Low back pain affects an estimated one in four American adults and is the leading contributor to disability globally. In most diagnosed cases, the pain is considered “nonspecific,” meaning it doesn’t have a clear cause. That’s also partly what makes it so hard to treat.
In the study, published on Tuesday in the journal BMJ Evidence-Based Medicine, researchers reviewed 301 randomized trials that compared 56 noninvasive treatments for low back pain, like medications and exercise, with placebos. They used a statistical method to combine the results of those studies and draw conclusions, a process known as a meta-analysis.
The researchers found that only one treatment — the use of nonsteroidal anti-inflammatory drugs, or NSAIDs, like ibuprofen and aspirin — was effective at reducing short-term, or acute, low back pain. Five other treatments had good enough evidence to be considered effective at reducing chronic low back pain. These were exercise; spinal manipulation, like you might receive from a chiropractor; taping the lower back; antidepressants; and the application of a cream that creates a warming sensation. Even so, the benefit was small.
But remember that this is a meta-study that lumps dozens of studies together to come to a global conclusion. Some of those individual studies have found that particularly interventions, like heat or exercise, work very well for some patients, but effects like that would be washed out in a big meta-study. The best advice is probably to try all the different options and try to find one that works for you; a doctor cited by the Times says you might as well try things like heat, which is cheap and causes no harm, or exercise, which is good for you even if it doesn't help your back pain. After all, they seem to help some people quite a bit.
It doesn't look like this study even considered the evidence that back pain is related to psychological issues and life stresses. Yet one of the things we are most certain about is that people who have recently gotten divorced or lost a job suffer more back pain than those with less stressful lives. That might not seem like a very useful piece of information – like, gee, sorry we can't help you, it's just that your whole life is messed up – but I find that awareness of how stress or other life factors are impacting my body helps me move to a better plane.
2 comments:
I tried all that, NSAIDs of all kinds (poor stomach) , spinal manipulation, creams and hot bags, even accupuncture; got worse and worse. Physiotherapy costed me a lot of money for nothing. Until finally I had surgery, low invasive surgery, and a titanium device screwed my spine corrected and solid. Until today, like new. I love titanium.
Another important point. While surgery is on the whole no better than other methods, it does help some people a lot, including two of my friends. The main issue is that doctors can't predict who will be helped.
Post a Comment