Science Indicates Persistent Unresponsiveness in Relieving Chronic Lower Back Pain for Many Individuals
Ain't Many Cures for the Common Backache, Says Study
If your back pain won't quit, you're not alone in your misery. The latest research reveals that only around 10% of popular remedies for back pain seem to provide relief, and that relief is often minimal.
The pioneering study, published Tuesday in BMJ Evidence Based Medicine, was led by researchers in Australia. They analyzed reams of data from hundreds of clinical trials testing numerous back pain treatments, and found that most therapeutic approaches fall flat compared to a placebo.
Low back pain is an awful affliction that plagues millions around the globe (yes, it's a global pain in the ass). Nearly everyone will experience this wretched suffering at some point in their lives, and statistics suggest that about 40% of adults in the US have suffered from back pain in the last three months.
While most instances of back pain eventually abate on their own, approximately 10% of Americans are estimated to have chronic or recurring back pain. The vast majority of back pain cases are non-specific, meaning no easily identifiable disease or structural issue can be pinpointed as the culprit.
The study aimed to conduct the most comprehensive review of non-surgical treatments for back pain yet, focusing on randomized, placebo-controlled clinical trials-the gold standard for medical evidence.
Run-of-the-Mill Back Pain Treatments? More Hot Air Than Help, Says Study
All in all, the researchers reviewed 301 trials encompassing 56 different treatments or treatment combinations for acute or chronic non-specific low back pain.
"We conducted this review because non-surgical, non-invasive approaches are the recommended first course of action for back pain treatment. However, there are many options available, and it's not always simple to discern which ones actually work," explained lead study author Aidan Cashin, an exercise physiologist and deputy director of the Center for Pain IMPACT at Neuroscience Research Australia.
After carefully sifting through the data, Cashin and his team determined that only NSAIDs, like aspirin or ibuprofen, exhibited modest effectiveness for acute back pain. For chronic back pain, they identified five treatments that showed promise: exercise, spinal manipulation, taping, antidepressants, and TRPV1 agonists (a type of pain relief drug that includes capsaicin, the active ingredient in chili peppers). Ineffective treatments included cannabinoids, muscle relaxants, opioids, acupuncture, and dry cupping.
Unfortunately, even these effective treatments provided only small benefits beyond a placebo, according to the researchers. "The current evidence indicates that approximately 10% of non-surgical and non-interventional treatments for low back pain are efficacious, yielding only moderate relief above placebo," they wrote.
Of course, it's possible that certain individuals may find substantial relief from one of these therapies or from a treatment that wasn't included in the study. But many treatments may still provide some relief even if they haven't been tested in high-quality, well-designed studies. Additionally, there are other unstudied remedies that are often touted for back pain that may prove to be effective. The researchers advocate for more high-quality studies to evaluate existing back pain treatments and address the dearth of data.
It's important to note that there isn't a foolproof, highly effective cure for back pain widely available at the moment-surgery included. The researchers acknowledge this unfortunate reality. "Many treatments target a single potential contributing factor, which may account for their lack of effectiveness on average," Cashin said.
However, there are exciting new treatments on the horizon that address multiple drivers of back pain. These include pain reprocessing therapy and graded sensorimotor retraining. Cashin believes these and future targeted treatments could provide substantial and sustained benefits for those with chronic back pain.
On a personal note, regular exercise and stretching seem to help keep my low back pain at bay most of the time (but YMMV). Let's hope these breakthroughs will eventually become viable solutions for this persistent, frustrating condition.
- The study found that only nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin or ibuprofen, exhibited modest effectiveness for acute back pain.
- For chronic back pain, the study identified five treatments that showed promise: exercise, spinal manipulation, taping, antidepressants, and TRPV1 agonists.
- Unfortunately, the effectiveness of these treatments only provided small benefits beyond a placebo, according to the researchers.
- The researchers advocate for more high-quality studies to evaluate existing back pain treatments and address the dearth of data, as they believe exciting new treatments like pain reprocessing therapy and graded sensorimotor retraining could provide substantial and sustained benefits for those with chronic back pain in the future.
