Relief for aching backs

Hands-on therapies - chiropractic manipulation, massage and physical therapy - were among the top-rated. Many of those who tried spinal injections found them to be very helpful, although the techniques their doctors used varied.

1. WHERE TO GO FOR TREATMENT
A visit to a primary care doctor is a smart first step when back pain is severe. A doctor can help rule out disease, such as infection or cancer.

Enduring the pain or seeing a chiropractor or physical therapist might be okay for a recurrent, familiar back problem. Research suggests that chiropractic manipulation can reduce acute low-back pain.

2. BE WARY OF OPIOID PAIN RELIEVERS
Clinical trials have shown that about half of the people who take them for pain suffer adverse effects such as drow-siness, respiratory depression (a potentially dangerous breathing problem) and gastrointestinal symptoms such as constipation, heartburn, cramping, nausea and vomiting.

There are almost always better solutions than opioids for low-back pain. For most people, the best first-line medicines are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Depending on the circumstances, second-line medications, including muscle relaxants, tricyclic antidepressants and anti-seizure drugs, can help.

3. USE CAUTON WITH SURGERY
Your doctor might suggest you see a surgeon if back pain is unrelenting and no other treatment seems to work.

Satisfaction depended on the diagnosis and the type of surgery. Those with degenerative disk disease (arthritis of the spine) were far less likely to be highly satisfied with surgery (54 percent) than those with a herniated disk (73 percent) or spinal stenosis (71 percent). The most common regret was that more post-surgery rehabilitation had not been planned.

If you're told you need surgery, get a second opinion from another practitioner, preferably one who is not a surgeon.