Low back pain is one of the leading causes of disability worldwide. Every individual case is unique. A cause and effect relationship is often difficult to determine. Moreover, treatment strategies and pain management vary widely based on the medical practitioner consulted.

As a result, many guidelines have been developed to help guide practitioners to management strategies which have been proven effective through research. Equally, as a patient it is particularly important to understand your diagnosis and treatment options, and become an active part of your own treatment and rehabilitation team.

Effective or Recommended Treatments:

  • Obtain an assessment from a spine specialist (Medical doctor, Chiropractor, Osteopath, Physiotherapist).
  • Become educated about the nature of pain and how to cope, lifestyle, nutrition, activity.
  • Spinal manipulation for acute and chronic low back pain can be an effective treatment. 
  • Manual therapy can help with relaxation, flexibility, and pain relief. 
  • Exercise or encouragement of activity. Or encouragement to return to activity for acute and chronic low back pain.
  • Reassurance and instruction on self management options from a licensed and regulated medical professional. 
  • Multimodal treatment including counselling and or cognitive behavioural therapy for chronic low back pain or patients with psycho social risk factors.
  • Acupuncture or massage therapy in combination with other active treatments.
  • Re-assessment or referral for patients whose symptoms do not resolve or change.
  • Imaging if any red flags present with radiculopathy (symptoms in the legs).
  • Using medication if it’s right for you, always talk to your doctor and pharmacist about options for you.
    • Acetaminophen, NSAIDs (Non-steroidal anti-inflammatories) or paracetamol.
    • Opioids when necessary.
  • Prevention: exercise/physical activity.
  • Yoga therapy: vinyasa types have been proven effective.
  • Aquatic exercise have also been proven effective.

Treatments: possibly effective/unknown:

  • Prevention: spinal manipulation or mobilization.
  • Prevention: chairs, mattress recommendations.
  • Injections (talk to medical doctor about these options).

Treatments: not recommended:

  • Bed rest.
  • Diagnostic imaging, particularly, acute low back pain with no red flags.
  • Any passive modality as the only treatment modality.
  • Traction as only treatment modality.
  • Prevention: using lumbar supports.
  • Prevention: wearing orthotics.

Overall, if you are suffering from low back pain do not hesitate to consult a licensed and regulated medical professional. Additionally, prepare a list of questions for your appointment and do not hesitate to ask them. 


  1. Wong, J. J., Côté, P., Sutton, D. A., Randhawa, K., Yu, H., Varatharajan, S., … & Carroll, L. J. (2017). Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. European journal of pain21(2), 201-216.
  2. Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. The Spine Journal8(1), 213-225.
  3. http://www.topalbertadoctors.org/download/1885/LBPguideline.pdf?_20181115202142