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“CBT has many, has many uses from a psychological perspective,” Dr. Bronson says. A 2022 meta-analysis of 22 studies suggested that people with chronic lower back pain who tried it had less pain and disability than people who had regular care without CBT. The WHO recommendations hinge on the idea that, while pain does happen, the road to feeling better can involve changing how you think and what you do about it.
5. NSAIDs as needed
NSAIDs—such as ibuprofen or naproxen—are anti-inflammatories, so taking them may help you get on track to recovery, Dr. Anderer explains.
For what it’s worth, Dr. Anderer cautions against just popping an Advil or two here or there. That can help relieve pain in the moment, but it isn’t going to help you deal with the inflammation behind the pain, he says.
Because NSAIDs can cause serious problems in some people like gastrointestinal bleeding, stomach ulcers, and kidney damage, Dr. Anderer suggests speaking with a health care provider who can monitor your back pain, direct you to take the right amount of medication for a safe length of time, and watch for worrying side effects.
The WHO recommends that they be used in combination with other treatments and for the briefest amount of time, and only in people who are good candidates for the meds—i.e., those who don’t have kidney, stomach, or other health problems that might be an issue.
Three things that don’t work for lower back pain
1. Opioids
Prescription narcotic medications have a well-documented history of being addictive, and they played a role in the estimated 100,000 overdose deaths in 2021 alone. “You have to look no further than the crisis itself, which I think is sort of precipitated in large part by a lot of very well-meaning doctors treating patients for pain syndromes,” says Dr. Anderer. “Chronic back pain is one of them, so that was one of the diagnoses that really fueled the opioid crisis.”
Besides being habit-forming, they don’t seem to work. At least one randomized clinical trial found that opioids were no better than the placebo at relieving back pain, but people who took them were at risk of misusing them a year after the trial was completed. The WHO specifically advises against the drugs, which include medications like OxyContin and Percocet, as “there are potentially serious adverse events associated with the use of opioid analgesics, such as dependence and overdose.”
2. Back support belts or braces
Remember the advice to get exercise, seek out physical therapists, and invest in self-care? Yeah, well, according to experts we spoke with, a back brace or support belt encourages you to do the opposite. Experts say it’s a quick-fix approach that doesn’t really work.
“Everyone asks for a brace,” says Dr. Bronson, “which I generally recommend against in the absence of some trauma that requires it.” Since the goal is to strengthen the back, “the last thing you want to do is wear a brace,” he says. “It’s sort of like using a crutch while trying to strengthen your leg.”
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