The aim of a prominent team in the USA was to provide a rigorous and balanced summary of the best available evidence about the effectiveness, safety, and costs of the most popular complementary and alternative medical therapies used to treat back pain. They assessed systematic reviews of RCTs published since 1995 and that evaluated acupuncture, massage therapy or spinal manipulation for non-specific back pain and RCTs published since the reviews were conducted. Two authors independently extracted data from the reviews (including number of RCTs, type of back pain, quality assessment and conclusions) and original articles (including type of pain, comparison treatments, sample size, outcomes, follow-up intervals, loss to follow-up and authors’ conclusions). The researchers found that the effectiveness of acupuncture for treating acute or chronic back pain is unclear. The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. A meta-regression analysis of the results of 26 RCTs evaluating spinal manipulation for acute and chronic back pain reported that spinal manipulation was superior to sham therapies and therapies judged to have no evidence of a benefit but was not superior to effective conventional treatments.