“Oh, my aching back!” is a complaint heard worldwide.

Back pain is a major reason for going to the doctor as many people will feel this pain in their life. In 2016, back pain treatment cost the U.S. healthcare system $ 134.5 billion, more than any other disease. Chronic lower back pain – not the occasional “Oh, I shouldn’t have moved this couch alone” complaint – has been a challenge for healthcare providers for decades.

Mind-body therapies to consider

The main treatment for back pain was medication. When the opioid crisis peaked in 2017, healthcare providers needed to find safer treatments.

And apparently they have. Many health care providers these days use complementary or alternative medicine to manage pain. These are a number of so-called non-mainstream therapies that are often used alongside standard treatments.

According to the National Cancer Institute, mind-body therapy is a therapy that combines controlled breathing, mental focus, and physical movement with the goal of relaxing the mind and body.

The American College of Physicians conducted a review of safe treatments and found evidence that changed their minds about treating back pain. In 2017, they updated their guidelines to include heat therapy, massage, acupuncture, and spinal manipulation as top treatments. They said medications – including ibuprofen, muscle relaxants, and opioids – should be a last resort.

And in a study published in the Journal of the American Medical Association (JAMA) in 2018, those treated with opioids during a tooth extraction had higher pain levels than those who did not use opioids during the same procedure.

Heat therapy, massage and manipulation of the spine

Heat therapy and massage are used to soothe inflammation and increase mobility. Spine manipulation is a hands-on therapy performed by a chiropractor. Fast movements are combined with slower movements in order to adapt and stimulate the spine and the surrounding muscles.

“As a chiropractor and nurse, I use conservative care like chiropractic, acupuncture, or massage,” said Mary E. Pregler-Belmont, who practices in Dubuque, Iowa. Her patients, she said in an email interview with Medical Daily, found relief with exercises, stretches, and relaxation positions, as well as with ice and heat.


Linda Farynowski, a 56-year-old school teacher from British Columbia, Canada, visited doctors for five years and had herself scanned. Doctors said she had arthritis in her back and was living with back pain. “I wanted to take lessons about living with pain when someone recommended acupuncture,” she said in an interview.

Ms. Farynowski’s visits to Zea Friesen, a British Columbia registered acupuncturist, were not an immediate cure. But after a few weeks she was free of pain and now only has an occasional sting. “If my back hurts now, I can usually get rid of it with 2 to 3 treatments,” said Ms. Farynowski.

Dr. Pregler-Belmont said her patients have had great success with acupuncture as well, but cautioned that some insurers may not cover the treatment.

Acupuncturists use thin needles that are inserted into specific locations in the body. The needles can help the body release pain relieving chemicals called endorphins. Ms. Friesen explained that acupuncture can release a flood of these chemicals into the nervous system, resulting in relaxation and balance.

Cognitive behavioral therapy (CBT) and physical therapy

Meriah Ward, MSN, a Raleigh, NC nurse, frequently recommends CBT, exercise, and physical therapy to her patients with chronic lower back pain. Because the combination has helped, she recommends it again and again.

Physical therapy strengthens the core muscle groups that support the lower back and improves flexibility and posture. They are often combined with mind-body treatments.

Cognitive therapy and stress reduction therapy use relaxation and coping techniques to relieve pain. Stress can make pain worse, and worsening pain can increase stress. “CBT has helped my patients address their stress and pain in different ways with more thoughtful approaches,” Ms. Ward told Medical Daily.

When back pain needs urgent treatment

Contact your doctor right away if back pain is due to a recent injury, especially a fall or blow to the head.

Further reasons for contacting your provider immediately are:

• Fever

• New loss of bladder or bowel control

• Numbness or tingling in your back, legs, or feet

• Weak legs or walking difficulties

• Severe pain that does not get better

Take them home

Promising treatments like acupuncture, massage, and CBT are high on the treatment list for back pain. Combining exercise and physical therapy with these low-tech treatments means even more hope for those living with chronic lower back pain.

Julie Nyhus is a nurse and a freelance health and medical writer. She lives in Indiana with her husband and their Bernese Mountain Dog, a five-minute walk from Lake Michigan.