Back Pain Relief: What Actually Helps

The short version

Back pain usually improves with time, and the right approach can make that time shorter and easier. Australian and international guidelines agree on a few key points: stay active, avoid bed rest, use simple non-drug treatments first, and only scan when there’s a reason to.

Relief for a new episode of back pain

• Keep moving. Gentle activity speeds recovery. Keep doing your usual activities as much as you can, even if you have to slow down.
• Heat. A heat pack or warm shower can ease pain and stiffness in the first few weeks. Guidelines from the American College of Physicians list superficial heat as a first treatment for new back pain.
• Massage, acupuncture or spinal manipulation. These have some evidence for short-term relief in new back pain, though the effect is modest.
• Sleep position. There’s no single right position. A pillow between your knees (on your side) or under your knees (on your back) helps some people.
• Reassurance. Knowing that back pain is common and rarely dangerous genuinely helps. Fear of damage tends to make people move less, which can make recovery slower.

Relief for back pain that lasts

When back pain lasts beyond about six weeks, the focus shifts to building strength, confidence and coping:

• Exercise has the strongest evidence. See exercises for lower back pain.
• Yoga, tai chi and pilates are all reasonable options.
• Psychological approaches, including cognitive behavioural therapy, mindfulness and pain education, help people manage pain and get back to activity.
• Combined programmes such as cognitive functional therapy, which joins movement retraining with work on beliefs and stress, produced large, lasting improvements in an Australian trial published in The Lancet in 2023.

What about medicines?

Medicines have a smaller role than many people expect. Some commonly used ones give little benefit for back pain, and some carry real risks with regular use, which is why guidelines recommend non-drug treatments first. If you’re thinking about medicines, or already taking several, talk to your GP or pharmacist about what’s appropriate and safe for you.

What doesn’t help

• Bed rest slows recovery.
• Routine scans don’t speed recovery when there are no warning signs, and can lead to worry and unnecessary treatment.
• Waiting for pain to go completely before doing anything. Gradual activity usually comes first and the pain eases after.

When to see a GP

See a GP if your pain is severe, isn’t improving after a few weeks, travels down your leg, or is affecting your sleep, work or mood. Get urgent help for numbness around the groin, new bladder or bowel problems, or worsening leg weakness. See back pain red flags.

References

1. Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
2. Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383.
3. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-747.
4. Kent P, Haines T, O'Sullivan P, et al. Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial. Lancet. 2023;401(10391):1866-1877.
5. Ho EK, Chen L, Simic M, et al. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ. 2022;376:e067718.
6. Australian Commission on Safety and Quality in Health Care. Low Back Pain Clinical Care Standard.