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I am one of those Baby Boomers who likes to take charge of my own life. I think of myself as a consumer of health care. Most recently, I've started looking into better ways to deal with my chronic low back pain. I've been told by several doctors there's nothing more that can be done. Where can I look for some answers?

Chronic back pain can be very difficult to evaluate and treat. There are many things we still don't know about pain, what causes pain, and how to stop it. In many ways, the nervous system in charge of perceiving pain and sending pain messages remains a complex mystery.

Many pain clinics use a management approach to chronic back pain. The combined efforts of the doctor, psychologist, physical therapist, nutritonist, and others are used to find the best program of intervention and management for each patient.

If you haven't been working with a team of pain experts, that may be your next step. You may live in an area where a pain clinic has not been developed yet. As a consumer, you may have to put together your own team.

Instead of the physician coordinating all of the services, you would have that role. It will be up to you to communicate with each individual member on the team.

There are many traditional and complementary techniques available now for pain management. On the traditional side, medications are often the first-line of treatment. They range from mild analgesics to powerful narcotics.

From a less traditional approach, there is acupuncture, hypnosis, massage, relaxation therapy, and biofeedback to name just a few. It may take a while to find the right one or the right combination to get maximum benefit, but it can be done.

There are also updated guidelines on the management of chronic spinal pain. These are published by the American Society of Interventional Pain Physicians (ASIPP). They come out every two years. The 2007 update is available on-line at www.guideline.gov. You can also download the document from www.asipp.org/documents/guidelines-2007.pdf.

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