There are a ton of suggestions out there for soothing an aching lower back — acupuncture, heat, cannabinoids, muscle relaxants, TENS electrical pulses, dry cupping, opioids, massage and more.

But not much actually eases back pain, including those suggestions, according to a new evidence review.

Only painkillers like aspirin or ibuprofen — non-steroidal anti-inflammatory drugs (NSAIDs) — have been shown to be moderately effective in treating short-term lower back pain based on available medical evidence, researchers concluded.

There’s also some evidence that five other treatments might help long-term low back pain, researchers said — exercise, spinal manipulation, taping, antidepressants and warming creams containing ingredients like capsaicin.

Overall, only 10% of treatments for low back pain had any medical evidence supporting their potential effectiveness, and even they didn’t work that great, concluded the review in the journal BMJ Evidence-Based Medicine.

“Surprisingly, we found only around one in 10 was effective and most provided pain relief that was only marginally better than placebo – in other words, our review did not find reliable evidence of large effects for any of the included treatments,” Aidan Cashin, deputy director of the Center for Pain IMPACT at Neuroscience Research Australia, said in a news release.

Non-surgical treatments are considered first-line care for back pain, Cashin said. Researchers performed the evidence review to see just how well these myriad therapies work.

For the review, they analyzed findings from 301 clinical trials examining 56 treatments or treatment combinations for low back pain.

Results showed that no sure-fire cures for back pain are currently available. Even ones with some evidence behind them can’t be counted on to work well for everyone.

“We found for acute low back pain, NSAIDs may be effective. For chronic low back pain, exercise, spinal manipulation, taping, antidepressants and TRPV1 agonists (warming creams) may be effective,” Cashin said. “However, those effects were small.”

Researchers also specifically highlighted five treatments that don’t work, based on the evidence.

These included three for short-term low back pain – exercise, steroid injections and acetaminophen – and two for chronic back pain, antibiotics and anesthetics.

For the rest of the treatments included in the research, there was simply not enough evidence to rule one way or the other, researchers concluded.

More research is needed to prove whether or not these other back pain cures might have something to them.

“We need further high-quality, placebo-controlled trials to understand the efficacy of treatments and remove the uncertainty for both patients and clinical teams,” Cashin said.

“Placebo-controlled studies are the gold standard for evaluating the effects of treatments, with a clear need to better understand which treatments work for people with low back pain,” he added.

In the meantime, Cashin recommends that people with back pain talk to their medical team to understand the treatments available and find one that works best for them.

More information

Johns Hopkins Medicine has more on low back pain.

SOURCE: University of New South Wales, news release, March 19, 2025

Source: HealthDay

Copyright © 2025 HealthDay. All rights reserved.