Treating lower back pain with non-invasive therapies like acupuncture and massage may help in the short term, but not in the long run, according to the latest research involving Adelaide University.
The collaborative international study led by Bochum University of Applied Sciences in Germany, found non-surgical treatments did provide some relief from symptoms of chronic lower back pain but the positive benefits only lasted for a few weeks.
Researchers analysed data from 551 randomised studies involving more than 71,000 patients. Numerous conservative therapies were examined, including exercise therapy, manual therapy, acupuncture, psychological approaches, and drug treatments.
Many of the treatments led to a noticeable improvement in pain and mobility – but only up until the three-month mark. After about a year, no clinically relevant benefits were observed, even though individual effects were still statistically detectable.
“We see that various forms of therapy are indeed effective—but this effect generally does not last long,” said study leader Professor Daniel Belavy, a Professor of Physical Therapy at Bochum University of Applied Sciences.
“Previous research shows only one third of the treatment benefit comes from the treatment itself.
“We desperately need to explore alternative approaches to help people in persistent pain manage their condition and improve their quality of life.”
The study is the first of its kind and found that active therapies such as exercise therapy and passive treatments like massage had similar benefits, which goes against common assumptions in clinical practice.
“There’s more than one cause of back pain so it’s not surprising that there’s more than one way to treat it and it’s not a one size fits all solution,” said Professor Ashish Diwan, who was involved in the study and is the Chair of Spinal Surgery at Adelaide University.
“While all of the non-surgical treatments analysed had similar benefits in the short term, there was no standout performer long term. In fact, the results suggest that having the treatments may not be any more effective than doing no treatment at all longer term.”
Around 4.0 million people in Australia were estimated to be living with back problems in 2022. The ailment is considered to be chronic when the pain lasts for longer than three months.
“Back pain can be debilitating and is one of the leading causes of disability in Australia, not to mention the significant impact it has on the national economy due to lost productivity,” said Professor Diwan.
“We urgently need more strategies to help people to manage their pain long term. This could include shifting the focus to self-management, lifestyle and behavioural changes rather than short-term therapy cycles from currently available options.
“While at the same time and with a sense of urgency, we also need to increase our investment in research to find novel therapies based on high quality science that address mechanisms and causes of pain directly. This is something that our patients who suffer from back pain have been desperately asking for.”
The research has been published in the journal, BMJ Medicine.
Other universities involved in the study include Deakin University, La Trobe University, Monash University and University of Melbourne, along with the University of Bristol in the United Kingdom and Xi’an University of Architecture & Technology and Xuanwu Hospital Capital Medical University in China.
“There is a need for more research into relieving back pain. Future studies should focus more on long-term effectiveness, patient involvement, and research into the causes and novel therapies,” said Professor Diwan.