Only one in 10 treatments for lower back pain ‘are effective’ – study
But researchers found that evidence was ‘inconclusive’ for a number of treatments.
The majority of treatments for lower back pain may not be effective, according to a new review.
While the NHS advises that back pain will usually improve “within a few weeks”, this may seem like a lifetime to sufferers who will look for ways to alleviate their pain.
But a new study has found that only one in 10 treatments for lower back pain are effective, with those that improve symptoms only having “slight” or “small” effects on pain.
Experts found that evidence was “inconclusive” for a number of popular treatments.
Researchers led by academics in Australia set out to examine the effectiveness of non-surgical back pain treatments in adults.
They looked at 301 trials examining 56 different treatments for lower back pain.
People involved with the studies reported pain intensity at the start of the trial and again after treatment.
Researchers also assessed the certainty of the evidence provided in the studies.
They found that just one treatment for acute low back pain and five treatments for chronic – or long-term – back pain were “efficacious”.
These include non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for short-term back pain.
For long-term back pain the treatments found to be effective were exercise, spinal manipulative therapy, taping, antidepressants and a type of drug called transient receptor potential vanilloid 1 (TRPV1).
But even these were only found to have “slight” or “small” reductions in pain compared with a placebo – or dummy drug.
“Best available evidence shows that one in 10 common non-surgical and non-interventional treatments for low back pain are efficacious, providing small analgesic effects beyond placebo,” the authors said.
They said that exercise, paracetamol and glucocorticoid injections “probably provides little to no difference in pain” for acute lower back issues.
Antibiotics and anaesthetics were also found to be “not efficacious” for long-term lower back problems.
Meanwhile the rest of the interventions studied had “inconclusive evidence” so the authors called for more studies to examine the “remaining uncertainty” surrounding a number of back pain treatments.
While the evidence was deemed to be inconclusive, the information available did point to some of these being effective for acute back pain.
For example the authors found that the certainty of the evidence for acupuncture was “low” but the information that is available suggests that it may provide moderate reductions in pain for both short and long-term back pain.
And while massage is said to have large reductions in pain, the evidence surrounding this claim is “very low”.
Other interventions where the evidence was deemed to be inconclusive include heat, TENS, opioids and muscle relaxants.
The authors, writing in BMJ Evidence-Based Medicine, added: “Most non-surgical and non-interventional treatments for low back pain were not efficacious.
“Around 10% of non-surgical and non-interventional treatments provided small analgesic effects beyond placebo.
“For acute low back pain, there is moderate certainty evidence that NSAIDs are efficacious.
“For chronic low back pain, there is moderate certainty evidence that exercise, spinal manipulative therapy, taping, antidepressants, and TRPV1 agonists are efficacious.”
