Medium firm mattresses reduced pain related disability more than firm mattresses in chronic, non-specific low back pain

Kovacs FM, Abraira V, Peña, etc.
Mattress hardness for chronic nonspecific low-
Back pain: Random, double
Blind, controlled, multi-center trial. Lancet 2003; 362:1599–604.
Effect of different mattress hardness of Openurlcrosspubmedweb of scienceq Q on clinical process of chronic non-functional mattress
Specifically, back pain and disability?
Clinical impact rating for GP/FP/primary care★★★★★☆ Instant messaging/mobile care★★★★★★☆ Rheumatism★★★★★★☆ Oas _ mark. loadAd(\"Middle1\");
Method Design: a randomized controlled trial.
Distribution: concealment. *Blinding:{
Patients, clinicians, data collectors, outcome assessors, data analysts, and monitoring committee}†.
* Follow-up period: 90 days. Setting:Spain.
Patient: 313 adults under the age of 18 (73% women)
, Had 3 months of chronic lower back pain, pain while lying in bed or rising.
Exclusion criteria: Referral pain;
Vomiting
Possible systemic, inflammatory, or cancer;
Diagnosis or suspicion of fibromyalgia; pregnancy;
2 nights/week, habitually sleeping in different beds; use of anti-
Effective inflammatory drugs for 24 hours;
Or use hypnotized painkillers,-
Inflammation or laxative drugs from 1700 hours to the time when the pain is assessed to rise.
Intervention: 155 patients were assigned to a medium-strength mattress (
The European Committee on Standards is rated 5. 6 [1.
Month = month firm and month. 0 u200a=u200a softest]
158 patients were assigned to a fixed mattress (
Hardness grade 2. 3).
Results: self-reported pain intensity while lying in bed and rising (
Visual Analog Scale)
Degree of disability (
Roland Morris questionnaire).
Follow-up of patients: 310 cases (99%)
Follow-up has been completed (
Intention to treat analysis).
The primary outcome of using a medium-strength mattress patients are more likely to improve pain-related disability than patients using a medium-strength mattress (table).
There is no difference between the two groups in the improvement of pain in lying in bed or the improvement of pain rise (table).
View this table: View inline View popupMedium corporate mattress v corporate mattress for chronic non-chronic
Specific low back pain in patients with chronic, non-chronic low back pain * conclusion
Specific lower back pain, medium-strong mattresses are better at relieving pain-related disabilities than solid mattresses, but do not affect pain when lying in bed or rising.
Do not recommend firm mattresses for people with chronic lower back pain.
Despite the findings of Kovacs and others, medium-strength mattresses are not recommended.
If this is the case, the ideal mattress is still unknown.
It is recommended to sleep on a sturdy mattress to relieve persistent regional back pain, to withdraw from unconfirmed ranks and to join the growing ranks of being denied.
Hundreds of other methods have also encountered this fate.
According to the evidence, more information and advice should be provided to stay active than on the counter.
Thanks to the results of the trials by Kovacs et al, the firmer mattress has now lost its competitive edge.
Inter-group differences are persuasive, but must be explained with caution, as most study patients correctly perceive the firmness of their new mattress, which means blinding is unsuccessful.
What\'s even more impressive is that, regardless of the new mattress type they receive, more than 70% of patients have improved back pain.
The test of this treatment is itself a treatment. The non-specific (
Hawthorne and placebo)
The effects of inter-group differences dwarf them.
How can it be palliative to simply participate in the trial?
Obviously, participation has overcome the obstacles caused by back pain for many months.
The context of this trial must have given patients enough sense of health so that they can downplay, ignore or even forget their pain.
Pain is behind them, but pain is in their mind.
There is a cheaper way to cope than buying a new medium-strength mattress.
3 References van Tulder MW, Scholten RJ, Koes BW, etc. Spine 2000; 25:2501–13.
The knowledge base of openurlcrossrefpmedweb Science Holdings Hagen, Sid, Jamtvedt, etc. Spine. 2002; 27:1736–41.
The place where OpenUrlCrossRefPubMedWeb Science received Hadler.
The last good man.
Montreal: McGill
Queen\'s University Press, 2004
See glossary.
Information provided by the author.
Correspondence: Dr. F. M. Kovacs, Parma Kovacs Foundation, Spain. kovacskovacs.
Kovacs Foundation: source of funding.
The mattress is provided by FLEX.
The non-Canadian magazine club also made summaries and comments.