Q: I'm starting to slip into a deep funk. A back injury years ago is acting up and causing pain everyday now. I'm not sleeping well. I can't exercise or golf like I used to. I've got to get this turned around. What can I do?

A: First, if you haven't already done so, make an appointment with your primary care physician. With any change in symptoms or new symptoms, it's a good idea to rule out a medical condition that requires medical treatment.

If your back pain is post-injury mechanical pain, then there are several other steps that can be taken. There are some very effective non-addictive pain relievers on the market. Your doctor may recommend one to help break the pain cycle. A non-steroidal antiinflammatory drug (NSAID) may be prescribed. NSAIDs offer pain relief and reduce inflammation at the same time.

Other noninvasive treatment approaches can be tried as well. Exercise and physical activity are very helpful for patients with chronic low back pain (CLBP). A physiotherapist can guide you through the right program for your situation.

A program of minfulness meditation may also benefit you. A clinical psychologist or social worker trained in Mindfulness-Based Stress Reduction (MBSR) can teach you some lifelong skills to help handle any stress, including the stress of CLBP.

MBSR may not take your pain away. But it can help you increase your activity level within the confines of your pain. Patients report improved sleep, decreased use of pain and sleep medication, and improved quality of life.

Natalia E. Morone, et al. Mindfulness Meditation for the Treatment of Chronic Low Back Pain in Older Adults: A Randomized Controlled Pilot Study. In Pain. February 2008. Vol. 134. No. 3. Pp. 310-319.