When it comes to easing lower back pain, patients are often overwhelmed by a long list of suggested treatments — from acupuncture, massage, and dry cupping to opioids, cannabinoids, muscle relaxants, and electrical stimulation therapies. But according to a new evidence-based review published in BMJ Evidence-Based Medicine, most of these remedies do little to relieve the discomfort.

The study, led by researchers from Neuroscience Research Australia, analyzed data from 301 clinical trials covering 56 different treatments for low back pain. The results were striking: only about 10% of the treatments had any reliable medical evidence supporting their effectiveness, and even those offered only modest relief.

“Surprisingly, we found only around one in ten treatments was effective, and most provided pain relief that was only marginally better than placebo,” said Aidan Cashin, deputy director of the Center for Pain IMPACT at Neuroscience Research Australia.

The review found that non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen were moderately effective for short-term lower back pain. Additionally, five treatments showed some promise for chronic lower back pain: regular exercise, spinal manipulation, therapeutic taping, antidepressants, and warming creams containing capsaicin (known as TRPV1 agonists). However, the effects were small and inconsistent across different patient groups.

“Even the treatments with evidence behind them can't be counted on to work well for everyone,” Cashin emphasized.

The researchers also pointed out certain treatments that failed to show any effectiveness. These included exercise, steroid injections, and acetaminophen (paracetamol) for short-term back pain, as well as antibiotics and anesthetics for chronic back pain.

For many other therapies commonly recommended for back pain, the study found insufficient evidence to make definitive conclusions.

Cashin stressed the need for more rigorous, placebo-controlled trials to provide clarity for both patients and healthcare professionals. “Placebo-controlled studies are the gold standard for evaluating treatment effects. We need high-quality research to better understand what actually works,” he said.

Until then, the advice for those suffering from back pain remains clear: consult with healthcare professionals to explore available options and find the most suitable approach on an individual basis.