Where to go for treatment

This article is the archived version of a report that appeared in May 2009 Consumer Reports Magazine.

"Everyone seems to be selling some kind of gimmick, treatment, or pill for low-back pain," says neurologist Scott Haldeman, M.D., who co-edited the January/February 2008 issue of The Spine Journal, which reviewed ways of treating low-back pain. But when treatments abound, it's usually because there's no clear winner.

A visit to a primary-care doctor is a smart first step when back pain is severe. A doctor can help rule out disease, such as infection or cancer. Although many of our respondents who saw a primary-care doctor left dissatisfied, doctors can write referrals for hands-on treatments that might be covered by health insurance.

Enduring the pain or seeing a chiropractor or physical therapist as a first step might be OK for a recurrent, familiar back problem. Most of the 35 percent of our respondents who didn't see a health professional had severely limiting pain for less than a week. Many of those with more prolonged pain who didn't see a healthcare professional said it was because of cost concerns or because they did not believe professional care could help.

Research suggests that chiropractic manipulation can reduce acute low-back pain, and many, though certainly not all, of the respondents who tried it said it helped. Albert McCann, 54, a respondent from Lakeland, Fla., has kept working as a petroleum transport engineer, driving a semi truck and using 20-foot-long hoses several times a day. By following a chiropractor's recommendations and getting treatment every few weeks—including manual adjustments, electric stimulation, and a spinalator (roller-massage table)—he is able to keep his back pain to a minimum.

Massage and physical therapy were other treatments rated very helpful by 48 and 46 percent of consumers, respectively. "My back pain was unrelenting," says survey respondent Charlene Mower of Fayetteville, Ark. "Before physical therapy, I thought I was done for." Mower, 51, hurt her back while trying to lift her bedridden mother. She credits the training in lifting and bending techniques that a therapist gave her and continued exercise for her long-term success in staving off pain.