Back pain, a common ailment affecting millions worldwide, often proves resistant to treatment. A recent study published in BMJ Evidence Based Medicine reveals that only about 10% of common back pain treatments offer any noticeable relief, and even then, the benefit is minimal.
Researchers in Australia analyzed data from hundreds of clinical trials evaluating dozens of back pain remedies. Their findings indicate that only a handful of treatments are demonstrably more effective than a placebo. These treatments, primarily exercise and non-steroidal anti-inflammatory drugs (NSAIDs), provide only a small average benefit.
Low back pain is a particularly widespread problem. Nearly everyone experiences it at some point in their lives. The World Health Organization estimates that 10% of the global population currently suffers from back pain, while the CDC reports that approximately 40% of U.S. adults have experienced back pain in the past three months.
While most back pain episodes resolve over time, about 10% of Americans experience chronic or recurring back pain. The vast majority of these cases are non-specific, meaning there’s no identifiable disease or structural cause. This makes finding effective treatment even more challenging.
The Australian researchers conducted an extensive review of non-invasive, non-surgical back pain treatments, focusing on randomized, placebo-controlled clinical trials – the gold standard of medical evidence. They analyzed 301 trials covering 56 different treatments or treatment combinations for acute or chronic non-specific lower back pain.
Lead study author Aidan Cashin, an exercise physiologist and deputy director of the Center for Pain IMPACT at Neuroscience Research Australia, explained to MaagX.com, “We were motivated to conduct this review because non-surgical and non-invasive approaches are recommended as the initial treatment approach. But many such options are available, and it’s not always easy to know which ones are effective.”
For acute back pain, only NSAIDs proved more effective than placebo. For chronic back pain, five treatments showed some efficacy: exercise, spinal manipulation (performed by chiropractors, physical therapists, or osteopaths), taping, antidepressants, and TRPV1 agonists (a class of pain-reducing drugs). Other treatments, including cannabinoids, muscle relaxants, opioids, acupuncture, and dry cupping, failed to demonstrate significant benefit.
Even the most effective treatments offered only modest relief. The researchers expressed moderate certainty in the supporting data, and the overall effectiveness was deemed modest at best. The study concludes, “The current evidence shows that one in 10 non-surgical and non-interventional treatments for low back pain are efficacious, providing only small analgesic effects beyond placebo.”
While some individuals may experience substantial relief from these therapies, and others may find benefit from treatments that don’t work for most, there is no universally effective cure for back pain. This includes surgical interventions. The researchers acknowledge this reality and call for more high-quality studies to address the gaps in current knowledge.
Many current treatments target only a single contributing factor to back pain, which may explain their limited effectiveness. Cashin emphasizes the need for more research: “More work is needed to better understand what causes and maintains low back pain so we can develop more targeted treatments.”
Promising new treatments, such as pain reprocessing therapy and graded sensorimotor retraining, offer hope for addressing the multiple drivers of chronic pain. These emerging therapies may eventually provide more substantial and lasting relief for back pain sufferers.
