Better than what? Comparisons in low back pain clinical trials
One article on PainSci cites Travers 2018: Studying the Studies
PainSci commentary on Travers 2018: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Many non-drug treatments are tricky to test scientifically, because it’s hard to compare them to a true fake treatment (like a comparing a drug to a sugar pill). Many scientists resort to comparing a treatment to some other treatment that we hope is “neutral” (probably doesn’t have much biological effect, like a sugar pill).
It’s a trap! Comparing a test treatment to an “active control” is likely to be misleading, because the active control pollutes the experiment with all kinds of unknown variables.
The point of this BJSM editorial is that these kinds of studies “need to be interpreted with caution.”
It doesn’t mean that they are all wrong, but it’s a significant and basic limitation that has to be taken seriously. And “these kinds of studies” constitute a large percentage of studies in musculoskeletal medicine …
related content
Specifically regarding Travers 2018:
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.
- No effect of creatine monohydrate supplementation on inflammatory and cartilage degradation biomarkers in individuals with knee osteoarthritis. Cornish 2018 Nutr Res.
- The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Bebee 2021 Med J Aust.
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.