What’s the best treatment for low back pain? I have back pain that hasn’t gone away after two months. I’ve tried rest, medications, and exercise. Has anything been proven most effective for everyone?

So far it looks like there may be more than one approach to low back pain (LBP). What works well for one person doesn’t always gain results for another.

There is general consensus that staying active is the most important feature of any back care program. Patients should strive for a balance of rest, exercise, recreation, and work-related activities.

A biomedical approach treats the symptoms with medications, rehab, and possibly surgery. A psychosocial approach looks at the behaviors, beliefs, and stresses in the patient’s life and tries to moderate them.

A review of many studies of therapies for back pain has been done. Results of nondrug therapies were reported for acute low back pain and chronic low back pain. Acute refers to the early onset of symptoms. This is usually within the first two weeks to two months of pain. Chronic back pain refers to painful symptoms that have persisted beyond three months.

There is fair evidence that spinal manipulation offers some benefit to patients with acute back pain. Hot packs or heating pads offer moderate relief of painful symptoms in the early phases of back pain.

Relaxation techniques, acupuncture, and massage provide moderate relief of pain and have fair quality of evidence. Exercise, rehab, and spinal manipulation have been proven more effective for subacute or chronic back pain.

Don’t despair if you haven’t found the right treatment for you. Sometimes it takes a while to find the treatment approach or combination of treatment methods that work best for each individual. A physical therapist can also help you with this.