Numerous randomized trials have been published investigating the effectiveness of treatments for non-specific low-back pain
(LBP) either by trials comparing interventions with a no-treatment group or comparing different interventions. In trials comparing
two interventions, often no differences are found and it raises questions about the basic benefit of each treatment. To estimate
the effect sizes of treatments for non-specific LBP compared to no-treatment comparison groups, we searched for randomized
controlled trials from systematic reviews of treatment of non-specific LBP in the latest issue of the Cochrane Library, issue
2, 2005 and available databases until December 2005. Extracted data were effect sizes estimated as Standardized Mean Differences
(SMD) and Relative Risk (RR) or data enabling calculation of effect sizes. For acute LBP, the effect size of non-steroidal
anti-inflammatory drugs (NSAIDs) and manipulation were only modest (ES: 0.51 and 0.40, respectively) and there was no effect
of exercise (ES: 0.07). For chronic LBP, acupuncture, behavioral therapy, exercise therapy, and NSAIDs had the largest effect
sizes (SMD: 0.61, 0.57, and 0.52, and RR: 0.61, respectively), all with only a modest effect. Transcutaneous electric nerve
stimulation and manipulation had small effect sizes (SMD: 0.22 and 0.35, respectively). As a conclusion, the effect of treatments
for LBP is only small to moderate. Therefore, there is a dire need for developing more effective interventions.
Keywords Effect size - Low-back pain - Placebo - Systematic review - Randomized controlled trial