Comparing The Treatments For Back Pain

To do this it means looking at the 'effect size', which is a measure of not just if the treatment worked but how much of an effect it had. The effect size of the techniques are then compared against each other. And, luckily, one study did just that.

So, which came out on top?

Surprisingly, acupuncture. But there's a slight caveat. Acupuncture has been criticised in multiple studies for not being designed properly, in that the people carrying out the study knew which subjects were getting acupuncture and which were getting a 'sham' treatment (which is a treatment that doesn't follow any of the principles of the tested treatment and isn't supposed to work, supposedly eliminating the placebo effect). This would be known as 'double-blinding' the study. So what happened when there was a double-blinded study carried out on multiple treatments, including acupuncture? Acupuncture came out on top. And so did the sham treatment, nearly equally. This shows not only the difficulty in assessing back pain relief, but also the hugely psychological element of therapy, and of low back pain.

Oh, and it should be mentioned that opioid drugs, like morphine and similar drugs, worked very well, but they worked on pretty much every type of pain, and had fairly high chance of addiction. So, while hardcore painkillers might be effective, they're not without their downsides.

So what came after acupuncture?

Actually the race got pretty tight after that, with exercise, behavioural therapy, and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), drugs like Ibuprofen and Aspirin showing similar results. And, unfortunately, all of the above therapies only had a modest effect size, meaning they should help but they'll by no means eliminate your back pain.

In fact a lot of the earlier studies on exercise therapy suffer the same flaws as the other studies on alternative methods. As bleak as it sounds, pain is a pretty complicated subject, with back pain being one of the trickiest sub-categories of pain.

READ Low Back Pain Rehabilitation Tips and Exercises

So, while evidence is still far from conclusive, it certainly doesn't hurt to increase exercise. Another important point to make is that, unlike every other intervention above, exercise is the only one that's free. So, as well as it being as effective as other means, it doesn't cost anything to try it either. So, in closing, I’ll offer a few tips if you are planning on attempting exercise as a means of alleviating your back pain:

1. Prioritise resistance training or low impact exercise like swimming over exercises like running or jumping.

2. If doing resistance training, focus on exercises that target the Gluteals, Hamstrings, and core musculature, but place minimal stress on the back, like Hip Thrusts, Hex Bar Deadlifts or Stationary Superman exercises.

3. If doing core exercises, avoid sit-ups or their variations as there is evidence showing they put quite a bit of stress on the spine. Instead look at isometric variations.

4. Exercise does not have to be chosen in isolation from other forms of therapy and can work quite well when integrated into a multidisciplinary approach, i.e. using massage, exercise and behavioural therapy.