Most cases of acute back or neck pain are treatable—that is, the cause of the pain is identified and a treatment plan is developed. The patient's pain usually is reduced or goes away completely. Chronic pain, on the other hand, often has to be managed over time. This is because the cause of chronic pain may be difficult to determine. The treatment plan may require multiple and/or combined therapies. The complexity of chronic pain may mean it takes a patient longer to find relief. Pain management specialists have many different therapies from which to create a chronic pain treatment plan. Such as:

Activity Modification
This may be included first in the patient's suggested treatment course. The idea is to restrict activities that irritate the patient's existing disorder.

Medications
Some drugs not only relieve pain but also reduce inflammation and help relax muscle spasm. Many can be found at the local drugstore or pharmacy and include:

• Acetaminophen (Tylenol* and other brands)
• Non-steroidal anti-inflammatory drugs (NSAIDs) and include aspirin, ibuprofen, Naproxen®, and other medicines
• COX-2 Inhibitors (available by prescription only, such as Celebrex®)
• Muscle relaxants (Flexeril® and others, available by prescription only)
• Anti-Depressants (Cymbalta®, Wellbutrin®, Zoloft®; by prescription only)
• Anti-seizure medications (Neurontin®, Tegretol®, Topamax®; by prescription only)

Physical Therapy
Physical therapy combines passive modalities and therapeutic exercise. Examples of passive modalities (treatments given to the patient) include:

• Heat/cold therapy
• Massage (deep tissue, Swedish, neuromuscular, other)
• Traction
• Transcutaneous electrical nerve stimulation (TENS)

Other Non-surgical Treatments
Chiropractic medicine is based on the understanding that malalignment of the spine's vertebral bodies can cause illness and back pain. Treatment by a doctor of chiropractic (DC) may include x-rays. Chiropractic care is drug-free and treatment techniques involve hands-on manipulation of the body and can help ease myofascial pain.

Complementary and Alternative Medicine (CAM) encompasses many types of holistic treatment including acupuncture, acupressure, Swedish and deep tissue massage (and others), biofeedback, and herbal medicine.