Review of Selected Physiotherapeutic Methods Used in the Rehabilitation of Low Back Pain in Light of Evidence-Based Medicine Principles

Introduction
Low back pain (LBP) is a major social and economic problem. Its prevalence in 2015 was 540 million cases, which is 7% of the general population. A number of physiotherapeutic methods are used to treat these spinal complaints.

Aims
This review aimed to compare the effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), Transcutaneous Electrical Nerve Stimulation (TENS), and the Pilates Method Exercise Program (PMEP) in patients with LPB.

Material and methods
This review analyzed studies considered high quality according to the Physiotherapy Evidence Database scale (PEDro score above 7/10) in terms of the effectiveness of the methods analyzed: MDT, TENS, and PMEP.

Results
In the studies reviewed, the MDT method was found to be inconclusively effective, while TENS, considered simple and popular, improved the condition of patients suffering from LBP. The PMEP method was the most effective, although it was compared only with the control group.

Conclusions
It seems necessary to continue randomized clinical trials (RCTs) on these methods with standardized methodology (double and triple blinding, a follow-up evaluation of the participants, selecting therapists with similar professional experience, and a comparison of more methods in high-quality systematic reviews and meta-analyses).