Does *Anything* Work for Low Back Pain?

Yes! One this one weird trick ....

NSAIDs:

These are the findings of a comprehensive systematic review of interventions for both acute and chronic low back pain – telling us what most of us already know: low back pain is incredibly frustrating, both for those who suffer from it and those who try to treat it.

The list of things that doesn’t work is quite long – everything from opiates to ultrasound to antibody injections to bee venom. Some of these did, actually, provide some relief from pain – but the evidence was low/very low, and the studies were at high risk for bias.

There are obviously limitations from this review – it includes only placebo-controlled trials, finding barely 301 trials for 56 different treatments, many of which enrolled barely handfuls of participants. There are many other studies doing head-to-head/active comparator evaluations, but those would be excluded from this report. Some of those studies could potentially be suitable for network meta-analyses, but I suspect the heterogeneity between studies invalidates that approach.

Until better evidence illuminates alternatives, we’re pretty much stuck with NSAIDs and, unsatisfyingly, time.