Frequently asked questions about back pain treatment

What are national guidelines for treating chronic back pain?

For people who do not see improvement with self-care options, several national and international studies recommend up to eight to 10 sessions of individual or group exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation over a period of 12 weeks.

For people who have not found success through the above treatments or have high disability or psychological distress, physicians are recommended to consider referral for a combined physical and psychological treatment. The UI Spine Rehabilitation Program includes professional contact involving the physician, psychologist, and physical therapists over a concentrated period.

Do pain rehabilitation programs work?

They do if you can make positive behavior changes. Research shows that chronic pain programs can offer a successful and cost-effective treatment for people with chronic pain. 

These findings also have been confirmed by the American Pain Society and the American College of Physicians and have been an integral part of their clinical practice guidelines. There is strong evidence that a graded activity program using a behavioral approach can be effective in getting patients back to work.

When should surgery be considered? 

What surgeons are looking for is any extension of pain into the leg or a substantial change in the quality of a person’s pain.

What medications are recommended for chronic back pain?

The American Pain Society and the American College of Physicians recommend acetaminophen or nonsteroidal anti-inflammatory medications. Second line treatments for chronic back pain include tricyclic antidepressants. The American Pain Society and the American Academy of Pain Medicine are concerned about harms of opiate medications including drug abuse, addiction, and diversion.

Last reviewed: 
April 2018

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