Conservative treatments

* Exercises can be an effective approach to reducing pain, but should be done under supervision of a licensed health professional. Generally, some form of consistent stretching and exercise is believed to be an essential component of most back treatment programs. However, one study found that exercise is also effective for chronic back pain, but not for acute pain.Another study found that back-mobilizing exercises in acute settings are less effective than continuation of ordinary activities as tolerated.

* Physical therapy consisting of manipulation and exercise, including stretching and strengthening (with specific focus on the muscles which support the spine). 'Back schools' have shown benefit in occupational settings. The Schroth method, a specialized physical exercise therapy for scoliosis, kyphosis, spondylolisthesis, and related spinal disorders, has been shown to reduce severity and frequency of back pain in adults with scoliosis.

* A randomized control trial, published in the British Medical Journal, found that the The Alexander Technique provided long term benefits for patients with chronic back pain.. A subsequent review concluded that 'a series of six lessons in Alexander technique combined with an exercise prescription seems the most effective and cost effective option for the treatment of back pain in primary care'.

* Manipulation, as provided by an appropriately trained and qualified chiropractor, osteopath, physical therapist, or a physiatrist. Studies of the effect of manipulation suggest that this approach has a benefit similar to other therapies and superior to placebo.

* Acupuncture has some proven benefit for back pain ; however, a recent randomized controlled trial suggested insignificant difference between real and sham acupuncture .

* Education, and attitude adjustment to focus on psychological or emotional causes - respondent-cognitive therapy and progressive relaxation therapy can reduce chronic pain.