Acupuncture and manual therapy should be available on the NHS for people with back pain, says the National Institute for Health and Clinical Excellence (NICE).
But despite new guidelines, the health watchdog reports that access to treatment for what is the second most common complaint after the cold varies across England and Wales.
Key recommendations include 12-week tailored exercise programmes, spinal manipulation, acupuncture and a combined programme of physical and psychological treatment.
NICE also suggests phasing out TENS electrical machines and therapeutic injections, while treatments such as X-rays, ultrasounds and MRI scans should only be used in particular cases. Surgical intervention and psychological therapy should not be used on their own.
Guidance focuses on nonspecific lower back pain, defined as lasting from six weeks to less than a year. Those with infections or fractures are not included in the guidelines.
Professor Martin Underwood, who chaired the committee overseeing the new guidance, said he was excited about the new advice.