It's various therapies—including painkillers, muscle relaxants, exercise, physical therapy, heat and spinal manipulation—have only a 'modest' effect, a major review has concluded.
Of these, analgesic drugs and spinal manipulation therapy (SMT) offered the best chance of some pain relief, say researchers from the West Los Angeles Veterans Affairs Medical Centre, although more than half of those who have manipulation say they suffer pain, muscle stiffness or headache afterwards.
The researchers took another look at 26 clinical trials, around half of which found that SMT had a 'moderate' effect on pain or general mobility. All the 3,092 participants in the trials had acute low back pain that they'd suffered from for less than six weeks.
The effectiveness of SMT was around the same as painkillers.