Your choices for treatment of back pain are surgery, steroid injections, pain medications, exercise strengthening and stretching programs, or techniques that place external force on the back such as deep massage, manipulation and passive stretching. Because surgery has such a high failure rate, it is usually recommended only when there is danger of permanent injury such as loss of feeling, loss of muscle control or intractable pain. Steroid injections offer temporary relief, but almost never cure back problems.
When possible, first line treatment is a program of active exercise to strengthen and stretch belly, back and leg muscles along with manipulation and deep massage, which is far more effective than bed rest. Strength training requires supervised exercising against progressively greater resistance one to three times a week. Stretching includes daily stretching of the back and leg muscles. Deep massage can be so painful and so irritating to the skin that it often is done only once a week. Superficial light massage has not been shown to help cure back pain. Manipulation can relax muscles that have gone into spasm and help to relieve pain effectively.
Anyone with persistent low back pain should check with his or her doctor to rule out a serious cause.
