Self-Healing: A Concept for Musculoskeletal Body Pain Management – Scientific Evidence and Mode of Action

Figures & data

Table 1 International Guideline Recommendations for Acute Low Back Pain

Country	Guideline	Year Published	Disease Management Option in Guideline
Australia	eTG complete by Therapeutic Guidelines Pain and analgesia: non-specific acute low back pain^Citation118	2017	1st line: Non-Pharmacological treatment, Massage and thermotherapy 2nd line: NSAIDs 3rd line: Paracetamol 4th line: Further investigation and follow-up
	NSW Agency for Clinical Innovations Clinical Model of Care Management of people with low back pain: model of care^Citation119	2016	1st line: Assessment, risk stratification, and patient education 2nd line: Active physical therapy and simple analgesic medications 3rd line: Complex medications, CBT 4th line: Review, imaging and referral
Brazil	Brazilian Medical Association and Federal Council of Medicine Project Guidelines (Projeto Diretrizes Associação Médica Brasileira e Conselho Federal de Medicina) Diagnosis and treatment of low back and sciatica pain (Diagnóstico e tratamento das lombalgias e lombociatalgias)^Citation120	2001	1st line: Rest, physical therapy, acetaminophen, dipyrone 2nd line: NSAIDs 3rd line: Corticosteroids 4th line: Carisoprodol, cyclobenzaprine 5th line: Trigger point inactivation 6th line: Surgical treatments
	Brazilian Association of Physical Medicine and Rehabilitation (Associação Brasileira de Medicina Física e Reabilitação) Chronic nonspecific low back pain: rehabilitation (Lombalgia inespecífica crônica: reabilitação)^Citation121	2013	1st line: Pharmacological (acetaminophen, NSAIDs, opiates, anti-depressants) and non-pharmacological (exercise, ultrasound, thermal water, shortwave diathermy) 2nd line: muscle relaxants
France	High Authority of Health Recommendation of Good Practice (Haute Autorité de Santé Recommandation de Bonne Pratique) Management of the patient with common low back pain (Prise en charge du patient présentant une lombalgie commune)^Citation122	2019	1st line: Patient Information, self-management 2nd line: Physical activity, paracetamol, NSAIDs 3rd line: Multidisciplinary approach 4th line: Biopsychosocial
	French Society of Rheumatology (Société Française de Rhumatologie) How is low back pain or common low back pain treated? (Comment se traite une lombalgie ou une lomboradiculalgie commune?)^Citation123	2019	1st line: Reassurance 2nd line: Pharmacological and non-pharmacological pain treatment 3rd line: Physical activity and psychosocial therapy
Germany	AWMF German Disease Management Guideline Non-specific low-back pain^Citation124	2017	1st line: Physical activity and educative measures 2nd line: Diclofenac, ibuprofen, naproxen 3rd line: Celecoxib, etoricoxib, metamizole 4th line: Heat, NSAIDs, multimodal treatment programs
	National German Guideline (S2k-Leitlinie) Specific low back pain (Spezifischer kreuzschmerz)^Citation125	2018	1st line: facet joint blocks, NSAIDs 2nd line: Surgery
UK	NICE Guideline (NG59) Low back pain and sciatica in over 16s: assessment and management^Citation126	2016	Risk stratification followed by activity promotion and self-management. Patients encouraged to remain at work NSAIDs or weak opioid with/without paracetamol
USA	Agency for Healthcare Research and Quality Effective Healthcare Program Noninvasive treatments for low back pain: current state of the evidence^Citation127	2016	1st line: Non-pharmacologic treatment (exercise, heat, massage, acupuncture, manipulation). 2nd line: NSAIDs or skeletal muscle relaxants 3rd line: Combination therapy/low evidence for mind-body interventions including yoga, tai chi and mindfulness
	VA/DoD Clinical Practice Guideline Diagnosis and treatment of low back pain^Citation128	2017	1st line: Education and self-care 2nd line: Non-pharmacological therapies 3rd line: Prescription NSAIDs or non-benzodiazepine skeletal muscle relaxants 4th line: Intensive interdisciplinary rehabilitation
	Clinical Practice Guideline from the American College of Physicians Noninvasive treatments for acute, subacute, and chronic low back pain^Citation38	2017	1st line: Non-pharmacological treatments (heat, massage, acupuncture, spinal manipulation, yoga, relaxation, cognitive behavioral therapy or mindfulness-based stress reduction). 2nd line: NSAIDs 3rd line: Tramadol or duloxetine 4th line: Opioids

Abbreviations: AHRQ, Agency for Healthcare Research and Quality; AWMF, Association of the Scientific Medical Societies in Germany; CBT, cognitive behavioral therapy; DoD, Department of Defense; NICE, National Institute for Health and Care Excellence; NSAIDs, non-steroidal anti-inflammatory drugs; NSW, New South Wales; VA, Veterans’ Affairs.

Figure 1 Self-healing concept: biological systems and mode of action.

Figure 2 Examples of integrative therapies and their links with the five body networks within the self-healing concept.

Abbreviations: MET, microcurrent electrical therapy; TCM, traditional Chinese medicine; TENS, transcutaneous electrical nerve stimulation.

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