On the Ineffectiveness of Back Pain Remedies...

Thankfully I don't suffer from it but low-back pain is among the world's most common and frustrating medical grievances — and if you do suffer from it, relief can be hard to find...

There are a staggering range of non-operative treatments commonly available, but a recent international review suggests that few of them actually do much good — and even those that do have only minimal benefits.

In a BMJ systematic review, researchers in Australia looked at 301 clinical trials conducted across 44 countries. They analysed the effectiveness of 56 different non-invasive treatments for lower-back pain, ranging from standard pain medicine to alternative remedies such as acupuncture and light treatment.

Ineffective treatments...

For acute lower back pain only one in ten treatments were found to do anything, and only non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, were found to have any measurable impact — and even that was limited.

The other treatments most commonly employed, such as paracetamol, exercise, and injections of steroids, were found to have no greater effect than a placebo treatment.

For chronic low-back pain, the results were somewhat more promising, but still far from good.

Five interventions had some evidence of success: exercise, spinal manipulative treatment (such as chiropractic manipulation), taping (such as in sports therapy), antidepressants, and a class of drugs known as TRPV1 agonists that act on pain receptors in the body. But in all cases, the benefits were small — once more, hardly more than a placebo.

This report highlights a glaring research deficit: in most treatments, the evidence simply isn't there. That is, both patients and practitioners are too often flying blind, led by tradition, anecdote, or hope rather than hard science.

Final thoughts...

This research presents a bleak scenario for the millions of individuals afflicted by back pain. The simple truth is that most of the popular treatments simply don't work!