Randy Shelerud, M.D., Mayo Clinic specialist in physical medicine and rehabilitation

Treatment for chronic low back pain is frequently multifaceted simply because there are several issues that are often on the table simultaneously to address. We have a decline in fitness. We have pain that we need to address. We have decreased flexibility, often in the soft tissues, and muscle spasms, for example. So, to use a single modality such as a treatment for muscle spasms certainly won't address the decline in fitness. The other reason is that many types of treatments are enhancing each other if they are done in combination. For instance, if you have a deficiency in soft tissue flexibility, if you simply heat those soft tissues, prior to launching into a stretching program, you will find that the soft tissues will actually stretch further after being heated and that stretch will be sustained better after the treatment is over than if those tissues were not heated beforehand.

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