This episode features a discussion with pain researcher Jason Busse about a recent BMJ systematic review and network meta-analysis evaluating interventional procedures for chronic non-cancer spine pain. Reviewing 81 trials and nearly 8,000 patients, the analysis found that commonly used injections and ablation techniques offer little to no benefit over compelling sham comparators. The conversation explores why invasive procedures show strong effects in observational data yet fail to outperform placebo in blinded RCTs, the growing evidence around non-specific and open-label placebo effects, and the emergence of centrally focused treatments such as pain reprocessing therapy. Busse reflects on mixed reactions from the clinical community and highlights ongoing work toward large-scale network meta-analyses and comprehensive back-pain guidelines that may clarify which patients benefit from which approaches.