A new study has delivered discouraging news for the millions of Americans suffering from chronic back pain: Only one in ten common treatments actually work.
Researchers from the University of New South Wales in Australia reviewed 301 randomized, controlled trials involving 56 non-surgical treatments aimed at easing both acute and chronic lower back pain.
The findings were published in the journal BMJ Evidence-Based Medicine.
The researchers found that for acute lower back pain, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen were somewhat effective.
For chronic lower back pain, treatments including exercise, spinal manipulation, antidepressants, taping, and pain receptor-targeting drugs known as TRPV1 agonists showed small positive effects.
However, even the treatments that appeared to be effective only produced slight reductions in pain compared to placebos.
The researchers noted that many other treatments, such as paracetamol (acetaminophen), corticosteroid injections, antibiotics, and anesthetics, were deemed ineffective or lacked conclusive evidence of effectiveness.
Dr. Aidan Cashin, the study’s lead author and deputy director of the Centre for Pain IMPACT at Neuroscience Research Australia, said, “Our review did not find reliable evidence of large effects for any of the included treatments.”
He stressed the need for further high-quality, placebo-controlled trials to help patients and medical teams better understand what works and what doesn’t.
Pain experts point out that pain itself is a complex condition influenced by various factors, including stress, sleep quality, nutrition, fear, and even social situations.
Dr. Stephen Clark, a physical therapist and chief clinical officer at Confluent Health in Georgia, emphasized that treating pain often requires a combination of approaches tailored to each individual’s experience.
“Physical therapy research shows that manual therapy, exercise, and education about why you hurt and what to do about it is the ticket,” Clark stated.
The study’s findings are a disappointment to the estimated 16 million American adults who struggle with chronic back pain.
Lower back pain is the most common type of pain, with eight in ten Americans experiencing it at some point in their lives. Yet, most cases have no immediately identifiable cause, making treatment difficult.
Experts stress the importance of pursuing “multimodal” treatments, which involve combining various interventions rather than relying on a single approach.
While the CDC recommends methods like ice, heat, rest, and exercise for pain relief, they also note that conservative care can often prevent or delay the need for surgical procedures.
Ash James, director of practice and development at the Chartered Society of Physiotherapy, noted that effective treatment requires considering multiple factors, including physical, mental, and lifestyle influences.
“Through a person-centered approach, they can explore a wide range of factors that may contribute to discomfort, such as stress, fear of movement, poor sleep, smoking, obesity, job-related strain, and insufficient physical activity,” James said.
The researchers acknowledged limitations in their study, including small sample sizes and inconsistent results. Still, they maintain that more robust research is necessary to provide clearer guidance for the millions of people suffering from back pain.
The study’s findings underscore the urgent need for better solutions to a problem that continues to affect so many, with many still waiting for an effective, long-lasting remedy.