Overall proportion of patients with meaningful response to treatment: Ordered by certainty of evidence and then highest to lowest risk ratios.
| GRADE CERTAINTY OF EVIDENCE | INTERVENTION TYPE | NO. OF RCTS* | INTERVENTION EVENT RATE, % (n/N) | CONTROL EVENT RATE, % (n/N) | TIME FRAME | RISK RATIO (95% CI) |
|---|---|---|---|---|---|---|
| Moderate | Exercise | 18 | 50 (734/1472) | 35 (386/1089) | 6 to 52 wk | 1.71 (1.37 to 2.15) |
| Oral NSAIDs | 4 | 55 (543/993) | 37 (237/644) | 4 to 16 wk | 1.44 (1.17 to 1.78) | |
| SNRIs (duloxetine) | 4 | 58 (482/832) | 47 (314/667) | 12 to 13 wk | 1.25 (1.13 to 1.38) | |
| Low | Spinal manipulation therapy | 5 | 57 (199/349) | 39 (132/337) | 2 to 12 wk | 1.54 (1.11 to 2.12) |
| Rubefacients | 3 | 64 (195/304) | 46 (142/307) | 3 wk | 1.39 (1.20 to 1.61) | |
| Very low | Acupuncture | 8 | 54 (1320/2457) | 35 (754/2161) | 4 to 24 wk | 1.58 (1.13 to 2.21) |
| Opioids | 6 | 39 (660/1712) | 32 (318/996) | 4 to 12 wk | 1.26 (1.02 to 1.55) | |
| Corticosteroid injections | 10 | 48 (276/581) | 45 (257/571) | 4 to 104 wk | 1.07 (0.87 to 1.30) |
GRADE—Grading of Recommendations Assessment, Development and Evaluation; NSAID—nonsteroidal anti-inflammatory drug; RCT—randomized controlled trial; SNRI—serotonin-norepinephrine reuptake inhibitor.
↵* Total number of RCTs is 63. Exercise and acupuncture have additional trials that do not report responder outcome data during the intervention period. Additionally, topical NSAIDs and anticonvulsants each have 1 study. Event rates for intervention and controls were calculated by meta-analyzing the responder outcome for the longest time frame in which the intervention was given.