What Works for Low Back Pain? New Study Suggests Not Much

This is hot off the press! I know many of you have Chronic Low Back Pain. A very large meta-analysis of 301 trials was done and I will summarize:

Most nonsurgical and noninterventional treatments for low back pain failed to outperform placebo in a new systematic review and meta-analysis, with just 10% showing only modest pain relief.

Researchers conducted a systematic review and meta-analysis using randomized placebo-controlled trials of nonsurgical and noninterventional treatments for adults with nonspecific low back pain. They searched four databases and the Cochrane Central Register of Controlled Trials up to April 2023.

In all, 301 trials were included, providing data on 56 different treatments or treatment combinations.

Takeaways

For acute low back pain, only nonsteroidal anti-inflammatory drugs showed efficacy with moderate-certainty evidence compared with placebo.

For chronic low back pain, five treatments showed efficacy with moderate-certainty evidence: Exercise, spinal manipulative therapy, taping, antidepressants, and transient receptor potential vanilloid 1 agonists.

Three treatments for acute low back pain (exercise, glucocorticoid injections, and paracetamol) and two for chronic low back pain (antibiotics and anesthetics) showed no efficacy with moderate-certainty evidence.

Overall, 20 treatments for acute low back pain and 38 for chronic low back pain had inconclusive evidence for efficacy because of low- to very low–certainty data.

The study was led by Aidan G. Cashin, PhD, Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia. It was published online on March 18 in BMJ Evidence-Based Medicine.