PICOT Question Introduction

Low back pain is a common health challenge for both active and former military service members. Among the military veterans, low back pain places higher risk and has been indicated to be bear the potential for long-term disability (Bagg et al., 2017). There is a lack of effective treatment strategies, and thus, military veterans rely on pain management strategies and other medical strategies, e.g., medical imaging, opioids, injections, and surgery. To both the Department of Defense (DoD) and the Department of Veteran Affairs (VA), the costs of care for members with low back pain have been on the rise; necessitating the need for research on the effectiveness of some of the available methods for treating and managing low back pain. Some of the methods available are non-narcotic pain medication, yoga stretches, and physiotherapy. These interventions can be administered in combination or singly (Bagg et al., 2017). This study assesses the effectiveness of non-narcotic pain medications combined with yoga and cold/heat therapy. Moreover, it compares the above with the use of non-narcotic pain medications to lower back pain (using the DVPRS pain scale) among veterans diagnosed with low back pain for three months.

Background and literature review

The management or treatment of low back pain, whether acute, sub-acute, or chronic, has from practice, shown to have less than desired outcomes. As a result, most veterans with low back pain have resulted in one or several unconventional methods for management of the same. Some of these alternative strategies include non-narcotic medications, yoga stretches, and hot/cold therapy. Non-narcotic analgesics are an effective strategy in dealing with mild to moderate low back pain. Some non-narcotic analgesics are aspirin, Tylenol, and NSAIDs, e.g., fenoprofen, sulindac, carprofen, and ketoprofen (Qaseem et al., 2017).

Yoga stretches have also been shown to offer effectiveness intervention for persons exercising low back pain. However, the findings regarding yoga are mixed, and those that report effectiveness have some significant limitations. That notwithstanding, yoga stretches have been reported to help deal with disability caused by low back pain, depression for low back pain patients, and as compared to a control group, the level of pain was significantly lower for those practicing yoga stretches (Groessl et al., 2008; Williams et al., 2009).

Heat/cold therapy has also been shown by research findings to offer effective remedies for both acute and moderate low back pain (Dehghan & FarahbOD, 2014). Even though the two might not have the same results on the same patient,...

For example, hot therapy works, especially if the cause of low back pain is the poor contraction of the otherwise smooth muscles, and cold therapy might work in the short-term by numbing nerve endings.
Purpose of the study

Even though research on the effectiveness of individual intervention for low back pain is wide and intensive, there is limited research on a combination of these interventions. In practice, persons suffering from low back pain will use several of these strategies to alleviate the pain. This study, therefore, compares how a combination of these strategies, namely, non-narcotic medication with yoga and therapy and how its effectiveness compares with non-narcotic medications used singly.

Literature search and strategies

A systematic literature review method was adopted or this study. Given the purpose of the study, this method is the most appropriate as it allows for a review of previous research to determine the findings and how they reflect on the current research problem.

The search was done in five electronic databases; Medline, CINAHL, Cochrane Library, PsycLIT, and EBSCOhost. The search was done using the keywords; “Low back pain,” “multifaceted treatment,” “treatment effectiveness,” “Yoga,” “Non-narcotic,” and “physiotherapy.”

The search was done by the principal research, and results were first analyzed on topic and abstract to determine whether they meet the inclusion criteria. Once determined to fit, they were further examined in the body text to determine whether they meet the specifics of the PICOT question.

The inclusion criteria: meet the PICOT question, reported on any of the low back pain treatment strategies, studies that published in English, not later than 2000, and they were research paper with a sample included. Exclusion criteria: unpublished studies include participants under the age of 18 include commentaries or opinions, and studies published in a non-English language.

The search strategy generated 247 results, of which 147 were considered to be potentially relevant to the study subject. There were three unpublished articles, and none that includes underage participants or published in non-English languages.

After review of the abstract, 39 studies where identified, and after further review of the text, 27 were expunged for not addressing low back pain. Figure 1, represents the eligibility assessment and inclusion.

These findings are crucial in filling the knowledge gap on the effectiveness of the combination…