Phytotherapy in the Management of Low Back Pain: A Comparative Analysis with Conventional Pharmacological Interventions

Background: Low back pain (LBP) is a leading cause of global disability, affecting up to 80% of the population. While conventional pharmacological treatments (NSAIDs, paracetamol) are standard, their efficacy is often limited by side effects or insufficient relief, particularly in chron-ic cases. Consequently, interest in Traditional Chinese Medicine (TCM) and phytotherapy has increased.Objective: To evaluate the clinical benefits of phytotherapy in the treatment of LBP and compare its efficacy and safety with conventional pharmacological interventions.Methods: A narrative literature review was conducted, focusing on clinical guidelines, compara-tive studies, and TCM theoretical frameworks. The review analysed the aetiopathogenesis of LBP, the structure of herbal formulations (Emperor, Minister, Assistant, Envoy), and the com-parative outcomes of botanical vs. synthetic drugs.Results: Evidence suggests that conventional analgesics, such as paracetamol, often show no su-periority over placebo for acute non-specific LBP. In contrast, phytotherapeutic agents, specifi-cally Boswellia serrata, Curcuma longa, and the Du Huo Ji Sheng Tang formula, demonstrated signif-icant reductions in pain intensity and functional disability. Studies indicated that combining phytotherapy with acupuncture (e.g., Palmijihwang-hwan) provides superior cost-effectiveness and clinical outcomes compared to isolated conventional therapies.Conclusion: Phytotherapy is a viable and safe complementary alternative for managing LBP. It addresses the systemic and energetic imbalances (such as Kidney Yang deficiency or Qi stagna-tion) that conventional medicine often overlooks. While further longitudinal trials are needed to standardise dosages, integrating herbal medicine into multidisciplinary care offers a promising path for reducing the global burden of LBP.