Back pain is one of the most common, and frustrating, complaints patients report to primary-care physicians. In some cases, pain begins in the lower back and eventually creeps up the spine and into the neck. Other people experience pain in only one part of the back or neck. Although injury is sometimes to blame, many develop back pain, often in their 30s, with no obvious cause. And the most difficult part isn’t even the pain; it’s determining which practitioner can help.

“Back and neck pain are complex and can happen for many reasons,” says Dr. Rahul Rastogi, a pain management specialist with Washington University Physicians. “Preventing these problems early is important.” Rastogi advises gentle stretching and strengthening for the entire body. “Just keep the muscles and ligaments toned with simple exercises,” he says. People who already have had episodes of back or neck pain may need to work with a physical therapist to develop a personalized plan, he adds.

Yoga is one type of stretching activity that may be helpful in preventing and treating lower back pain. A study in the September issue of Spine reports that after six months, a greater proportion of back pain patients who’d done yoga “had less pain, less functional disability and less depression,” compared with those who did not include yoga in their treatment regimen.

Rastogi says that yoga, Pilates and other exercises that strengthen the core and gently stretch the muscles can “stabilize the body’s dynamics and at least slow down the cascade of problems that result in acute episodes of pain.” He also recommends managing stress, seeking the advice of an occupational therapist to modify surroundings as needed, and talking with your physician about other types of medical treatments to keep back and neck pain at bay.

Chiropractic medicine is another effective approach to easing back and neck pain. “Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available,” says Dr. Matthew Berman, a chiropractic physician with Berman Chiropractic and Wellness. “Many patients feel immediate relief following chiropractic treatment, but some may sometimes experience mild soreness or aching, just as they do after some forms of exercise.”

Chiropractic adjustments to the neck, known clinically as ‘cervical manipulation,’ are also effective pain management techniques, Berman says. “This works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasms, which helps relieve pressure and tension. Neck adjustment is a precise procedure that’s generally applied by hand to the joints of the neck. Patients typically notice a reduction in pain, soreness, stiffness and an improved ability to move the neck.”

Berman explains that the neck has a built-in shock absorber—its gentle curve, or ‘lordosis.’ “Imagine trying to balance a 10-pound ball on a stick,” he says. “The curve in the neck acts like a spring and absorbs the shock of your head. When your neck loses the curve, the ligaments supporting it become over-stretched and lose the ability to maintain the curve. This can occur from a car accident, poor posture or spinal misalignments. To  help correct the normal curve of your neck, we can provide stretches, chiropractic adjustments and cervical traction.”

Dr. Rajiv Yadava, an osteopathic physician specializing in neuromuscular/skeletal medicine, adds osteopathic manipulation, trigger injections and acupuncture to the list of effective treatments. Instead of searching for new methods of care, he believes that physicians should focus on optimal delivery of existing methods, striving to master both the “art and skill” involved.

Finding the ‘best’ practitioner, however, can be a challenge, since each person’s situation is different and may respond best to various treatments. Yadava suggests asking around for referrals. “Do as much homework as you can,” he urges.

The bottom line, he says, is that people do not have to endure unremitting back and neck pain. “If you have pain, don’t give up trying to find an effective treatment solution,” he says. “Seek help, even if it means you have to see more than one physician or type of practitioner.”