Other Therapy

• Spinal manipulation: Osteopathic or chiropractic manipulation appears to be beneficial in people during the first month of symptoms. Studies on this topic have produced conflicting results. The use of manipulation for people with chronic back pain has been studied as well, also with conflicting results. The effectiveness of this treatment remains unknown. Manipulation has not been found to benefit people with nerve root problems.



• Acupuncture: Current evidence does not support the use of acupuncture for the treatment of acute back pain. Scientifically valid studies are not available. Use of acupuncture remains controversial.



• Transcutaneous electric nerve stimulation (TENS): TENS provides pulses of electrical stimulation through surface electrodes. For acute back pain, there is no proven benefit. Two small studies produced inconclusive results, with a trend toward improvement with TENS. In chronic back pain, there is conflicting evidence regarding its ability to help relieve pain. One study showed a slight advantage at one week for TENS but no difference at three months and beyond. Other studies showed no benefit for TENS at any time. There is no known benefit for sciatica.



• Exercises: In acute back pain, there is currently no evidence that specific back exercises are more effective in improving function and decreasing pain than other conservative therapy. In chronic pain, studies have shown a benefit to the strengthening exercises.