Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis
Open accessAbstract
Objective: To investigate the cost-effectiveness of exercise therapy in the treatment of patients with non-specific neck pain and low back pain. Design: Systematic review of economic evaluations. Data sources: The search was performed in 5 clinical and 3 economic electronic databases. Eligibility criteria for selecting studies: We included economic evaluations performed alongside randomised controlled trials. Differences in costs and effects were pooled in a meta-analysis, if possible, and incremental cost-utility ratios (ICUR) were descriptively analysed. Results: Twenty-two studies were included. On average, exercise therapy was associated with lower costs and larger effects for quality-adjusted life-year (QALY) in comparison with usual care for subacute and chronic low back pain from a healthcare perspective (based on ICUR). Exercise therapy had similar costs and effect for QALY in comparison with other interventions for neck pain from a societal perspective, and subacute and chronic low back pain from a healthcare perspective. There was limited or inconsistent evidence on the cost-effectiveness of exercise therapy compared with usual care for neck pain and acute low back pain, other interventions for acute low back pain and different types of exercise therapy for neck pain and low back pain. Conclusions: Exercise therapy seems to be cost-effective compared with usual care for subacute and chronic low back pain. Exercise therapy was not (more) cost-effective compared with other interventions for neck pain and low back pain. The cost-utility estimates are rather uncertain, indicating that more economic evaluations are needed. Registration: PROSPERO, CRD42017059025.
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A 2019 meta-analysis concluded that exercise is more cost-effective than usual medical care for subacute and chronic low back pain.
“A meta-analysis published in 2019 concluded that exercise is more cost-effective compared to usual medical care for subacute and chronic low back pain [10].”
From Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis (2024) · cites this paper as [10]
The Abstract says exercise therapy may be cost-effective compared with usual care for subacute and chronic low back pain, but calls the cost-utility estimates uncertain. The ‘Subacute and chronic low back pain’ section reports mixed cost-utility results, including one finding that exercise was not cost-effective. The citing sentence overstates this qualified conclusion as a definitive one. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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- Authors
- Miyamoto, G. C., Lin, C.-W. C., Cabral, C. M. N., van Dongen, J. M., & van Tulder, M. W.
- Affiliations
- Universidade Cidade de São Paulo (BR)
- The University of Sydney (AU)
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Noord-Holland, The Netherlands
- Corresponding author
- Miyamoto, Gisela Cristiane
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2018-04-20
- Volume
- 53
- Issue
- 3
- Pages
- 172-181
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2802922258
- Cited by
- 155
- References
- 65
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 37 · 2023: 20 · 2022: 18 · 2021: 28 · 2020: 16 · 2019: 3 · 2018: 5
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Health and Medical Research Council
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Keywords
- exercise therapy, cost-effectiveness, non-specific neck pain, low back pain, chronic low back pain, subacute low back pain, acute low back pain, quality-adjusted life years, incremental cost-utility ratio, usual care comparison, economic evaluation
- MeSH terms
- Cost-Benefit Analysis, Exercise Therapy, Humans, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Low Back Pain, Quality-Adjusted Life Years, Neck Pain, Physical Therapy Modalities
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