BMJ Evid Based Med

How effective are non-surgical treatments for low back pain?

March 21, 2025

Study details: This systematic review and meta-analysis included 301 randomized controlled trials evaluating non-surgical and non-interventional treatments for adults with non-specific low back pain.

Results: One treatment for acute low back pain (NSAIDs) and five treatments for chronic low back pain (exercise, spinal manipulative therapy, taping, antidepressants, TRPV1 agonists*) showed small but significant analgesic effects. Conversely, three treatments for acute low back pain (exercise, glucocorticoid injections, acetaminophen) and two treatments for chronic low back pain (antibiotics, anesthetics) were found ineffective.

Clinical impact: The findings suggest that most non-surgical and non-interventional treatments offer limited analgesic benefits beyond placebo. Clinicians should consider these results when recommending treatments for low back pain and prioritize high-quality, placebo-controlled trials to better understand treatment efficacy.

*TRPV1 agonist: transient potential vanilloid receptor 1 agonists (eg, capsaicin)

Source:

Cashin AG, et al. (2025, March 18). BMJ Evid Based Med. Analgesic effects of non-surgical and non-interventional treatments for low back pain: a systematic review and meta-analysis of placebo-controlled randomised trials. https://pubmed.ncbi.nlm.nih.gov/40101974/