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Walking is the simplest and perhaps the best exercise for the low back. Your doctor or a physical therapist can recommend more specific exercises to help your back muscles get stronger. These may include a series of simple exercises called core stabilization. The muscles of your trunk, or core, support your spine. Strengthening these muscles can improve your posture, keep your body in better balance, and decrease your chance of injury.

Most people have at least one repeat episode of low back pain. If you have had Low Back Pain, remember that your back is now more vulnerable than before. Keep your stomach and back muscles strong, lift properly, and use good posture. For more information, see:

 Exercises for low back pain.

 Lifting properly to prevent back injury.

One treatment choice for acute Low Back Pain is spinal manipulation, or spinal manual therapy. The aim of spinal manipulation is to increase a joint's range of motion. Spinal manipulation can be done by a chiropractor, osteopathic doctor, or some physical therapists or physiatrists. For more information on this type of treatment, see:

 Should I have spinal manipulative therapy to treat low back pain?

New research suggests that a brief program of instruction in pain management-addressing how to manage usual daily activities, how to deal with worries about back pain, and overcoming fear of causing pain-can also be an effective treatment for Low Back Pain.⁷

Treatment for ongoing (chronic) Low Back Pain

Chronic low back pain is pain that has lasted longer than 3 months. As Low Back Pain continues beyond 3 months, it becomes vitally important that you develop skills for managing and coping with Chronic Pain so you can avoid getting into a cycle of sleeplessness, inactivity, irritability, depression, and more pain.

Chronic Pain often requires both psychological counseling and medical treatment, because pain has a wearing effect on both the mind and the body. Seek out a cognitive-behavioral therapist who can teach you stress management and pain control skills. Look for a "back school" program and at least one type of health professional who specializes in spinal care. The most successful programs are usually those that combine exercise, activities to increase your function, and techniques to help you manage pain.⁶ Depending on your condition, you can start taking charge of pain by continuing with home treatment measures and using one or more of the following treatments:

• Daily exercises to strengthen your trunk and back. See a physical therapist for specific exercises. For more information, see:

  Exercises for low back pain.

• Medicine if needed. They are not effective for all people, but medicines that doctors sometimes suggest for Low Back Pain include:
  • Acetaminophen to reduce pain and/or medicines that reduce pain, swelling, and irritation, including ibuprofen (such as Advil or Motrin), naproxen (such as Aleve or Naprosyn), and ketoprofen. These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
  • Prescription pain medicine or muscle relaxants for a short time, to help break the pain cycle.
  • Tricyclic antidepressants, to treat chronic pain. This type of medication not only treats depression but may have an additional effect on Chronic Pain.
  • Anesthetic or corticosteroid injections, to block pain sensation or reduce inflammation.
• Other therapies. These may include:
  • Ice and/or heat, depending on which seems to help you more. You may want to try switching between heat and cold.
  • Therapeutic massage, to ease muscle spasm.
  • Spine adjustment (manipulation), by an osteopath, chiropractor, physiatrist, or a physical therapy spine specialist. People who benefit from this usually notice improvement after one visit, and additional manipulation is not needed.⁸
  • Cognitive-behavioral therapy or biofeedback, for controlling pain and pain triggers. See a psychologist, licensed counselor, or clinical social worker who specializes in pain management skills.
  • Acupuncture.
  • Spinal cord stimulation, sometimes used for severe, chronic nerve pain.