Anyone who has suffered from back pain knows that it can be challenging to treat and manage symptoms. Physical limitations on movement and function can lead to psychological distress, feelings of helplessness, depression, anxiety, and other mental symptoms that often worsen pain.

The sheer number of possible surgical and nonsurgical interventions can be overwhelming for a patient to consider. And numerous unproven treatments touted on the Internet and at various clinics can add to the confusion.

In addition, it’s not unusual for patients who consult multiple physicians to get conflicting recommendations, adding to the challenge of finding the right intervention.

Patients often turn to medication for relief. For some of them, acetaminophen or Tylenol can be a safe and effective way to relieve pain.

Unfortunately, many patients are prescribed much stronger medications such as opioids, which have serious side effects and high risk of dependence and addiction.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin, Advil, and Aleve are commonly used to treat various forms of back pain, including sciatica.

But a recent review from the nonprofit research organization Cochrane concluded that NSAIDs offered relatively little benefit over placebo for treating sciatica.

NSAIDs do reduce inflammation, however, and can help some patients deal with other forms of back pain.

Experts have attempted to separate fact from fiction regarding back pain treatments by assessing scientific evidence and clinical practice guidelines.

For example, the American Pain Society published clinical practice guidelines that concluded very few nonsurgical interventions for low back pain were effective in randomized placebo-controlled studies.

But for sciatica, the researchers did find good evidence that chemonucleolysis (injection of a chemical to dissolve the inner part of the discs that cushion vertebrae) was better than placebo injections — though not as effective as surgery.

Moreover, epidural steroid injections were shown to be moderately effective for short-term pain relief.

Another analysis — again using a Cochrane database — focused on the impact of physical activity and exercise on chronic pain.

Unfortunately, the quality of evidence was relatively low. Yet despite this limitation, researchers confirmed that physical activity and exercise did help reduce pain severity and improve physical function.

Because physical activity and exercise have few negative effects and can improve physical functioning, it is often recommended.

Other research shows that getting regular physical exercise improves symptoms of depression and lowers the rate of age-related cognitive decline.

The American College of Physicians published clinical practice guidelines for low back pain in 2017. The group concluded that several nondrug therapies provide small-to-moderate benefits that are generally short term.

They further concluded that yoga, tai chi, and mindfulness-based stress reduction methods were helpful for chronic low back pain.

Evidence also supported the effectiveness of exercise, psychological therapies, spinal manipulation, massage, and acupuncture.

Other studies have shown the benefits of yoga for chronic low back pain. Pilates — a system of exercises using special equipment designed to improve physical strength, flexibility, and posture — was also beneficial.