Chronic Low Back Pain
Conditions
Keywords
low back pain, fish oil, omega 3
Brief summary
Objectives: To investigate the efficacy of omega-3 polyunsaturated fatty acids (PUFA) on patients with chronic nonspecific low back pain (NLBP). Methods and Materials: Twenty-nine patients with chronic NLBP were randomly divided into experimental and control groups. For 8 weeks, participants in the experimental group received omega-3 PUFA at 3000 mg/day plus physical therapy, while those in the control group received placebo plus physical therapy. The visual analog pain scale, pressure algometer, Biering-Sorenson test, Roland-Morris Low Back Pain and Disability Questionnaire (RMQ), and occupational burnout inventory (OBI) were used in assessments at baseline (T0) and after 4 (T1) and 8 weeks (T2). Serum erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hs-CRP) were checked at baseline and T2.
Detailed description
Low back pain is a common symptom in modern society. However, nearly 85% of those who seek medical care for low back pain have no specific history and no specific finding in image study, and therefore do not receive a specific diagnosis. This type of low back pain is termed nonspecific low back pain. Fish oil contains omega-3 polyunsaturated fatty acid, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA can reduce the synthesis of prostaglandin E2. They are also the precursors of the E-resolvin and D-resolvin that suppress inflammatory cytokine production and act to resolve inflammation. Several previous studies showed that fish oil has the effect of anti-inflammation and pain reduction without side effect that affecting stomach and renal function. Therefore, fish oil is considered a new type of NSAID, and many studies are investigating its effect of anti-inflammation and pain reduction on different diseases. The purpose of this study is to investigate the effects of fish oil on patients with chronic nonspecific low back pain.
Interventions
DIETARY_SUPPLEMENTFish oil
Five 1000mg fish oil soft capsules per day (each capsule containing 350mg EPA and 250mg DHA) for 8 weeks
DIETARY_SUPPLEMENTPlacebo
Five 1000mg sunflower oil soft capsules per day for 8 weeks
PROCEDUREHotpacking
Hotpacking 15min on low back, three times a week for 8 weeks
PROCEDURETranscutaneous electrical nerve stimulation (TENS)
Transcutaneous electrical nerve stimulation (TENS) 15min on low back, three times a week for 8 weeks
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Male and female aged 20-50 * Low back pain duration over 3 months and pain intensity over 40mm when assessed with 100mm VAS
Exclusion criteria
* History of major trauma or surgery at back * Obvious spinal pathology on plain film (e.g. scoliosis, spondylosis, spondylolisthesis) * Not suitable for taking fish oil or receiving physical modality treatment * Having other inflammatory disease (e.g. rheumatic arthritis, endometriosis, ankylosing spondylitis, infection) * Pregnancy * Regularly taking fish oil or fatty fish more than 2 times per week * Having coagulopathy or currently taking anti-coagulation agent * Receiving oral or topical NSAID in the past one week * Taking oral corticosteroid in the past 6 weeks * Receiving local injection of corticosteroid or prolotherapy in the past 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 100mm Visual Analogue Scale (VAS) | Week 8 (T2) | Assess low back pain intensity (current, least and worst in the past one week) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Roland Morris Low Back Pain and Disability Questionnaire (RMQ) | Baseline (T0), Week 4 (T1), Week 8 (T2) | Assess the impact of low back pain on daily life with Taiwan version of Roland Morris Low Back Pain and Disability Questionnaire |
| Biering-Sorenson test | Baseline (T0), Week 4 (T1), Week 8 (T2) | Assess back extensor endurance |
| Occupational burnout inventory | Baseline (T0), Week 4 (T1), Week 8 (T2) | Assess objective occupational burnout feeling |
| Pressure pain threshold | Baseline (T0), Week 4 (T1), Week 8 (T2) | Assess pressure pain threshold with pressure algometer at quadratus lumborum and sacroiliac joint |
| Blood test: ESR | Baseline (T0) and Week 8 (T2) | Draw 10ml blood for checking the level of ESR |
| Blood test: hs-CRP | Baseline (T0) and Week 8 (T2) | Draw 10ml blood for checking the level of hs-CRP |
| 100mm Visual Analogue Scale (VAS) | Baseline (T0), Week 4 (T1) | Assess low back pain intensity (current, least and worst in the past one week) |
Countries
Taiwan
Outcome results
None listed