50. lumbago.mp.

  51. exp Low back pain/

  52. or/41‐51

  53. exp herbaceous agent/

  54. herbal.mp.

  55. exp medicinal plant/

  56. exp phytotherapy/

  57. exp herbal medicine/

  58. phytomedicine.mp.

  59. exp plant extract/

  60. herb*.mp.

  61. weed.mp.

  62. exp alga/

  63. exp fungus/

  64. exp traditional medicine/

  65. exp pharmacognosy/

  66. (oriental adj traditional).mp.

  67. exp Chinese medicine/

  68. exp pepper/

  69. capsicum.mp.

  70. exp willow/

  71. salix.mp.

  72. exp Angelica sinensis/

  73. exp Aloe/

  74. exp Arnica montana/

  75. exp Curcuma longa/

  76. tanacetum/ or exp tanacetum parthenium/

  77. exp harpagophytum/ or exp harpagophytum extract/ or exp harpagophytum procumbens extract/

  78. or/53‐77

  79. 40 and 52 and 78

October‐November 2009

Medline

  1. randomized controlled trial.pt.

  2. controlled clinical trial.pt.

  3. Randomized Controlled Trials/

  4. Random Allocation/

  5. Double‐Blind Method/

  6. Single‐Blind Method/

  7. or/1‐6

  8. Animal/ not Human/

  9. 7 not 8

  10. clinical trial.pt.

  11. exp Clinical Trial/

  12. (clinic$ adj trial$).tw.

  13. ((single$ or double$ or treble$ or triple$) adj (mask$ or blind$)).tw.

  14. Placebos/

  15. placebo$.tw.

  16. random$.tw.

  17. Research Design/

  18. (Latin adj square).tw.

  19. or/10‐18

  20. 19 not 8

  21. 20 not 9

  22. Comparative Study/

  23. exp Evaluation Studies/

  24. Follow‐Up Studies/

  25. Prospective Studies/

  26. (control$ or prospective$ or volunteer$).tw.

  27. Cross‐Over Studies/

  28. or/22‐27

  29. 28 not 8

  30. 29 not (9 or 21)

  31. 9 or 21 or 30

  32. low back pain/

  33. low back pain.tw.

  34. backache.mp.

  35. lumbago.mp.

  36. or/32‐35

  37. exp Drugs, Chinese Herbal/

  38. herbal.tw.

  39. exp Plants, Medicinal/

  40. phytomedicine.tw.

  41. herb$.tw.

  42. weed.tw.

  43. exp Algae/

  44. exp Fungi/

  45. Medicine, Traditional/

  46. exp Phytotherapy/

  47. exp Pharmacognosy/

  48. (oriental adj traditional).tw.

  49. exp Medicine, Chinese Traditional/

  50. (Camphora adj molmol).tw.

  51. Capsicum/

  52. Salix/

  53. (Maleluca adj alternifolia).tw.

  54. exp Angelica sinensis/

  55. Aloe/

  56. (Thymus adj officinalis).tw.

  57. Menthe piperita.tw.

  58. Arnica Montana.mp. or exp Arnica/

  59. Curcuma longa.mp. or exp Curcuma/

  60. exp Tanacetum parthenium/

  61. Harpagophytum procumbens.mp. or exp Harpagophytum/

  62. Zingiber officii.tw.

  63. or/37‐62

  64. 31 and 36 and 63

  65. limit 64 to yr="2005 ‐Current"

Embase

  1. Randomized Controlled Trials/

  2. Random Allocation/

  3. Double‐Blind Method/

  4. Single‐Blind Method/

  5. 4 or 1 or 3 or 2

  6. Animal/ not Human/

  7. 5 not 6

  8. exp clinical trial/

  9. (clinic$ adj trial$).tw.

  10. ((single$ or double$ or treble$ or triple$) adj (mask$ or blind$)).tw.

  11. Placebos/

  12. placebo$.tw.

  13. random$.tw.

  14. Research Design/

  15. (Latin adj square).tw.

  16. or/8‐15

  17. 16 not 6

  18. 17 not 7

  19. Comparative Study/

  20. exp Evaluation Studies/

  21. Follow‐Up Studies/

  22. Prospective Studies/

  23. (control$ or prospective$ or volunteer$).tw.

  24. Cross‐Over Studies/

  25. or/19‐24

  26. 25 not 6

  27. 26 not (7 or 18)

  28. 7 or 18 or 27

  29. low back pain/

  30. low back pain.tw.

  31. backache.mp. or exp backache/

  32. lumbago.mp.

  33. /29‐32

  34. exp Drugs, Chinese Herbal/

  35. herbal.tw.

  36. exp Plants, Medicinal/

  37. phytomedicine.tw.

  38. herb$.tw.

  39. weed.tw.

  40. exp Algae/

  41. exp Fungi/

  42. Medicine, Traditional/

  43. exp Phytotherapy/

  44. exp Pharmacognosy/

  45. (oriental adj traditional).tw.

  46. exp Medicine, Chinese Traditional/

  47. (Camphora adj molmol).tw.

  48. Capsicum/

  49. Salix/

  50. (Maleluca adj alternifolia).tw.

  51. exp Angelica sinensis/

  52. Aloe/

  53. (Thymus adj officinalis).tw.

  54. Menthe piperita.tw.

  55. Arnica Montana.mp. or exp Arnica/

  56. Curcuma longa.mp. or exp Curcuma/

  57. exp Tanacetum parthenium/

  58. Harpagophytum procumbens.mp. or exp Harpagophytum/

  59. Zingiber officii.tw.

  60. or/34‐59

  61. 28 and 33 and 60

  62. limit 61 to yr="2005 ‐Current"

CENTRAL

#1 MeSH descriptor Low Back Pain, this term only

#2 MeSH descriptor Back Pain, this term only

#3 backache

#4 lumbago

#5 (#1 OR #2 OR #3 OR #4)

#6 MeSH descriptor Drugs, Chinese Herbal explode all trees

#7 MeSH descriptor Plants, Medicinal explode all trees

#8 herbal

#9 phytomedicine

#10 herb*

#11 weed

#12 MeSH descriptor Algae explode all trees

#13 MeSH descriptor Fungi explode all trees

#14 MeSH descriptor Medicine, Traditional explode all trees

#15 MeSH descriptor Phytotherapy, this term only

#16 MeSH descriptor Pharmacognosy explode all trees

#17 Oriental NEXT traditional

#18 MeSH descriptor Medicine, Chinese Traditional, this term only

#19 Camphora NEXT molmo

#20 MeSH descriptor Capsicum, this term only

#21 MeSH descriptor Salix, this term only

#22 Maleluca NEXT alternifolia

#23 MeSH descriptor Angelica sinensis, this term only

#24 MeSH descriptor Aloe, this term only

#25 Thymus NEXT officinalis

#26 Menthe NEXT piperita

#27 MeSH descriptor Arnica, this term only

#28 Arnica NEXT Montana

#29 Curcuma NEXT longa

#30 MeSH descriptor Curcuma, this term only

#31 MeSH descriptor Tanacetum parthenium, this term only

#32 MeSH descriptor Harpagophytum, this term only

#33 Harpagophytum NEXT procumbens

#34 Zingiber NEXT officii

#35 (#6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34)

#36 (#5 AND #35)

#37 (#36), from 2005 to 2009 (Searched with limiter Clinical Trials)

CINAHL

S55 S54 and S28 and S32

S54 S33 or S34 or S35 or S36 or S37 or S38 or S39 or S40 or S41 or S42 or S43 or S44 or S45 or S46 or S47 or S48 or S49 or S50 or S51 or S52 or S53

S53 (MH "Devil's Claw")

S52 (MH "Feverfew")

S51 Curcuma longa

S50 (MH "Arnica")

S49 (MH "Aloe")

S48 (MH "Dong Quai")

S47 (MH "Willow Bark")

S46 ("Capsicum") or (MH "Cayenne Pepper")

S45 Camphora W1 molmol

S44 (MH "Medicine, Traditional")

S43 oriental W1 traditional

S42 Pharmacognosy

S41 ("Phytotherapy") or (MH "Medicine, Herbal")

S40 (MH "Medicine, Chinese Traditional")

S39 (MH "Fungi+")

S38 (MH "Algae+")

S37 "weed"

S36 herb*

S35 phytomedicine

S34 (MH "Plants, Medicinal+")

S33 (MH "Drugs, Chinese Herbal")

S32 S29 or S30 or S31

S31 "lumbago"

S30 "backache"

S29 ("low back pain") or (MH "Low Back Pain")

S28 S8 or S18 or S27

S27 S26 not (S18 or S8)

S26 S25 not S7

S25 S19 or S20 or S21 or S22 or S23 or S24

S24 (MH "Crossover Design")

S23 "Follow‐up Studies"

S22 control* or prospective* or volunteer*

S21 (MH "Prospective Studies")

S20 (MH "Evaluation Research+")

S19 (MH "Comparative Studies")

S18 S17 not S8

S17 S16 not S7

S16 S9 or S10 or S11 or S12 or S13 or S14 or S15

S15 Latin W1 Square

S14 (MH "Study Design")

S13 random*

S12 placebo*

S11 (MH "Placebos")

S10 clinic* W2 trial*

S9 "clinical trial"

S8 S6 not S7

S7 (MH "Animals") not ("Human")

S6 S1 or S2 or S3 or S4 or S5

S5 "Single‐Blind Method"

S4 "randomized controlled trial"

S3 "Double‐Blind Method"

S2 (MH "Random Assignment")

S1 (MH "Clinical Trials+")

Appendix 3. Criteria for assessing risk of bias for internal validity

Random sequence generation (selection bias)

Selection bias (biased allocation to interventions) due to inadequate generation of a randomized sequence

There is a low risk of selection bias if the investigators describe a random component in the sequence generation process such as: referring to a random number table, using a computer random number generator, coin tossing, shuffling cards or envelopes, throwing dice, drawing of lots, minimisation (minimisation may be implemented without a random element, and this is considered to be equivalent to being random).

There is a high risk of selection bias if the investigators describe a non‐random component in the sequence generation process, such as: sequence generated by odd or even date of birth, date (or day) of admission, hospital or clinic record number; or allocation by judgement of the clinician, preference of the participant, results of a laboratory test or a series of tests, or availability of the intervention.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Allocation concealment (selection bias)

Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment

There is a low risk of selection bias if the participants and investigators enrolling participants could not foresee assignment because one of the following, or an equivalent method, was used to conceal allocation: central allocation (including telephone, web‐based and pharmacy‐controlled randomization); sequentially numbered drug containers of identical appearance; or sequentially numbered, opaque, sealed envelopes.

There is a high risk of bias if participants or investigators enrolling participants could possibly foresee assignments and thus introduce selection bias, such as allocation based on: using an open random allocation schedule (e.g. a list of random numbers); assignment envelopes were used without appropriate safeguards (e.g. if envelopes were unsealed or non‐opaque or not sequentially numbered); alternation or rotation; date of birth; case record number; or other explicitly unconcealed procedures.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Blinding of participants

Performance bias due to knowledge of the allocated interventions by participants during the study

There is a low risk of performance bias if blinding of participants was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Blinding of personnel or care providers (performance bias)

Performance bias due to knowledge of the allocated interventions by personnel or care providers during the study

There is a low risk of performance bias if blinding of personnel was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Blinding of outcome assessors (detection bias)

Detection bias due to knowledge of the allocated interventions by outcome assessors

There is low risk of detection bias if the blinding of the outcome assessment was ensured and it was unlikely that the blinding could have been broken; or if there was no blinding or incomplete blinding, but the review authors judge that the outcome is not likely to be influenced by lack of blinding, or:

  • for patient‐reported outcomes in which the patient was the outcome assessor (e.g. pain, disability): there is a low risk of bias for outcome assessors if there is a low risk of bias for participant blinding (Boutron 2005);

  • for outcome criteria that are clinical or therapeutic events that will be determined by the interaction between patients and care providers (e.g. co‐interventions, length of hospitalisation, treatment failure), in which the care provider is the outcome assessor: there is a low risk of bias for outcome assessors if there is a low risk of bias for care providers (Boutron 2005);

  • for outcome criteria that are assessed from data from medical forms: there is a low risk of bias if the treatment or adverse effects of the treatment could not be noticed in the extracted data (Boutron 2005).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Incomplete outcome data (attrition bias)

Attrition bias due to amount, nature or handling of incomplete outcome data

There is a low risk of attrition bias if there were no missing outcome data; reasons for missing outcome data were unlikely to be related to the true outcome (for survival data, censoring unlikely to be introducing bias); missing outcome data were balanced in numbers, with similar reasons for missing data across groups; for dichotomous outcome data, the proportion of missing outcomes compared with the observed event risk was not enough to have a clinically relevant impact on the intervention effect estimate; for continuous outcome data, the plausible effect size (difference in means or standardised difference in means) among missing outcomes was not enough to have a clinically relevant impact on observed effect size, or missing data were imputed using appropriate methods (if drop‐outs are very large, imputation using even "acceptable" methods may still suggest a high risk of bias) (van Tulder 2003). The percentage of withdrawals and drop‐outs should not exceed 20% for short‐term follow‐up and 30% for long‐term follow‐up and should not lead to substantial bias (these percentages are commonly used but arbitrary, not supported by literature) (van Tulder 2003).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Selective reporting (reporting bias)

Reporting bias due to selective outcome reporting

There is low risk of reporting bias if the study protocol is available and all of the study's pre‐specified (primary and secondary) outcomes that are of interest in the review have been reported in the pre‐specified way, or if the study protocol is not available but it is clear that the published reports include all expected outcomes, including those that were pre‐specified (convincing text of this nature may be uncommon).

There is a high risk of reporting bias if not all of the study's pre‐specified primary outcomes have been reported; one or more primary outcomes is reported using measurements, analysis methods or subsets of the data (e.g. subscales) that were not pre‐specified; one or more reported primary outcomes were not pre‐specified (unless clear justification for their reporting is provided, such as an unexpected adverse effect); one or more outcomes of interest in the review are reported incompletely so that they cannot be entered in a meta‐analysis; the study report fails to include results for a key outcome that would be expected to have been reported for such a study.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Group similarity at baseline (selection bias)

Bias due to dissimilarity at baseline for the most important prognostic indicators.

There is low risk of bias if groups are similar at baseline for demographic factors, value of main outcome measure(s), and important prognostic factors (examples in the field of back and neck pain are duration and severity of complaints, vocational status, percentage of patients with neurological symptoms) (van Tulder 2003).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Co‐interventions (performance bias)

Bias because co‐interventions were different across groups

There is low risk of bias if there were no co‐interventions or they were similar between the index and control groups (van Tulder 2003).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Compliance (performance bias)

Bias due to inappropriate compliance with interventions across groups

There is low risk of bias if compliance with the interventions was acceptable, based on the reported intensity or dosage, duration, number and frequency for both the index and control intervention(s). For single‐session interventions (e.g. surgery), this item is irrelevant (van Tulder 2003).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Intention‐to‐treat‐analysis

There is low risk of bias if all randomized patients were reported or analysed in the group to which they were allocated by randomization.

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Timing of outcome assessments (detection bias)

Bias because important outcomes were not measured at the same time across groups

There is low risk of bias if all important outcome assessments for all intervention groups were measured at the same time (van Tulder 2003).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Other bias

Bias due to problems not covered elsewhere in the table

There is a low risk of bias if the study appears to be free of other sources of bias not addressed elsewhere (e.g. study funding).

Unclear' reflected the fact that there was insufficient information to determine whether this criterion was fulfilled or not.

Summary of risk of bias for each of the included trials.
Figuras y tablas -
Figure 1

Summary of risk of bias for each of the included trials.

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Summary of findings for the main comparison. Summary of findings table 1: Brazilian arnica extract compared to placebo for patients with non‐specific chronic back pain or soft tissue pain

Brazilian arnica extract compared to placebo for patients with non‐specific chronic back pain or soft tissue pain

Patient or population: patients with back pain

Settings: outpatient clinic

Intervention: extract of Brazilian arnica

Comparison: placebo

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain reduction based on

Pain VAS instrument 0‐100 scale

20
(one trial)

⊕⊝⊝⊝
very low1

Very small sample size only N = 10 in the treatment group. This trial found that topical application of Brazilian arnica reduced the perception of pain and increased flexibility in the treated group compared to baseline values in that group. Unknown if acute or chronic LBP.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Selection bias was high to unclear, performance bias was low risk to unclear risk, with other attributes being low risk.

Figuras y tablas -
Summary of findings for the main comparison. Summary of findings table 1: Brazilian arnica extract compared to placebo for patients with non‐specific chronic back pain or soft tissue pain
Ir a la tabla de la revisión
Summary of findings 2. Summary of findings table 2: Topical capsaicin cream or plaster compared to placebo for patients with non‐specific chronic back pain or soft tissue pain

Topical capsaicin cream or plaster compared to placebo for patients with non‐specific chronic back pain or soft tissue pain

Patient or population: patients with chronic LBP or soft tissue pain

Settings: Outpatient clinic

Intervention: topical capsicum cream or plaster

Comparison: placebo

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain perception according to the Pain VAS scale

0‐10

755
(three trials)

⊕⊕⊕⊝
moderate1

All three trials found a statistically significant difference between

the capsaicin intervention vs. placebo. In three trials minor adverse effects were noted in the treatment groups requiring no specific follow‐up treatments.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1All three trials exhibited low to unclear risk in selection bias, performance bias and attrition bias. One trial was at high risk for selective reporting.

Figuras y tablas -
Summary of findings 2. Summary of findings table 2: Topical capsaicin cream or plaster compared to placebo for patients with non‐specific chronic back pain or soft tissue pain
Ir a la tabla de la revisión
Summary of findings 3. Summary of findings table 3: Topical capsaicin cream compared with placebo for patients with acute non‐specific LBP

Topical capsaicin cream compared with placebo for patients with acute non‐specific LBP

Patient or population: patients with acute mechanical LBP

Settings: outpatient clinic

Intervention: Rado‐Salil ointment

Comparison: placebo

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain evaluation on a 10 cm linear scale

40

(one trial)

⊕⊝⊝⊝
very low1,2

Pain improvements were significantly greater in the capsicum cream group up to day 14. Adverse events: Pruritis, one in placebo, one in Rado‐Salil group. Local erythema and burning, three in the Rado‐Salil group.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Exhibited unclear risk for selection bias as well unclear baseline similarities. Performance bias was low risk as was attrition bias but it was high risk for incomplete outcome data.

2As under 400 participants were included, evidence was downgraded to very low from low.

Figuras y tablas -
Summary of findings 3. Summary of findings table 3: Topical capsaicin cream compared with placebo for patients with acute non‐specific LBP
Ir a la tabla de la revisión
Summary of findings 4. Summary of findings table 4: H. procumbens compared to placebo for non‐specific chronic back pain

H. procumbens compared to placebo for non‐specific chronic back pain

Patient or population: patients with chronic back pain

Settings: outpatient clinic

Intervention:H. procumbens extract

Comparison: placebo

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Arhus pain index

scale 0‐130

315
(two trials)

⊕⊕⊝⊝
low1,2

In one trial a 50mg dose of H. procumbens was used, and in

the second trial a 50 mg and 100 mg dose was used with both trialss

showing a significantly improved pain score over placebo.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Both included trials exhibited low risk of bias regarding selection bias with one trial at unclear risk of bias. Performance bias was at low risk of bias, as was attrition bias with one trial at high risk of bias for incomplete outcome data.

2Two trials included under 400 participants and we downgraded the evidence to low from moderate.

Figuras y tablas -
Summary of findings 4. Summary of findings table 4: H. procumbens compared to placebo for non‐specific chronic back pain
Ir a la tabla de la revisión
Summary of findings 5. Summary of findings table 5: H. procumbens extract compared to Vioxx® for non‐specific chronic LBP

H. procumbens extract compared to Vioxx®for non‐specific chronic LBP

Patient or population: patients with chronic LBP

Settings: outpatient clinic

Intervention:H. procumbens extract

Comparison: Vioxx®

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Modified Arhus Index

Scale 0‐120

88
(one trial)

⊕⊝⊝⊝
very low1,2

H. procumbens was compared to Vioxx®

and while both groups showed similar pain reduction scores there were no

demonstrable difference among groups. There were adverse effects noted in both

groups.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1This trial was at low risk of bias for all risk of bias factors, with the exception of allocation concealment and compliance which were at unclear risk of bias.

2Downgraded to very low versus low as under 400 participants were included.

Figuras y tablas -
Summary of findings 5. Summary of findings table 5: H. procumbens extract compared to Vioxx® for non‐specific chronic LBP
Ir a la tabla de la revisión
Summary of findings 6. Summary of findings table 6: Willow bark extract compared to placebo for non‐specific chronic LBP

Willow bark extract compared to placebo for non‐specific chronic LBP

Patient or population: patients with chronic LBP

Settings: outpatient clinic and public advertisement

Intervention: willow bark extract

Comparison: placebo

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain VAS

Scale 0‐10

261
(two trials)

⊕⊕⊕⊝
moderate1,2

The high dose (240 mg) treatment group

showed a significant reduction in pain

scores versus the low dose (120 mg) group

and the placebo group. There was one severe

allergic reaction related to the extract noted.

One trial (N = 51) also examined the effect of

the extract on platelet aggregation.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Both trials were at low to unclear risk for selection bias, low risk for performance bias with one trial exhibiting high risk in baseline characteristics similarity. Both trials were rated as an overall low risk of bias since they met our predetermined cut‐point of 50% of the criteria on which the trial methods were assessed.

2Downgraded from high to moderate as under 400 participants were included between both trials.

Figuras y tablas -
Summary of findings 6. Summary of findings table 6: Willow bark extract compared to placebo for non‐specific chronic LBP
Ir a la tabla de la revisión
Summary of findings 7. Summary of findings table 7: Willow bark extract compared to rofecoxib for non‐specific chronic LBP

Willow bark extract compared to rofecoxib for non‐specific chronic LBP

Patient or population: patients with chronic LBP

Settings: outpatient clinic

Intervention: willow bark extract

Comparison: rofecoxib

Outcomes

No of participants
(one trial)

Quality of the evidence
(GRADE)

Comments

Arhus Index

Scale 0‐130

Pain VAS

Scale 0‐10

228
(one trial)

⊕⊝⊝⊝
very low1,2

There was no significant difference

in the effectiveness and adverse

events between the extract and

rofecoxib.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Low risk for selection bias, high risk for performance bias, and high and low risk for attrition bias.

2Downgraded from low to very low due as under 400 participants were included.

Figuras y tablas -
Summary of findings 7. Summary of findings table 7: Willow bark extract compared to rofecoxib for non‐specific chronic LBP
Ir a la tabla de la revisión
Summary of findings 8. Summary of findings table 8: Comfrey root extract compared to placebo for acute lower and upper back non‐specific pain

Comfrey root extract compared to placebo for acute lower and upper back non‐specific pain

Patient or population: patients with acute lower and upper back pain

Settings: outpatient setting

Intervention: comfrey root extract

Comparison: placebo

Outcomes

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Pain VAS sum (decrease) on active standardized

movement (mm)

120
(one trial)

⊕⊕⊝⊝
low1,2

The root extract showed a statistically

and clinically relevant reduction in

acute back pain versus placebo.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Unclear risk for selection bias, low risk for both performance and attrition bias.

2Downgraded from moderate to low as under 400 participants were included.

Figuras y tablas -
Summary of findings 8. Summary of findings table 8: Comfrey root extract compared to placebo for acute lower and upper back non‐specific pain
Ir a la tabla de la revisión
Summary of findings 9. Summary of findings table 9: Lavender oil acupressure massage and acupoint stimulation compared to usual treatment for acute non‐specific LBP

Lavender oil acupressure massage and acupoint stimulation compared to usual treatment for acute non‐specific LBP

Patient or population: patients with acute LBP

Settings: old aged home and community centre

Intervention: lavender oil massage

Comparison: usual therapy

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain VAS

0‐10 scale

61
(one trial)

⊕⊝⊝⊝
very low1

One week post‐study the treatment group

showed a significant (P = 0.0001) reduction

in VAS pain as well as improved walking time

and lateral spine flexion range.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Sequence generation was at low risk of bias but allocation concealment was at high risk. Performance bias was at high and unclear risk. Co‐interventions and timing outcome assessment factors were at high risk of bias.

Figuras y tablas -
Summary of findings 9. Summary of findings table 9: Lavender oil acupressure massage and acupoint stimulation compared to usual treatment for acute non‐specific LBP
Ir a la tabla de la revisión
Summary of findings 10. Summary of findings table 10: Spiroflor SRL compared to CCC for chronic non‐specific LBP

Spiroflor SRL compared to CCC for chronic non‐specific LBP

Patient or population: patients with acute and chronic LBP

Settings: outpatient clinic

Intervention: Spiroflor SRL

Comparison: CCC

Outcomes

No of participants
(trials)

Quality of the evidence
(GRADE)

Comments

Pain VAS

0‐100 scale

161
(one trial)

⊕⊝⊝⊝
very low1

Spiroflor SRL and CCC were equally effective in

treating acute LBP but the CCC

group experienced greater adverse events

and adverse drug reactions.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

CCC = Cremor Capsici Compositus FNA; SRL = Homeopathic combination of Symphytum officinale, Rhus toxicodendron and Ledum palustre

1All risk of bias factors were at low risk of bias, except patient compliance which was at high risk.

2Downgraded from low to very low as under 400 participants were included.

Figuras y tablas -
Summary of findings 10. Summary of findings table 10: Spiroflor SRL compared to CCC for chronic non‐specific LBP
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