Back pain: Management

Woman holding back

Managing back pain

Back pain frequently resolves within a few weeks or months.1,2

However, sometimes the pain can persist over the long term, or keep recurring.1

Here we review physiotherapeutic and pharmacological treatment options to help your patients manage their back pain.2–4

Guideline recommendations for treating back pain

Graphic summarising treatment pathway for back pain

Guidance on managing back pain recommends multimodal intervention

Recommendations from the National Institute for Health and Care Excellence and the American College of Physicians are available, providing guidance on the pharmacological and non-pharmacological management of lower back pain.2–4

This advice covers several modes of intervention:

  • Exercise
  • Pharmacological treatments
  • Manual therapy
  • Physical and/or psychological therapy
  • Exercise

    Resting for long periods can make back pain worse.1

    Certain forms of exercise can relieve pain and improve function as part of a multidisciplinary rehabilitation approach.3

    Walking, swimming, yoga and Pilates are activities that may be particularly helpful for back pain.1

    Specific exercises and stretches are also available for relieving back pain.1

  • Pharmacological treatments

    Guidelines recommend that oral non-steroidal anti-inflammatory drugs (NSAIDs) are considered for managing lower back pain.4

    Weak opioids with or without paracetamol may be considered for acute lower back pain but only if NSAIDs are contraindicated, not tolerated or ineffective.4

  • Manual / physical therapy

    Manual therapies, which involve massage and manipulating the spine, can be considered as part of a treatment package that also includes exercise.1,2,4

    Manual therapy can be provided by physiotherapists, chiropractors or osteopaths.

  • Heat

    Several guideline bodies recommend application of low-level superficial heat for back pain relief.1,3,5,6

    Indeed, superficial heat is the only non-pharmacological treatment for lower back pain that has good evidence to support its efficacy.5,6

  • Psychological therapy

    Psychological interventions such as cognitive behavioural therapy can be helpful for coping with pain, as part of a treatment approach that also includes manual therapy and exercise.1,4

How can Laura and Riya be helped?

Woman with child


Laura has recently hurt her back and cannot do as much with her family as she used to. She is having difficulty bending, twisting and reaching.

Laura needs a solution that offers rapid relief from her strong pain.

Voltaren Rapid 25 contains diclofenac, an active ingredient that not only gives pain relief but treats a root cause: inflammation.7

Find out more



Riya has been experiencing aches and twinges in her back. She is on medications for a couple of chronic conditions and is reluctant to take any more tablets.

Riya needs a non-medicated solution that offers effective pain relief and fast recovery from back pain.

Riya can consider continuous low-level heat, relieving pain so she can get back on with her life.

Understanding back pain

Magnifying glass icon


Find out about the causes of back and neck pain.

Find out more

Signs and symptoms icon

Signs and symptoms

Find out how to recognise back pain and when to refer patients.

Find out more

Sprains and strains icon

Overview of sprains and strains

Learn more about sprains and strains, and meet two patients with these conditions.

Find out more

Learn more

Voltaren Rapid 25

Voltaren Rapid 25

Unlike non-NSAID pain killers that treat pain only, diclofenac, the active ingredient in Voltaren Rapid 25 has a dual action – it treats pain and reduces inflammation to help manage strong pain, such as back pain.7,12

Learn more

Voltaren Emulgel with No Mess Applicator

Voltaren Emulgel with No Mess Applicator for strains and sprains8

Relieves muscle pain and reduces inflammation. 9-11

The No Mess Applicator enables targeted, effective pain relief straight from the tube to the point of pain, without messy fingers.

Learn more

Educational resource

Educational resources

Access detailed clinical information about pain.

Find out more