Ah you've asked the question many scientists and researchers have spent years looking for an answer to. Chronic back pain is a common problem. A gold-standard treatment approach hasn't been discovered.

Treatments tested and compared have included spinal manipulation, advice to "stay active," and strengthening exercises. The McKenzie Method is another popular treatment approach to low back pain. It's based on knowing and avoiding movements that make it hurt.

A recent review of the McKenzie method showed only a small difference between this and other methods already mentioned. Analysis of the data suggested the difference was not enough to declare the McKenzie method as the best approach.

Activity and exercise are still the number one top-ranked methods for managing chronic back pain. Until we have a way to diagnose low back pain accurately and match the treatment to the problem, many patients are going to have to go with the trial and error method. The key to managing painful back symptoms is to find what works and apply it consistently over time. That's where activity and exercise seem to have the best overall results.