Low back pain is a common and debilitating condition, affecting millions of people worldwide. Research suggests that only around one in 10 common non-surgical treatments for lower back pain are effective. The findings indicate that the pain relief offered by these treatments is only marginally better than that achieved with a placebo.
The researchers analyzed pooled data from published randomized placebo-controlled trials on non-surgical and non-interventional treatments for people with non-specific low back pain. They found that 301 trials investigating 56 different treatments or treatment combinations were included in the analysis. The most common interventions were NSAIDs, opioids, laser therapy, acupuncture, and gentle manual therapy.
The results showed that only NSAIDs emerged as effective for acute low back pain, while exercise, spinal manipulation, and antidepressants were found to be effective for chronic low back pain. However, the effects of these treatments were small.
Moderate quality evidence suggested that treatments such as steroid injections and paracetamol were not effective for acute low back pain, while anesthetics and antibiotics were ineffective for chronic low back pain.
The researchers emphasized the need for large, high-quality placebo-controlled trials to reduce uncertainty in efficacy estimates for many non-surgical and non-interventional treatments. Their review did not find reliable evidence of large effects for any of the included treatments, which is consistent with clinical guidelines and previous reviews.
A total of 52 trials sampled participants with acute low back pain, 228 trials with chronic low back pain, and 21 trial participants with both types. Pain intensity was most often assessed using the Visual Analog Scale or the Numeric Rating Scale.
Source: https://medicalxpress.com/news/2025-03-common-surgical-invasive-treatments-pain.html