What intervention gives sustained improvement in chronic back pain?

What intervention gives sustained improvement in long-standing back pain?  The intervention that showed a greater than 30% reduction in back pain was exercise. 

Patients may have trialed opioids or non-steroidal anti-inflammatory pills, but those are routinely not given for long.  A 2020 systematic review of 25 randomized controlled trials (with over 2,400 patients!) found that if you have low back pain for 12 months or more, epidural steroid injections do not give long-term meaningful improvement. Yes, epidural injections may be more effective than placebo in the short-term, but not in the long term.

Other interventions that help are osteopathic manipulation and topical capsaicin cream. Physical therapists are a great resource for initiating back exercises and confirming that your technique is correct.  Then, you can continue the therapist’s exercises as your “homework.”

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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