Research has shown that several mind and body practices, including acupuncture, mindfulness-based stress reduction, progressive muscle relaxation, spinal manipulation, tai chi, and yoga, may be helpful for chronic low-back pain.
These practices are generally considered safe when used appropriately. However, that doesn’t mean they are risk-free for everyone, choose a well-qualified instructor and use your head.
Low-back pain is a very common problem in the United States and around the world. About 80 percent of adults have low-back pain at some point in their lives. It’s the most common cause of job-related disability and a leading contributor to missed workdays and visits to physicians.
Most episodes of low-back pain last only a short period of time. Health professionals call this acute low-back pain. Acute low-back pain is often defined as pain that lasts for up to 4 weeks. In most cases, acute low-back pain goes away without causing any lasting problems.
Low-back pain that lasts for between 4 and 12 weeks is called subacute. If low-back pain lasts for 12 weeks or longer, it’s called chronic. Treatment sometimes relieves chronic low-back pain successfully, but in other cases, pain persists despite treatment.
Clinical guidelines encourage alternatives
The American College of Physicians issued a clinical practice guideline for the treatment of low-back pain in 2017. The guideline recommends that health care providers and patients use non-drug treatments as first-line therapy for chronic low-back pain. It also recommends the use of nondrug approaches for acute low-back pain, with or without drug therapy. Several complementary health approaches are among the treatment options suggested for acute low-back pain, chronic low-back pain, or both.
Read more about what science say’s about it
What the Science Says About Complementary Health Approaches for Low-Back Pain
- Acupuncture is a technique in which practitioners stimulate specific points on the body—most often by inserting thin needles through the skin.
- A 2017 evaluation of 49 studies of acupuncture for low-back pain with more than 7,900 participants found evidence that acupuncture has a modest benefit on acute low-back pain and a moderate benefit on chronic low-back pain.
- A 2018 review by the Agency for Healthcare Research and Quality (AHRQ) looked at the impact of therapies for chronic low-back pain at least 1 month after the end of treatment. It found that acupuncture was associated with slightly greater effects on pain and function at 1-6 months when compared to controls, such as sham (simulated) acupuncture or usual care. One study also found a greater reduction in pain after more than 12 months.
- The American College of Physicians clinical practice guideline on low-back pain treatment includes acupuncture as an option for initial treatment of chronic low-back pain (based on moderate-quality evidence) and as a treatment option for acute/subacute low-back pain (based on low-quality evidence).
- Serious complications of acupuncture are rare.
- For more information, see the NCCIH webpage on acupuncture.
- Tai chi is a centuries-old mind and body practice that combines certain postures and gentle movements with mental focus, breathing, and relaxation.
- A 2016 review of 3 studies of tai chi for low-back pain (385 participants), all of which involved at least 10 weeks of tai chi, found it was helpful. In two additional studies, not included in the review, tai chi was at least as helpful as some other treatments for low-back pain and better than no treatment.
- The American College of Physicians clinical practice guideline for low-back pain treatment includes tai chi as an option for initial treatment of chronic low-back pain (based on low-quality evidence).
- Tai chi is generally considered safe. It may lead to minor aches and pains but is unlikely to cause serious injury.
- For more information, see the NCCIH webpage on tai chi.
- Yoga, as practiced in the United States, typically emphasizes physical postures, breathing techniques, and meditation.
- A 2017 review of 12 studies (1,080 participants) of yoga for low-back pain concluded that yoga, when compared to interventions that did not involve exercise, produced small to moderate improvements in back-related function after 3 and 6 months and may also have been slightly more effective for pain. It was uncertain whether there was any difference between yoga and exercise for either back pain or function.
- A 2018 AHRQ review that looked at the impact of therapies for chronic low-back pain at least 1 month after the end of treatment found that yoga was associated with moderately greater effects on pain and slightly greater effects on function at 1-6 and 6-12 months, when compared to controls (such as being on a waiting list for a yoga program).
- The American College of Physicians clinical practice guideline for low-back pain treatment includes yoga as an option for initial treatment of chronic low-back pain (based on low-quality evidence).
- Yoga is generally considered safe for healthy people when performed properly, under the guidance of a qualified instructor. However, as with other types of physical activity, injuries can occur. People with health conditions, older adults, and pregnant women may need to avoid or modify some yoga poses and practices.
- For more information, see the NCCIH webpage on yoga.
- The term “mindfulness” can refer to a variety of practices, but most definitions involve keeping attention or awareness on the experience of the present moment and being open or accepting toward that experience. Mindfulness-based stress reduction (MBSR) is a structured program that teaches meditation and mindfulness, including incorporation of mindfulness into everyday life.
- A 2017 review of 7 studies (864 participants) that evaluated MBSR for low-back pain found evidence of short-term improvements in pain intensity and physical functioning, but it was uncertain whether the improvement was large enough to be meaningful to patients.
- A 2018 AHRQ review that looked at the impact of therapies at least 1 month after the end of treatment found that MBSR was associated with slightly greater effects on pain after 1-6 and 6-12 months, when compared to usual care. There was no evidence of an impact on function.
- The American College of Physicians clinical practice guideline for low-back pain treatment includes MBSR as an option for initial treatment of chronic low-back pain (based on moderate-quality evidence).
- Mindfulness-based interventions are usually considered safe for most people. However, because only a few studies have systematically looked in detail for harmful effects, it isn’t possible to make definite statements about their safety.
- A variety of herbal products, administered either orally (by mouth) or topically (by rubbing on the skin) have been tested for low-back pain. There’s evidence that cayenne, used topically, reduces pain. Other herbal products that might be beneficial include devil’s claw or white willow bark, used orally, and comfrey, Brazilian arnica, and lavender essential oil, used topically.
- It’s important to be aware that herbal products may have side effects or interact with medications. Talk with your health care provider about the safety of any herbal products you’re considering or using for low-back pain.