Although there’s no compelling evidence to show that biofeedback works specifically for chronic back pain, there is evidence that it can ease chronic pain generally. It’s worth a try, Cherkin says.
Chiropractic. Chiropractic’s signature treatment, spinal manipulation, may help relieve back pain. The National Center for Complementary and Alternative Medicine reports that spinal manipulation “appears to be as effective as conventional treatments.”
“We don’t know what’s going on in the body [during spinal manipulation],” says William C. Meeker, DC, president of Palmer College of Chiropractic in San Jose, Calif. “But we know that it alleviates sensations of pain and soreness and increases joint mobility.”
During your first visit, the chiropractor will usually take a medical history and do a physical exam that focuses closely on the spine. In subsequent visits, the chiropractor will use twisting, pulling, or pushing movements to adjust the bones and joints in your spine. The chiropractor may also use heat, electrical stimulation, or ultrasound to relax your muscles.
Physical therapists, osteopaths, and even some conventional medical doctors use spinal manipulation, too. Health insurance plans often cover the cost of chiropractic care.
Massage. It feels good to get a massage, and massage does ease the muscle tension that often accompanies back pain. Though few studies have looked at massage as a remedy for chronic back pain, Cherkin says all showed positive results. Cherkin's own study, the largest of its kind, showed that back pain sufferers treated with 10 weekly massage visits got long-lasting pain relief.
Meditation. A kind of meditation known as mindfulness may help ease chronic back pain, possibly by changing emotions that tend to make pain worse. “The emotional component of pain cannot be overestimated,” says Natalia E. Morone, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine.
“Mindfulness helps people become aware of thoughts, emotions, and sensations without judging them,” Morone says. She says that the overall pain-relieving effect of mindfulness appears small, though some people who participated in her studies experienced dramatic pain relief. Others said that, although they continued to have back pain, it didn’t bother them as much.
Yoga. For anyone with a bad back, learning yoga might sound like the ultimate bad dream. Why would anyone wracked with pain want to try poses (asanas) with names like "Cobra Posture" and "Supine Butterfly?" But research suggests that this ancient movement-and-meditation technique can ease chronic back pain. In one study, people with back pain who took 12 classes learning a gentle, easy-to-do form of yoga known as viniyoga had pain relief that lasted at least several months.
"Yoga was clearly better than self-care," says one of the study’s authors, Karen J. Sherman, PhD, senior investigator at Group Health Research Institute. "It's certainly worth trying, but only if you're willing to practice." She recommends finding a yoga instructor who has experience working with people who have back pain, and cautions that physically demanding forms of yoga could actually make back pain worse.