New means to cure back pain

Health & Wellbeing

The evidence for acupuncture is interesting, because it suggests some people find it helpful, but possibly not for the reasons traditional acupuncturists think. There have now been quite a lot of studies looking at acupuncture for back pain, including some good-quality studies comparing traditional acupuncture to a 'sham' version. The research we found shows:

Compared to no treatment, some people having acupuncture have less back pain. But people having a 'sham' version of acupuncture have about the same reduction in pain as people having traditional acupuncture.Traditional acupuncturists believe that the therapy works by unblocking energy flows through the body, which become blocked at certain points. They put needles into these points in order to unblock the energy.

In 'sham' acupuncture, the therapist doesn't use the traditional acupuncture points, and may only put the needles a short way into the skin, or not puncture the skin at all.
If the 'sham' therapy works as well as the traditional therapy, it suggests something is happening other than the traditional explanation.

It could be that acupuncture is simply a powerful placebo, meaning that people feel better because they're having a complex treatment that they expect to work. Or it could be that putting needles against or into the skin triggers a painkilling response in the body. We don't know the answer.

Acupuncture is generally safe, as long as you see a properly trained therapist who uses sterile equipment. There's a risk of infection if needles aren't properly sterilised.
What does the evidence say about manual therapies? Manual therapy includes massage, spinal mobilisation and spinal manipulation. In massage and spinal mobilisation, the therapist works on the soft tissues and on moving the joints of the spine within their normal range. In spinal manipulation, the therapist moves the joint beyond the usual passive range of movement, using quick thrusting movements. Spinal manipulation can be carried out by chiropractors, osteopaths and specially trained physiotherapists and doctors.
There is some evidence that spinal manipulation can reduce back pain and may help people get back to work faster, compared to usual treatment or exercise. But not all the research agrees. Some studies say it's no better than usual GP care, exercise, or standard physiotherapy. Most of the studies looking at spinal manipulation are quite small. This makes it hard to draw definite conclusions. There's not much evidence to say whether massage works for back pain. The studies carried out have problems that make it hard to draw conclusions. There's no evidence that massage can be harmful, although you shouldn't have massage over skin that's infected or inflamed. Spinal manipulation causes minor side effects such as headache or nausea in about half the people having it. Serious side effects are thought to be very rare, but can include stroke, damage to the spinal cord and fracture.

Exercises

What does the evidence say about exercise programmes? There's plenty of evidence that keeping active is helpful for low back pain. People with back pain who keep active need less time off work and are less likely to become disabled by their back pain. Exercise programmes reduce pain and help people get on with their normal activities, for people who've had back pain for more than three months. But the evidence isn't clear for people who've had back pain for less than three months. Some research suggests that specific types of exercise, including yoga, the Alexander technique and a type of back exercise called McKenzie exercises, might work a little better than general exercise. But the evidence for this is not clear. Some people find their pain is worse after  exercise.
Painkillers, including simple analgesics (like paracetamol) and non-steroidal anti-inflammatory drugs (like ibuprofen), work well for low back pain.