Low-back pain is a global issue causing pain, disability and economic burden. It’s a leading cause of missed work and decreased productivity.

Jon L. Gelman

Nonsurgical and noninterventional treatments are the first line of treatment for low-back pain. But which ones really work?

What the research says

A recent systematic review and meta-analysis published in the BMJ Evidence-Based Medicine journal aimed to evaluate the effectiveness of nonsurgical, noninterventional treatments for low-back pain compared to placebo. Researchers analyzed 301 trials involving 56 different therapies or combinations.

The study found that only a small number of these treatments demonstrated efficacy, meaning they provided pain relief beyond what a placebo would. 

For acute low-back pain, only one treatment, NSAIDs, was effective. 

For chronic low-back pain, five treatments were effective: exercise, spinal manipulative therapy, taping, antidepressants and TRPV1 agonists. 

A major concern

The New Jersey Compensation Rating and Inspection Bureau indicates that lower-back injuries are a common workers' compensation claim. In fact, it is the third most common injury, representing 10.59% of total losses. This highlights the importance of effective treatments for low-back pain, especially in the context of returning to work and preventing long-term disability.

Implications for workers and employers

The study's findings have important implications for workers and employers. The research supports the use of NSAIDs for acute low-back pain. For chronic low-back pain, exercise, spinal manipulative therapy and other non-drug therapies can be effective. This can help injured workers manage pain and potentially return to work sooner. Employers can use this knowledge to inform their return-to-work programs and ensure that employees can access appropriate and effective treatments.

The importance of more research

The authors of the review emphasize the need for more high-quality research. This will help clarify the effectiveness of other treatments and optimize care for individuals with low-back pain. 

Key takeaway

While many treatments are available for low-back pain, this study shows that only a few have proven efficacy beyond placebo. Effective management is crucial for work-related injuries. The findings of this review can help guide treatment decisions and potentially improve outcomes for workers with back injuries.

Claimants' attorney Jon L. Gelman is the author of "New Jersey Workers’ Compensation Law" and co-author of the national treatise "Modern Workers’ Compensation Law." He is based in Wayne, New Jersey. This blog post is republished with permission.