The list of “nontraditional” therapies and treatments for lower back pain is extensive, and many have not been proven safe or effective. However, there are a number of well-established options, such as those listed below, that are generally acknowledged to be potentially effective in relieving lower back pain:

• Spinal manipulation: The United States Agency for Health Care Policy and Research recognizes spinal manipulation by chiropractors and osteopaths as an effective treatment for acute lower back pain, but the benefit for chronic back pain is less clear.
• Traditional chiropractic therapy involves manipulating the spine to properly align the vertebrae, which may restore mobility to the spine and relieve muscle spasms.
• Chiropractors sometimes combine spinal manipulation with muscle massage, ultrasound stimulation of deep tissue, nutritional counseling, and exercise.
• Osteopathic treatment may include drug therapy along with spinal manipulation or traction, followed up with exercises.

• Body education: The Alexander Technique and the Feldendkrais Method ^® are ways of learning how to stand and move naturally without creating unnecessary tension in the body. Both methods may help reduce pain and relieve stress.
• Each approach has an international sanctioning body with a dedicated Web site to help interested individuals find more information or locate a practitioner in your area.

• Yoga: The National Institute of Neurological Disorders and Stroke cites yoga as a type of exercise that can gently stretch muscles and ease pain. In addition, the National Institute of Arthritis and Musculoskeletal and Skin Diseases describes yoga as a good option to try when seeking to increase balance and strength and decrease risk of falling and back injury.
• Acupuncture: The National Institutes of Health (NIH) have declared acupuncture a reasonable treatment option for people with lower back pain. Both traditional acupuncture and electro-acupuncture, in which an electric current is applied to the acupuncture point, have been shown to ease back pain.
• Cognitive behavior therapy: Cognitive behavioral therapy (CBT), along with stress management, behavioral adaptation, education, and relaxation techniques, can change perceptions about pain and disability. It may reduce the pain and also improve depression. The NIH considers CBT useful for relieving lower back pain, and it remains effective over the long term.
• Biofeedback: Biofeedback is a technique that helps to measure general aspects of health, such as breathing, heart rate, blood pressure, skin temperature, and muscle tension. Biofeedback teaches people how to alter those functions through relaxation or imagery.
• If your lower back pain is caused by muscle tension or spasm, you may be able to use biofeedback to retrain yourself so muscles become less tense when you are stressed.

• Other kinds of physical therapy and exercise: Physical therapy may include massage, ultrasound, whirlpool baths, and specially designed exercise programs to help patients regain full use of the back.
• Aquatic exercise, for example, can improve flexibility and decrease pain for those with chronic lower back problems. It can be an especially safe environment for exercising a sore back because the water provides buoyancy and gentle resistance, preventing sudden stress on muscles.

Feldenkrais Method ^® is a service mark of the FELDENKRAIS GUILD ^® of North America.