About six months ago, I started having low back pain. No one knows what caused it. I saw a physiotherapist and that was helpful. But I still have back pain. I went to see a different therapist this time. I thought he might do what the first therapist did to help me. This time the program is very different. Should I go back to my original therapist?

It's always helpful to see a health care professional who understands your medical and treatment history. When you return for follow-up, that individual may be able to save time and see the big picture of what happened to you and what has been tried.

But sometimes seeing a different person offers new insight or ideas. There's nothing wrong with that! And, it's possible your new treatment program is based on your condition and not the person prescribing it.

For example, doctors and therapists know from research studies that acute episodes of low back pain are best treated by reassurance, activity, short term pain relievers, and antiinflammatory drugs.

When pain persists longer than expected and if it lasts more than three months, it's labelled chronic pain. Chronic low back pain is more likely to be treated with exercise therapy, behavioral treatment, and a multidisciplinary management approach.

With this kind of care, you're more likely to have a medical doctor, physiotherapist, social worker, psychologist, and nurse on your team. You may or may not get further improvement in your painful symptoms. But with proper management, you'll be able to do more within the confines of your pain. The goal is to increase function even if you still have back pain.

Don't hesitate to ask your therapist about your treatment and what is the long-range plan. Let him know what worked the first time in case it might be helpful information this time. And don't be surprised if those treatments aren't advised for a chronic condition.

Joel J. Gagnier, ND, MSc, PhD(cand), et al. Herbal Medicine for Low Back Pain. In Spine. January 1, 2007. Vol. 32. No. 1. Pp. 82-92