Do you wake with a horrific backache each morning? Or wince with pain when you stand up after a long day at your desk?

Back pain is more likely with age, a sedentary lifestyle, poor nutrition, obesity and stress. “Adjusting your lifestyle is one of the best ways to manage chronic back pain,” say

Standard chronic low back pain treatments include medications, physical therapy and steroid injections. “Injections may not be as effective or long-lasting for chronic pain and do carry some risk,” notes Dr. Welches.

Long-term use of NSAIDs (non-steroidal anti-inflammatory drugs) can damage your kidneys and liver and cause GI bleeding or leaky gut. Acetaminophen can damage the liver and slow liver detoxification. Opioids may lead to anxiety, endocrine problems, dependency and addiction. Muscle relaxers are often sedating. So what options are left?

Dr. Welches recommends making several lifestyle changes to help ease your back pain.

Use food as medicine

“Inflammation is the root cause of many types of chronic pain, “Eating lots of sugars, refined carbs like flour and processed foods increases inflammation and pain.”

Step away from the standard American diet that’s high in calories and low in micronutrients. Embrace a diet rich in vitamins, minerals and phytonutrients instead. Here are some recommendations:

• Eat your colors. Different colors indicate a variety of nutrients. “Make vegetables the primary part of your meals. The FDA recommends eight to nine portions a day,” he says.
• Get moderate amounts of protein. Avoid red meat and substitute fish and skinless chicken. “Even better, consider eating more plant-based proteins, such as soy,” 
• Simple carbohydrates like sugar and flour are especially troublesome. Avoid cakes, pies, candies and other carbs such as pasta and breads.
• Cut back on dairy products such as eggs, cheese and milk-based products.
• Eat healthy fats. Wild salmon and other small wild fish, olive oil, nuts, seeds and avocado all contain healthy fat.

Manage the stress in your life

Pain triggers the release of stress hormones that make muscles tighten up. “Muscle tension reduces blood flow to tissues, bringing them less oxygen and fewer nutrients. When this happens, you feel pain,” e.

You can’t avoid stress, but you can learn to manage it. Cognitive behavioral therapy and meditation are excellent tools, he says. Skilled therapists can change the way you perceive stress. Meditation can reduce anxiety, provide a calm sense of focus and reduce pain.

Don’t shortchange your sleep

“Sleep is very, very important — it helps your body heal,” . “Lack of sleep releases more stress hormones, lowers pain tolerance and worsens existing pain.”

Sleep loss can complicate other health issues, making it harder to control glucose levels when you have diabetes, for example.

So practice good sleep hygiene. Avoid blue light from smart phones or TV for one hour before bedtime. “Go to bed at about the same time every evening and get up at about the same time every morning to keep your internal clock regular,” says Dr. Welches.

Meditation is also a great tool for a better night’s sleep. Many meditation apps are available. starting with five to 10 minutes of meditation before bedtime. If you wish, you can gradually increase to 20 or 30 minutes a night.

Supplements such as melatonin can also help you sleep at night.

Make physical activity a habit

“Physical activity is essential to good healt, but also a way to reduce pain,”  Exercise— even when you’re in pain — is critical to recovery. Start out with an activity you like, and see yourself gradually progress from a less active to a more active lifestyle.

If you can’t move very easily, try chair yoga, walking, biking or swimming. “Even a small increase in daily activity can bring major improvements in overall health,” he says.

Try acupuncture for relief

Acupuncture can help you resume the activity that back pain has limited. Used for thousands of years in China for everything from pain relief to stroke rehabilitation, acupuncture is now used in the United States and other Western counties for a variety of chronic pain.

The outpatient procedure is suitable for most people. “Tell your acupuncturist if you are on blood thinners, or have a spinal cord stimulator or pacemaker,”  “The acupuncturist will adjust your treatment plan.”