A key in using exercise to hasten relief, says Dartmouth's Weinstein, is to distinguish hurt from harm. The pain could get worse while a back sufferer exercises, but that does not mean the activity is dangerous. One way to judge the nature of the pain, says New York orthopedic surgeon Russell Windsor, is to see whether it is possible to distract oneself from the pain for even a few moments. If so, patients should keep trying to walk, climb a few stairs, or stretch. If not, they should rest and try again soon.
Exercise also helps by controlling weight, which plays a role in protecting the back from pain.
Losing just five or 10 pounds, says Windsor, can help frequent back pain sufferers feel much better. Relaxation techniques such as massage, yoga, and meditation probably do some good for back pain, for at least two reasons. First, say researchers, people in a state of stress hold their muscles in a tightened position, which reduces blood flow, cuts off oxygen and builds up painful waste products, and can lock muscles in a constricted spasm. For 99 out of 100 back pain sufferers, surgery is not even an option. Still, the number of procedures exceeds 600,000 a year.