Management, not treatment, is the new byword for patients with low back pain. Bed rest is no longer advised even for a day or two. Staying active is the number one piece of advice doctors now give their back pain patients.

The goal is to avoid becoming a chronic pain patient. Treatment such as acupuncture, medications, and chiropractic care may have a place in reducing the painful symptoms. But most patients get better without anything but movement and activity.

Patient education goes hand in hand with staying active. Doctors, chiropractors, and physiotherapists are helping patients understand and manage their own symptoms. Knowing what to expect takes a big load off the patient's mind. And easing anxieties and worries can actually help reduce back pain.

Some patients who don’t get better following this management advice may need physiotherapy. The therapist can help patients correct posture and gait. The physiotherapist can help patients regain normal motion and joint dynamics.

If patients do not get better with a management approach, then further medical evaluation may be needed. The doctor may need to order lab tests or imaging exams such as X-ray or MRI.

The bottom-line with a management approach is that patients must become responsible for themselves. Poor posture, obesity, and low levels of fitness are all within our individual control. These factors are an important part of good health, including having a healthy spine.

Bill H. McCarberg, MD and Gladstone C. McDowell II, MD. Recent Advances in the Management of Chronic Low Back Pain. In Pain Medicine News. March/April 2007. Vol. 5. No. 2. Pp. Insert 1-7.