A new study suggests that most non-surgical treatments for lower back pain—ranging from medications to physical therapy—may not be as effective as previously thought.
Back Pain’s Widespread Impact
Lower back pain is a common issue that can seriously disrupt daily life. When patients seek treatment, they’re often prescribed non-surgical options such as medication, physical therapy, and injections. In more severe cases, surgery might be recommended.
However, a recent study published in the British Medical Journal (BMJ) Evidence-Based Medicine casts doubt on the effectiveness of these non-invasive treatments. The findings suggest that most approaches, aside from surgical and more invasive procedures like spinal injections and nerve stimulation, offer limited relief.
The Study’s Findings
Researchers analyzed data from 52 cases of acute low back pain, 228 cases of chronic low back pain, and 21 cases involving both types. Pain intensity was measured using visual analog and numerical rating scales.
Of the 69 different treatment comparisons evaluated, the evidence was classified using the GRADE system:
- 16% showed “moderate certainty” of effectiveness
- 36% showed “low certainty”
- 48% showed “very low certainty”
In other words, nearly half of the treatments lacked strong scientific backing.
What Worked—and What Didn’t
For chronic lower back pain, treatments like exercise, spinal manual therapy, and certain medications targeting pain receptors (TRPV1) showed some moderate effectiveness.
For acute back pain, evidence with moderate certainty suggested that exercise, steroid injections, and acetaminophen (Tylenol) were largely ineffective. Similarly, for chronic pain, lidocaine (a local anesthetic) and antibiotics showed little to no benefit.
More Research Needed
The research team concluded that none of the treatments included in the study demonstrated consistent, reliable effectiveness. They stressed the need for larger, high-quality, placebo-controlled trials to determine the true value of non-surgical back pain treatments.
The findings suggest that while specific therapies may provide short-term relief, a more tailored, evidence-based approach may be necessary to manage chronic back pain effectively.
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