An Australian study has found anti-inflammatory painkillers like ibuprofen have little impact on back pain, but patients are still advised to take the drugs.
The study was based on 35 trials, involving 6000 back pain sufferers from around the world. Researchers used common anti-inflammatory brands including Nurofen, Ibuprofen and Voltaren.
They found anti-inflammatory drugs offered some pain relief, but the effect was limited compared to sugar pill placebos.
Meanwhile, those taking anti-inflammatory painkillers for a week were two-and-a-half times more likely to develop gastrointestinal problems.
Sydney Medical School's musculoskeletal division senior research fellow, Associate Professor Manuela Ferreira, who was behind the study, said back pain had no "quick fix".
Medication might offer limited relief, but would not solve the problem, she said.
Back pain affected 80 percent of the population at least one day of their life and 25 percent of the population on any given day. It affected children too, Dr Ferreira said.
"It's the main reason for involuntary retirement ... it is a very large economic problem."
Theories about the prevalence of back pain included that people sat or stood for too long and did not exercise or move enough.
"Our bodies were made to move. We haven't really been moving as much over time," Dr Ferreira said.
Australia spent about $5 billion a year on healthcare for back pain, she said.
In the first few days, when pain was most acute, in about 90 percent of cases the cause was benign - meaning there was no serious condition behind the pain.
Keeping active, such as a light walk, could help. Bed rest could delay the recovery.
"We know bed rest, it doesn't help you, but it actually aggravates the problem," she said.
Thai Chi could reduce pain and improve function for those with chronic back pain, by building core strength, she said.
There was little research about the benefits of pilates and yoga, but moving the back could help.
"Get moving, that's my advice," she said.
Dr Ferreira cautioned those who regularly took anti-inflammatory painkillers to consult their doctor before stopping.