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Pilates
Pilates is another great exercise for relieving back pain because it focuses on strengthening your core muscles, which include the back. Pilates exercises are very smooth and controlled movements, so there is little danger of getting injured while exercising. It’s also a great way work on your strength and flexibility, both of which help to alleviate back pain. However, as with yoga, you should avoid any extreme twisting or bending movements. Also as with yoga, Pilates exercises should be done on a mat or other soft, supportive surface. One of the best benefits of Pilates is that it helps improve posture, a common cause of lower back pain. Use common sense when doing Pilates; if exercises that arch your back hurt, don’t do those. Or if exercises that round your back hurt, do only the back arching ones.
The following Pilates exercises benefit the spine and are appropriate for beginners. Do each exercise slowly and smoothly, and repeat ten times if you can. The key to pilates is quality of exercise, not quantity; it is more important to do fewer exercises slowly and correctly than to do all ten repetitions quickly.

THE HUNDRED: Start by lying on your back with your legs either stretched out or bent at the knees, whichever is most comfortable. Raise your head and, if you can, your legs off the floor a few inches. If this puts too much stress on your lower back, just raise your head and keep your feet on the floor with your knees bent. Try to keep your neck relaxed. Now extend your arms, and raise and lower them about two inches. While doing this, inhale for a count of five and exhale for a count of five.

SPINE STRETCH FORWARD: Sit with legs extended in front of you and slightly more than hip width apart and feet flexed. Inhale and pretend that you are hovering over an imaginary beach ball by leaning your upper body forward, arms extended, while rounding your back and pulling in your abdomen. Exhale as you sit back up slowly one vertebra at a time.

The ROLLUP: Begin by lying on your back, legs extended, and arms stretched above your head with your shoulders on the floor. Alternately, you may want to do this exercise with your feet on the floor, knees bent. Inhale and lift your arms toward the ceiling. Exhale and roll your torso forward, as if you are doing a full body sit-up. You should ideally roll into a sitting position, but if you can’t, just bring your torso as far off the mat as you comfortably can before returning to your starting position.

The SAW: Sit with your legs slightly wider than hip width, feet flexed. Your arms should be extended straight out to the side. Sit up very straight as if you are trying to touch the ceiling with the top of your head. Exhale; turn your body to the left, keeping your arms in line with your shoulders, and bend over as if your hand is going to saw off your little toe. Inhale, return slowly to your original position, and repeat on the other side.

SPINE TWIST: Sit with your legs slightly more than hip width apart and your arms extended out to the sides. Inhale, tighten your abs, and sit up very straight as if you are trying to touch your head to the ceiling. Now exhale and turn to the right as far as you comfortably can. This exercise is to increase your back mobility only, so do not stretch your back muscles. Inhale and return to your starting position. Repeat on the left side.

BALLERINA ARMS: Sit with legs crossed and spine straight, as if you were sitting against an imaginary wall. Bend the elbows at a 90-degree angle and pull the arms back so that the shoulder blades are touching. Next take your arms down so that the shoulder blades slide down the spine. Next raise the arms over the head as a ballerina would. Return arms to starting position.

PHYSICAL TREATMENTS

Unless back pain is due to an infection, malformation of the back, or tumor, your pain can probably be alleviated by some type of physical treatment. All physical treatments are more effective when done in combination with other treatments. It is best if you can get a referral from your doctor for physical treatment, and many insurance companies require you to do so before they will pay for treatment. The effectiveness of the various physical treatments varies, and it’s really up to you as to which you are most comfortable with. The effectiveness of physical treatments is increased when they are combined with exercise.
Chiropractic Therapy

One of the most common physical treatments for back pain is chiropractic therapy, which is the manipulation of the spine. The purpose is to realign the spine, increase the range of motion in the muscles of the back, increase the flexibility of spinal soft tissue, break down scar tissue, and reduce pressure that occurs from restricted and misaligned spinal joints, all of which help to relieve pain. Chiropractic therapists, which include not only chiropractors, but also osteopaths and some physical therapists, diagnose and treat only problems with the muscles, nerves, and skeletal system and do not use drugs or surgery. Going to a chiropractor is much like going to a regular doctor: you will be asked for a case history involving your symptoms, have a physical exam, and possibly have x-rays taken.
Chiropractors undergo intense medical training. They must have two years of undergraduate work, and when they enter chiropractic college, they study the same topics doctors do, including anatomy, physiology, x-ray, psychology, and orthopedics. After getting the basics down, chiropractors then study diagnosis and adjustment techniques that most other doctors do not. Besides their coursework, chiropractors also have intern and externships, where they observe and assist licensed chiropractors. All in all, chiropractors spend about 900 hours studying and working in their field. After graduation, chiropractors must either take a test to be licensed in the state in which they want to practice or the National Board of Chiropractic Examination.
Osteopaths are medical doctors and can prescribe medications. They must have an undergraduate degree and take the Medical College Admissions Test before being admitted to osteopathic medical school. Like other doctors, osteopaths take four years of coursework and spend time observing in medical settings. They do internships and sometimes residencies, and must take exams in order to be licensed.
Studies have shown that chiropractic manipulation is effective in treating lower back pain. However, it has not been shown to be any more effective than any other method of treatment, but has been shown to be better than no treatment at all. Chiropractic treatment is most effective when applied within two months of the onset of lower back pain, but probably will not help people who have disc prolapsed, previous back surgery, or back pain due to disease. If you decide to consult a chiropractor, make sure you tell him about any serious back injuries you have had, and any sharp pain or lower back pain with leg pain or numbness. These could be the signs of serious conditions that could be worsened by spinal manipulations.
If you are interested in chiropractic treatment, meet with the chiropractor in person to get a feel for the kind of treatment he offers, and look for someone who diagnoses with a physical exam. While x-rays are occasionally taken, they should not be the only diagnostic tool used. Ask about what kind of manipulations the doctor or therapist generally does and look for someone who uses primarily slow, gentle motions rather than sharp and sudden jolts. Avoid anyone who wants to crack your neck, as this can be very dangerous.
When you go for treatment, you will lie on your side or stomach while the therapist does various manipulations. He may put one hand on your shoulder and one on your hip and gently twist your body, or he may put pressure on the spinal joints. When this is done, you may or may not hear a crack. Chiropractors may also use ultrasound, therapeutic massage, stretching, and muscle stimulation to help relieve back pain. You may have some soreness for a day or two after treatment.
Studies have shown that you should feel relief from pain in four to eight sessions. While some chiropractors may suggest a longer course of treatment, there is no evidence that it will be more effective. If you don’t feel better in four to eight sessions, chiropractic treatment probably won’t help you.
There are few risks involved with gentle manipulations, but there are some serious ones that can occur in certain situations. People with osteoarthritis should avoid twisting manipulations as this can cause bone spurs to damage the spinal cord and nerves. Although it is rare, there have been cases where forceful neck manipulations have resulted in neurological damage and death. It’s best to avoid spinal manipulations if you have osteoporosis or nerve damage. Check with your doctor if you’ve had spinal surgery, or back pain along with fever, chills, sweats, or unintentional weight loss. Chiropractic therapy won’t help you if you have back pain due to infection or tumor. And finally, rapid neck manipulations can lead to strokes. You can avoid risks by giving your therapist a thorough account of all injuries and illness you’ve had.
A good chiropractor is one who is willing to work with your other medial professionals. She should also give you self-care information and exercises to do at home. Avoid anyone who wants you to continue sessions to prevent future back pain; studies do not show this to be effective.