The Effectiveness of Non-surgical Interventions for Managing Chronic Low Back Pain

Chronic low back pain (CLBP) is a widespread condition with a substantial effect on quality of life and work capacity. Non-drug, non-surgical options - physical therapy (PT), cognitive-behavioral therapy (CBT), and acupuncture - appear promising, yet stronger empirical evidence is still needed to confirm their value.

This study set out to compare PT, CBT, and acupuncture against standard care for the management of CLBP.

Two hundred participants with a diagnosis of CLBP took part in a randomized controlled trial and were allocated to one of four arms - PT, CBT, acupuncture, or standard-care control. Pain intensity, functional disability, quality of life, and psychological well-being were recorded at baseline and again at 6 and 12 weeks, using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), 36-item short form survey (SF-36), and beck depression inventory (BDI), respectively; outcomes were compared using analysis of variance with post hoc testing.

All three active arms outperformed the control. Both PT and acupuncture produced marked reductions in pain (VAS) and disability (ODI) scores (P < 0.01), whereas CBT produced its largest gains in psychological well-being (BDI) (P < 0.01) alongside more modest gains in pain and disability. SF-36 scores rose across every domain in the treatment arms, with PT and acupuncture producing the strongest gains in the physical-functioning and pain domains (P < 0.01).

PT, CBT, and acupuncture each represent a viable non-surgical option for CLBP, delivering meaningful gains in pain, function, and psychological well-being. Incorporating them into routine care could support a more holistic model of CLBP management, improving outcomes while lowering dependence on drug-based treatment.