National Center for Complementary and Alternative Medicine (NCCAM)

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5 Things To Know About Chronic Low-Back Pain and Complementary Health Practices

Low-back pain is a very common condition, but often the cause is unknown. Most people have significant acute back pain at least once in their lives. Usually it resolves on its own without specific treatment.

But for some people, the pain can become chronic or even debilitating, and difficult to treat. Spinal manipulation, acupuncture, massage and yoga are complementary health approaches often used by people with low-back pain. They are all included in a longer list of treatment options recommended by the American Pain Society and the American College of Physicians for patients whose low-back pain does not improve with more conservative care. Other options include exercise, physical/occupational rehabilitation, cognitive-behavioral therapy, and progressive relaxation.

Here’s what you need to know about what the science says for chronic low-back pain and some of these practices.

  1. Overall, studies have provided good evidence that spinal manipulation is moderately effective for chronic low-back pain. Spinal manipulation includes various interventions administered by osteopathic physicians, chiropractors, and physical therapists.
      
  2. There is fair evidence that acupuncture is helpful in relieving chronic back pain. Current evidence suggests that factors such as expectations and beliefs of the patient and the provider, rather than acupuncture-specific effects of needling, are primarily responsible for beneficial effects of acupuncture on pain.
      
  3. There is also fair evidence that massage is helpful in relieving chronic low back pain. In general, however, these effects appear to be short term.
      
  4. Current research, while limited in scope, suggests that a carefully adapted set of yoga poses may reduce low-back pain and improve function. NCCAM is also supporting research specifically associated with safety of this widely-used self-care practice. People with back pain should work with an experienced teacher who can help modify or avoid some yoga poses to prevent adverse effects.
      
  5. Be sure to tell your health care provider about any complementary health practice you are considering. This will help ensure coordinated, safe care.