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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental group | Experimental | Participants in the experimental group will take fish oil (five 1000mg fish oil soft capsules per day, each capsule containing 350mg EPA and 250mg DHA) and receive physical modality treatment (hotpacking 15min and transcutaneous electrical nerve stimulation (TENS) 15min, three times a week) for 8 weeks |
|
| Control group | Placebo Comparator | Participants in the control group will take placebo (five 1000mg sunflower oil soft capsules per day) and receive physical modality treatment (hotpacking 15min and transcutaneous electrical nerve stimulation (TENS) 15min, three times a week) for 8 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fish oil | Dietary Supplement | Five 1000mg fish oil soft capsules per day (each capsule containing 350mg EPA and 250mg DHA) for 8 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| 100mm Visual Analogue Scale (VAS) | Assess low back pain intensity (current, least and worst in the past one week) | Week 8 (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Pressure pain threshold | Assess pressure pain threshold with pressure algometer at quadratus lumborum and sacroiliac joint | Baseline (T0), Week 4 (T1), Week 8 (T2) |
| Roland Morris Low Back Pain and Disability Questionnaire (RMQ) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tsung-Hsun Yang, MD | Kaohsiung Chang Cung Memorial Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital | Kaohsiung City | 833 | Taiwan |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D005395 | Fish Oils |
| D015525 | Fatty Acids, Omega-3 |
| D004561 | Transcutaneous Electric Nerve Stimulation |
| ID | Term |
|---|---|
| D009821 | Oils |
| D008055 | Lipids |
| D004042 | Dietary Fats, Unsaturated |
| D004041 | Dietary Fats |
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| Placebo | Dietary Supplement | Five 1000mg sunflower oil soft capsules per day for 8 weeks |
|
| Hotpacking | Procedure | Hotpacking 15min on low back, three times a week for 8 weeks |
|
| Transcutaneous electrical nerve stimulation (TENS) | Procedure | Transcutaneous electrical nerve stimulation (TENS) 15min on low back, three times a week for 8 weeks |
|
Assess the impact of low back pain on daily life with Taiwan version of Roland Morris Low Back Pain and Disability Questionnaire
| Baseline (T0), Week 4 (T1), Week 8 (T2) |
| Biering-Sorenson test | Assess back extensor endurance | Baseline (T0), Week 4 (T1), Week 8 (T2) |
| Occupational burnout inventory | Assess objective occupational burnout feeling | Baseline (T0), Week 4 (T1), Week 8 (T2) |
| 100mm Visual Analogue Scale (VAS) | Assess low back pain intensity (current, least and worst in the past one week) | Baseline (T0), Week 4 (T1) |
| Blood test: ESR | Draw 10ml blood for checking the level of ESR | Baseline (T0) and Week 8 (T2) |
| Blood test: hs-CRP | Draw 10ml blood for checking the level of hs-CRP | Baseline (T0) and Week 8 (T2) |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D005223 |
| Fats |
| D005231 | Fatty Acids, Unsaturated |
| D005227 | Fatty Acids |
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D000698 | Analgesia |
| D000760 | Anesthesia and Analgesia |