Treatment options for back pain 

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Treatment
 Pros
Cons

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Paracetamol

The first painkilling medication usually recommended for back pain
  • Can help relieve mild pain
  • Available without a prescription
  • Side effects are rare
  • Safe for most people to take, including pregnant women
  • May not help if your pain is severe
Anti-inflammatory painkillers (NSAIDs)

Ibuprofen or naproxen

  • Can reduce mild pain and stiffness
  • Available without a prescription 
  • Any side effects are usually mild
  • Long-term use can cause indigestion, stomach ulcers and kidney problems
  • May not be suitable if you have asthma or a history of stomach ulcers
Opiate-based painkillers

Prescription painkillers ranging from moderate-strength (e.g. codeine) to powerful (e.g. morphine)

  • More effective than paracetamol and NSAIDs in treating severe pain
  • Potentially addictive, so long-term use is usually not recommended
  • Can cause nausea, dizziness, dry mouth, drowsiness, vomiting, constipation
Exercise classes

Programme of group exercises designed to strengthen muscles and improve posture
  • Can help relieve symptoms and speed up recovery
  • May not be suitable for people in severe pain and those with other long-term conditions
Manual therapy

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

  • Can provide some relief of pain and improvement in function
  • 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
Acupuncture

A complementary medicine, where needles are placed in different parts of the body

  • Some evidence it is an effective treatment for chronic back pain
  • Side effects usually mild and short-lived
  • 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, bruising, bleeding, drowsiness, worsening of existing symptoms
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 currently recommended by NICE
Tricyclic antidepressants
Antidepressants used for their painkiller effect
  • Can be effective when conventional painkillers don't work
  • Can cause dry mouth, constipation, sweating, problems passing urine, slight blurring of vision, drowsiness
Psychological therapy

Therapies such as cognitive behavioural therapy (CBT)
  • Can help you cope with your pain if other treatments don't work
  • Therapy is intensive, involving around 100 hours of treatment
  • The psychological elements may be unsuitable for people with learning difficulties or mental health conditions
Spinal surgery

Surgery to reduce pain caused by compressed nerves near the spine
  • Can be effective in relieving problems such as numbness and pain in the legs (sciatica)
  • May help reduce back pain
  • Less effective at reducing back pain than leg pain
  • May result in infection, blood clots, bowel and/or bladder incontinence, or paralysis