Again I think you are confusing the process with the personalities.
It’s the process that matters to eventually yield results. Along the way there will be mistakes and errors, but the process has value.
I didn’t devalue the process. In fact, I have a pet saying on the subject:
Ignoring science because it’s inherently imperfect is like being unwilling to aim or practice because your first shot didn’t hit the bullseye.
The process and the personalities inevitably conflate.
The process of experts evaluating the body of research, grading the strength of the evidence, vs expert opinions, and balancing recommendations with consideration to possible harms/costs as well as possible benefits? That’s fine. Absolutely correct that the evidence in medicine can often be messy and incomplete. The reviews are not always perfect but the process is the least poor option we have.
The process of those expert evidence based guidelines impacting what people believe and recommend? That gets filtered through our biases, by the personalities.
This thread is the illustration of that.
Several posters early on made statements about how proven some approaches to chronic low back pain are, and how in comparison acupuncture has poor evidence. That despite the fact that multiple of the expert evidence based guidelines say otherwise. They grade evidence for acupuncture AND for other interventions pretty much all the same. Each are from the perspective of the process equally “evidence based medicine.” Acupuncture is considered a reasonable option by those guidelines.
How we implement those recommendations is where personal biases, personalities, come to play a role. What are we biased to believe should work.
“Everything Works If You Let It” was an OK song in Roadie.
It’s not something physicians should adopt as their motto.
It’s a cheap trick on patients.
I’m sorry but I see you are insisting on conflating the process with the personalities.
The scientific process will eventually yield results.
Relying on tradition and lore might get some benefits but in the long run it’s not a self correcting process and far more susceptible to ineffective treatments.
I can’t tell if this is directed at me or someone else but either way: I don’t see anyone here arguing for tradition and lore over an evidence based process.
There could be, perhaps a fun discussion over how much the scientific process is intrinsically entwined with who is doing it and who is applying it, a social endeavor at its core, vs independent of those personalities … I’d participate if you create a thread about it!
But my point was more that the practice of medicine is science influenced, limited in degree both by the fact that the evidence answering clinical questions is often insufficient, and by the fact that we apply our biases to its application.
That sounds dangerously akin to “Nothing can be dismissed because eventually, in some unknown future, it might turn out to be true”.
Unfortunately the option of nothing is too often dismissed when it actually is the least poor choice …
Seriously though. Sometimes getting people to choose a course least likely to cause harm is what we can accomplish.
Not at all. I’m saying that if something works, there may be a reason for it even though we don’t know why yet. Like bumblebees were proven to not be able to fly. But they do. And we know why and it is scientifically sound.
No they obviously weren’t
Zombied on that one…and thank you.
And of course I meant "ninja"d. 
The bit is that it was allegedly considered by understanding of the physics and the math impossible for bumblebees to fly. It failed the plausibility test. But the evidence that they could fly was solid. The understanding how came later.
Short and stubby, the bumblebee doesn’t look very flight-worthy. Indeed, in the 1930s, French entomologist August Magnan even noted that the insect’s flight is actually impossible, a notion that has stuck in popular consciousness since then.
So it wasn’t “proven” at all.
Yet another case of someone not understanding the process.
Also it’s being quite misconstrued what was actually stated re: bumblebees.
I can’t speak for @Saint_Cad but the meaning was very clear to me, and I would imagine to anyone who knew of that fairly famous bit. Of course it isn’t actually impossible for bumblebees to fly. No one actually thought that.
I’ve posted here several times that my pediatrician-sister-in-law’s practice will no longer accept patients whose parents won’t vaccinate, after an infant in their care died of whooping cough (too young to be vaccinated). The docs do their best to explain why to the parents, and will even adjust the vaxxing schedules if necessary. Most parents go along with it.
OK, I’ve had to skip quite a few of these posts, because I just can’t take the conflict right now. But I want to offer what support I can.
As a person whose back looks a lot like CrowManyClouds’s photo (add arthritis in the surrounding vertabrae) I strongly advise you to get imaging - at least an x-ray - before you do anything else. Just go see your PC and ask for it. That should be easy. If you can, get a referral to an Orthopedist, who can probably do the x-rays in their office.
Keep copies of ALL your imaging files and reports. It is critical to be able to show degeneration later on if/when you need surgical intervention.
Once you have a report and are certain it is safe to do so, then I would advise going to this youtube site and searching for videos on low back pain. Even with my extreme issues, Bob and Brad have provided more relief than anything else except the occasional course of steroids.
I cannot emphasize enough the importance of getting imaging first. But then, once you know it’s safe, work through some of their diagnostic exercises to find where your problem lies. Then search their site again with those terms for strengthening exercises to improve the situation.
Good luck! I hope this helps.
P.S. You asked about acupuncture. I think the worst case scenario is that it gives you some placebo relief, thus delaying real diagnosis and corrective care. Back trouble gets worse if you don’t address it. Pain is your body asking for help, so get some.
I know you don’t want conflict but it shouldn’t be easy. A decent PCP should be aware that the evidence based guidelines strongly discourage imaging and more aggressive management without specific indications. They should be a bit of a roadblock to that. On this at least @Jackmannii and I seem to agree.
I don’t now what you/they are basing this on, but it makes no sense to me. Imaging doesn’t hurt, and it can identify serious problems. Many of the standard early therapies can exacerbate a problem if it isn’t identified. I went YEARS with doctors giving me short shrift and labeling me a drug seeker before somebody finally looked and found out there was a serious problem. They put me through a lot of painful and useless PT which only made things worse. For YEARS.
I’m betting the “evidence” those guidelines are based on is biased toward saving insurance the cost of imaging.