LETTER TO THE EDITOR

Year : 2014  |  Volume : 28  |  Issue : 3  |  Page : 193

Chronic low back pain and treatment with microwave diathermy

Gourav Banerjee
Centre for Pain Research, Faculty of Health and Social Sciences, Leeds Metropolitan University; Leeds Pallium Research Group, Leeds, United Kingdom

Correspondence Address:
Gourav Banerjee
Faculty of Health and Social Sciences, Leeds Metropolitan University, Civic Quarter, Leeds LS1 3HE
United Kingdom

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0970-5333.138460

1. The abstract is perplexing. The title and the published text suggest that the research intervention was Microwave Diathermy (MWD). The authors concluded, 'the present study suggests that short wave diathermy is effective for the treatment of patients with chronic low back pain'. MWD and shortwave diathermy (SWD) are two different physical thermotherapy modalities though their physiological effects have been assumed to be similar.
2. It could not be established by reading the article whether the participants included in the study had had non-specific chronic low back pain. Specific causes or "red flags" may have other implications.
3. It has been stated "the patients were selected randomly according to...". Requesting information on why the included participants were randomized. From the given information, it is assumed that all 100 participants were selected to receive MWD + NSAIDs + Therapeutic Exercises + Instructions on Activities of Daily Living.
4. Missing information on ethical clearance and adherence to clinical research principles.
5. Missing information on parameters of intervention (e.g., MWD frequency), intervention's manufacturer name, etc.
6. Missing other vital information such as secondary outcome measures, baseline data collection, participant attrition (if any), adverse event(s) reporting (if any), contraindications, etc.
7. Possible typographical error in reporting "worst possible pain" as 100 on a scale (VAS) of 0-10.
8. Information is missing on daily living activities. Some such activities may aggravate pain; brief information is, therefore, warranted.
9. Since it is difficult to assume or isolate the effect of NSAIDs and Therapeutic Exercises from the study, it should be questionable to conclude that MWD is effective and helpful in low back pain. It is very likely that Therapeutic Exercises and NSAIDs together might have improved participants' VAS scores. Presently, there is paucity in research evidence for the use of MWD in chronic nonspecific low back pain. The authors of international (UK ^[2] , USA ^[3] , and European ^[4] ) clinical guidelines on chronic low back pain management are unconvinced to recommend MWD.
10. Without answers to the questions raised above, the overall validity and reliability of this study would appear questionable.

References

1.	Ahmad SJ, Buchh VN, Koul AN, Rather AH. Chronic low back pain and treatment with microwave diathermy. Indian J Pain 2013;27:22-5.
2.	NICE information for the public [Internet]. (England and Wales): National Institute for Health and Clinical Excellence, UK. Early management of persistent non-specific low back pain. c2009 . Available from: http://www.nice.org.uk/nicemedia/live/11887/44346/44346.pdf [Last cited on 2014 Mar 15].
3.	Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann Intern Med 2007;147:492-504.
4.	European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;15:192-300.