Lower back pain is the leading cause of disability in America. Fortunately, in around 90% of cases it's temporary and improves without surgery, according to the American Association of Neurological Surgeons.

But even if it’s transitory, about half the time there's another flare-up within a year.

Often, pain results from a strain or sprain to muscles or tendons in the back caused by sitting in a hunched position, being sedentary, a bad mattress, not exercising, being overweight or obese, or wrenching your back while lifting or moving.

Cigarette smoking and vaping are also major causes because they trigger rampant inflammation in your back.

Fortunately, if these are the causes you can do a lot to ease your discomfort. But if you don't take steps to improve your pain, it can become chronic.

The Back Pain Research Consortium recognizes four proven therapies, which they say work well but not for everyone. These are:

1. Enhanced self-care, stretching/yoga, heat, self-massage, and meditation

2. Evidence-based exercise and manual therapy, including therapist-managed exercise and physical therapy

3. Acceptance and commitment therapy aimed at changing your reaction to pain

4. Duloxetine, which is an antidepressant.

It's also smart to stop smoking or vaping, and eliminate inflammatory red meat, simple carbs, and added sugar from your diet.

We recommend starting with self-care. Then ask your doctor about physical and/or behavioral therapy and perhaps the antidepressant. If one technique isn't effective, try another.