The treatment will often depend on the cause of the back pain. Contrary to the conventional wisdom, bed rest beyond a day or two is not usually recommended and can actually do more harm than good. Low-impact exercise and specialized stretches are commonly recommended and physical therapy can also help. Most back pain improves within a few weeks with over-the-counter pain relievers and self-care. If it does not, other medications or therapies may be needed.

Medications for back pain include the over the counter non-steroidal anti-inflammatory drugs (NSAIDs) which can help reduce inflammation that occurs with most types of back pain. If these are not enough, a doctor may prescribe muscle relaxants or narcotic pain relievers such as hydrocodone. Certain anti-depressants such as amitriptyline have also been shown to help the physical symptoms of lasting back pain.

If the pain is chronic and the inflammation is not going away, injections of corticosteroids, naturally produced hormones which reduce inflammation, may be placed directly into the space surrounding the spinal cord. Sometimes, injections of numbing medications can be placed directly into an affected structure (such as a muscle in spasm).

Surgery is a treatment of last resort for back pain. It is rarely performed and is not always successful. It does not help pain caused by soft tissue damage (muscles and ligaments) and is usually reserved for herniated discs or bone abnormalities. Surgeries for back pain include removal or replacement of all or part of a disc or vertebra and fusion of adjacent vertebrae to limit motion.