Is It Time to Rethink How We Treat Chronic Back Pain?

Is it time for medical science to rethink how we treat chronic back pain? If a new study out of Australia means anything, yes. The study boldly asserts that most of the treatments commonly recommended for back pain do not work very well, if at all. Researchers were not impressed by how the treatment compared to placebo.

 

Mainstream treatments in 2025 include non-steroidal anti-inflammatory drugs (NSAIDs), pain medications, spinal manipulation, and surgical procedures. Less common procedures include spinal cord stimulation and a variety of injection therapies.

 

Researchers concluded that it’s difficult to recommend any particular therapy because the benefits of those that may work are still minimal. All I can say to that is, wow. If current back pain treatments don’t work, why do doctors keep recommending them?

 

More About the Study

 

Researchers from the University of New South Wales took a deep dive into 301 previous trials that looked at 56 non-surgical treatments for back pain. In each of the trials, patients were asked to rank pain intensity at the start and the conclusion.

 

Researchers wrote in their report that “random effects meta-analysis was used to estimate pooled effects and corresponding 95% confidence intervals on outcome pain intensity.” They also wrote that their research included both acute low back pain and chronic back pain in adults.

 

What did they discover? That most pharmacologically based treatment did not perform better than placebo. Among those that did, the improvement was so minimal as to not provide any practical benefits. They were left with “a low certainty of evidence” that most of the traditional treatments help patients in any substantial way.

 

Reasons for Lack of Efficacy

 

Although researchers did not provide any concrete reasons explaining the lack of efficacy, they did suggest that one of the problems doctors run into is the inability to understand the root causes of a person’s pain. Back pain can be caused by:

 

  • Strained muscles
  • Pinched or inflamed nerves
  • Bone disease
  • Infections
  • Trauma

 

Things like slipped discs and osteoporosis are easy to diagnose. There are tests to confirm such diagnoses. But the vast majority of back pain sufferers experience what the healthcare field refers to as nonspecific pain. It is pain for which no underlying cause can be found.

 

A Different Approach to Back Pain

 

While traditional medicine struggles to treat chronic back pain, some doctors in the pain medicine field take a different approach. Their approach focuses on three fundamental things: understanding root causes, developing individualized treatment plans, and looking at nontraditional treatments.

 

There are times when nonspecific back pain is diagnosed as such because GPs don’t know how to look for root causes. Pain medicine doctors specializing in back pain are more adept at finding root causes. They know where to look, how to look, and what types of tests to run.

 

Pain medicine doctors are also less likely to simply pull out the prescription pad and send a patient home with a drug. They tend to develop individualized treatment plans that could involve a number of therapies offered simultaneously.

 

Pain medicine clinics like Texas-based Lone Star Pain Medicine also think outside the box with their treatments. Options like facet joint injections, nerve blocks, and spinal cord stimulation are on the table.

 

It’s Time to Start Over

 

Assuming the results of the Australian study are correct, I’m left with no other choice but to believe it’s time to start over. It doesn’t make sense to continue recommending therapies that don’t work. Patients need relief from back pain. They don’t need endless prescriptions that cost money without offering anything in return.

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