Treatment
Pros
Cons

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Staying active

Keeping mobile and continuing with your normal daily activities

  • Can help you recover faster than resting your back for long periods
  • May be uncomfortable at first
Exercises

Exercises to strengthen and stretch your back

  • Can help reduce pain and stiffness
  • Simple and easy to do at home
  • May be uncomfortable at first
Painkillers

Anti-inflammatories (such as ibuprofen) and stronger painkillers (such as codeine)

  • Can help relieve back pain and allow you to stay active
  • Available to buy without a prescription
  • Safe for most people to take
  • Not suitable for everyone
  • Can cause side effects, such as indigestion or stomach ulcers
  • Stronger painkillers should only be used for a few days, as they can cause addiction if used for longer
Hot and cold packs

Heat or ice packs, hot water bottles or bags of frozen vegetables wrapped in a towel or cloth

  • May help reduce pain in the short-term
  • Very widely available
  • Not much scientific evidence to support their use
  • Not a long-term solution
Relaxing and staying positive

Reducing stress levels and remaining optimistic

  • May help you recover faster
  • May also have other health benefits, such as improved sleep
  • May be difficult to remain optimistic if you have severe or long-lasting pain
Exercise classes

Programme of group exercises designed to strengthen muscles and improve posture

  • Can help relieve symptoms and speed up recovery
  • May be available on the NHS
  • May be uncomfortable at first
  • May not be suitable for people in severe pain and those with other long-term conditions or mobility problems
Manual therapy

Joints and muscles in the spine are massaged and manipulated, usually by a physiotherapist, chiropractor or osteopath

  • Can provide some pain relief
  • Safe treatment that poses no health risks for most people
  • Access on the NHS can be limited in some parts of the country, so you may need to pay for private treatment
  • Can cause pain and stiffness
  • Should only be used alongside other treatments such as back exercises
Alexander technique

Lessons to help improve your posture and movement

  • Some evidence it can be effective for long-term back pain
  • Safe treatment that poses no health risks for most people
  • Access on the NHS can be limited in some parts of the country, so you may need to pay for private treatment
  • Not specifically recommended by NICE
Psychological support

Therapies such as cognitive behavioural therapy (CBT)

  • Can help you cope with your pain and speed up recovery
  • May be available on the NHS
  • Therapy can be intensive, involving lots of sessions with a therapist
  • Should only be used alongside other treatments such as back exercises
Radiofrequency denervation

A procedure to stop nerves in the spine from sending pain signals

  • May help reduce back pain for at least 6-12 months, and probably longer
  • Can be repeated if the pain comes back
  • Relatively simple procedure that doesn't require general anaesthetic (where you're asleep) or an overnight stay in hospital
  • Only suitable for pain originating from the joints in the spine
  • Some uncertainty about how effective it is and how long the pain relief lasts – the pain may eventually come back
  • Doesn't work for everyone
  • Not clear whether repeat treatment is as effective as the first treatment
  • Risk of complications such as infection or accidental nerve damage