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Neuroreflexotherapy for Nonspecific Low Back Pain: A Systematic Review

Urrútia, Gerard MD*; Burton, Kim PhD; Morral, Antoni; Bonfill, Xavier PhD*; Zanoli, Gustavo PhD§

doi: 10.1097/01.brs.0000155575.85223.14
Clinical Case Series

Study Design. Systematic review.

Objective. To assess the effectiveness of neuroreflexotherapy (NRT) for low back pain (LBP).

Summary of Background Data. Few of the alternatives for the management of LBP have a firm base of evidence for their effectiveness. Recently, a new intervention known as NRT has been developed in Spain and has been reported to have favorable results.

Methods. Searches were undertaken according to Cochrane Collaboration guidelines, and randomized controlled trials that evaluated NRT as treatment for patients with nonspecific LBP were included. A qualitative synthesis and an assessment of methodological quality were undertaken.

Results. Three randomized controlled trials were included, with 125 and 148 subjects in control and intervention groups, respectively. NRT was compared with sham in two trials and standard care in one. Individuals receiving active NRT showed significantly better outcomes for pain, mobility, disability, medication use, consumption of resources, and costs. No major side effects were reported by those receiving active NRT.

Conclusions. NRT appears to be a safe and effective intervention for nonspecific LBP. This conclusion is limited to three trials conducted by a small number of experienced clinicians. Further trials in other settings are needed to determine whether these favorable results can be generalized.

We performed a systematic review to assess the effectiveness of neuroreflexotherapy (NRT) for the treatment of nonspecific low back pain. NRT appears to be a safe and effective intervention for the current episode of nonspecific low back pain as shown by the results of three randomized controlled trials. Generalizability of these promising results in other settings as well as the long-term effects of NRT should be assessed in further studies.

From the *Centro Cochrane Iberoamericano, Hospital de la Santa Creu i Santa Pau, Barcelona, Spain and Red Temática de Medicina Basada en la Evidencia (G03/090) and Red Española de Investigadores en Dolencias de la Espalda; †Centre for Health and Social Care Research, University of Huddersfield, Huddersfield, United Kingdom; ‡Escola Universitaria d’Infermeria i Fisioterapia Blanquerna, Spain; §Dipartimento di Scienze Biomediche e Terapie Avanzate - Clinica Ortopedica e Traumatologica, Universita degli Studi di Ferrara, Italy

None of the authors of this report have any experience in performing NRT, have participated in any of the trials included in this review, or have any kind of professional or commercial involvement with the investigators or clinics in the trials reviewed. The reviewers undertook the task for its scientific and clinical interest only. The reviewer who initially registered the title (G. U.), although not working in this field, chose this topic mainly because of the impact of this procedure on the Spanish mass media. Since then, G. U. has kept in relatively close contact with Dr. Kovacs in relation to this and other initiatives (a grant application). One reviewer (G. Z.) visited one NRT clinic in Palma de Mallorca in April 2002, whereas another (K. B.) has worked with the lead author of the trials on an unrelated initiative.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Gerard Urrútia, MD, Centro Cochrane Iberoamericano, Hospital de la Santa Creu i Santa Pau, St. Antoni M. Claret 171, 08041 Barcelona, Spain; E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.