Types of treatments Simon Crompton Below are some different methods of treatments used by health practitioners. We're not recommending any of the options - it's up to you, with the help of a skilled practitioner, to find what works best.

In this article

Exercise Manipulation Medicines and injections

Massage, heat and hydrotherapy Traction Transcutaneous electrical nerve stimulation (TENS)

Braces and supports Complementary approaches Recurring pain

Regular gentle exercise builds strength and suppleness in the back and can stop pain returning.

Staying active is recommended to reduce pain and speed recovery from acute back pain. This means doing the physical things you'd normally do and avoiding sitting for prolonged periods of time.

Trained professionals can teach you how to exercise safely while you have pain, but research indicates exercise programmes are unlikely to help if you have acute (short-term) back pain. In this case, a more strenuous regime of strengthening the muscles to help prevent future bouts of back pain is often recommended.

This is use of the hands to apply force to the back. Chiropractors say the technique 'adjusts' the spine. Physiotherapists see it as taking a joint to the limits of its natural movement.

Manipulation should only be carried out by appropriately trained doctors, physiotherapists, osteopaths and chiropractors.

Doctors can prescribe a wide range of medicines to reduce pain and inflammation. A pharmacist can also provide advice.

In cases of serious back pain, it's possible to inject anaesthetic or anti-inflammatory drugs (steroids) into the back.

Massage can stimulate the tissues, while applying hot and cold packs can help to reduce pain and inflammation in the early stages of back pain.

Occasionally, physiotherapists provide programmes of exercises in a special swimming pool for those with serious or long-term back problems. Warm water helps to support damaged tissues and provides resistance for exercises.

Traction involves pulling the bones slightly apart to reduce pressure on the discs and nerves, and relieve muscle tension. It's used less often than it once was and is only practised by doctors and physiotherapists.

This is a small box with terminals attached to the painful area. It produces a tingling sensation and can help reduce pain.

TENS machines are available from pharmacies. Always read the instructions and seek the advice of a health professional if possible.

Back supports are best avoided because they allow the back muscles to become weak. However, wearing a light support for short periods - as recommended by physiotherapists - can keep you moving properly.

These include acupuncture, aromatherapy, hypnotherapy, Alexander technique and yoga.

Ask your GP about treatments available on the NHS.

Some people have more serious, long-term (or chronic) back problems, caused by disease or damage to the spine. If your back problem doesn't clear up quickly your GP may refer you to a specialist and ask you to visit the hospital for tests and treatment.

Help yourself

Print out and fill in a back pain plan to help keep track of your back problems. It could help you pinpoint the triggers and enable you to take better care.

You may need to see doctors or other health practitioners more regularly, take medication and follow a tailored set of exercises. You may even need surgery to correct the problem, but this is rare.

Some people find nothing seems to help the pain. Doctors usually refer these patients to pain management clinics, where teams of doctors, physiotherapists, psychologists, nurses and occupational therapists can help them cope with long-term pain.

For most people the route involves a short course of painkillers with a gentle return to work and normal life. For others, the process will be longer, and require long-term treatment and lifestyle changes.

This article was last medically reviewed by Dr Rob Hicks in September 2007.
First published in March 1999.