Most back pain treatments don’t work, study finds

Chronic back pain is a prevalent issue affecting millions of American adults, with around 16 million individuals experiencing persistent or chronic back pain. However, a new study published in BMJ Evidence-Based Medicine has uncovered some disheartening findings about the effectiveness of treatments for lower back pain.

The study, conducted by researchers at the University of New South Wales in Sydney, Australia, reviewed 301 randomized, controlled trials that examined 56 non-surgical treatments for acute low back pain, chronic low back pain, or a combination of both. The results revealed that only one in every 10 treatments was found to be effective in relieving lower back pain. Many of the treatments were deemed to be “barely better than a placebo” in terms of pain relief.

Lead study author Dr. Aidan Cashin, deputy director of the Centre for Pain IMPACT at Neuroscience Research Australia (NeuRA), emphasized that the review did not find reliable evidence of significant effects for any of the included treatments. Ineffective treatments for acute low back pain included exercise, steroid injections, and paracetamol, while antibiotics and anaesthetics were deemed unsuitable for chronic low back pain.

However, the study did suggest that non-steroidal anti-inflammatory drugs (NSAIDs) could be effective for acute low back pain, while therapies such as exercise, taping, spinal manipulation, antidepressants, and TRPV1 agonists might be beneficial for chronic low back pain, although the effects were found to be small.

Dr. Stephen Clark, a physical therapist and chief clinical officer at Confluent Health in Georgia, highlighted the complexity of pain as a condition influenced by various factors, including stress, sleep quality, fatigue, fear, social situations, nutrition, sickness, and previous history of pain. Clark recommended multimodal treatments tailored to individual patients’ experiences, including manual therapy, active interventions like exercise, and education about pain management.

While surgical intervention may be effective for some patients, Clark cautioned that it should be considered a last resort for non-emergency situations. He emphasized the importance of understanding the complexity of pain and tailoring treatment plans accordingly to prevent or delay the need for invasive procedures.

In conclusion, the study’s findings underscore the need for further high-quality, placebo-controlled trials to better understand the efficacy of treatments for lower back pain. By taking a comprehensive and individualized approach to pain management, healthcare providers can better address the complex nature of chronic back pain and improve outcomes for patients.