Back pain is one of the leading reasons for physician visits in the U.S. Recently, the American College of Physicians (ACP) released new guidelines for treating chronic back pain. The new guidelines emphasize the use of non-drug therapies, such as massage, heat therapy, or exercise, as the initial treatment method. If this treatment is inadequate, patients can consider nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants. Opioids should only be prescribed for treatment as a last-case scenario due to the high risks associated with opioid use. While the guidelines are useful, there is still more research that needs to be done to identify the mechanisms of chronic back pain. Our current research indicates that these mechanisms are very different among individuals. Therefore, future therapies should be based on the evaluation of such mechanisms in the spinal cord and brain. #FibroGator