Recurrent low back pain is an equal opportunity ailment — women suffer from it as often as men. Common causes include muscle strain, disc degeneration and herniated disc, in which the jellylike core material in a spinal disc protrudes into the spinal canal. Surgery does not always alleviate back pain, and may even worsen the problem, so you should explore all nonsurgical options first. If your doctor has ruled out serious causes for your back pain, such as a spinal fracture, tumor or large disc herniation, the following steps may bring relief…

Get at the root cause. If you experience low back pain, ask, “Am I taking care of myself?” Emotions often are expressed physiologically. Perhaps you are the family caretaker and one evening, while clearing the table, your back begins to ache. What else is going on? Are you stressed from work? Arguing with your spouse? Such dynamics can play a role in low back pain. Tension and anxiety often result in prolonged muscle contraction and spasm… and fear can affect brain pathways involved in pain perception.

Practice mindfulness exercise. Exercise eases back problems in part by developing the core muscles that maintain back stability. Too often, though, exercise is performed while the person mentally tunes out — by watching TV or thinking about the day’s to-do list. Better: “Mindfulness exercise” means working out while fully focusing on your body — breath, muscle movement, physical and emotional sensations. This reduces tension and alters brain pathways that mediate pain — so you can intuitively work through emotions that may contribute to back pain.

Aim to exercise for at least 30 minutes four times a week. Good choices…

Pilates. This strengthens the core muscles in the abdomen, buttocks, and upper and lower back. Best: Learn the techniques from a certified Pilates instructor, who can make sure you perform the moves correctly.

Yoga. Various types of yoga are good for low back pain. To avoid straining muscles and ligaments, move slowly and never force a pose. Try the Child’s Pose: Kneel with knees a few inches apart and feet together. Sink back so your buttocks are resting on your heels… let your arms relax at your sides… rest your forehead on the floor. Hold for a minute or two, relaxing fully.

Walking. Initially, walk for 30 minutes at an easy pace, preferably outdoors so you can breathe fresh air. Steady, controlled breathing will ease muscle tension. As your muscles grow stronger, gradually pick up the pace.

Know when to get help. If symptoms don’t improve after one month, see a physical therapist or a chiropractor. He/she should assess your posture… determine why your core muscles are out of balance… and perform hands-on maneuvers to alleviate the problem.

Acupuncture also can help by balancing pain-relieving brain chemicals, such as endorphins, promoting muscle relaxation. Referrals: American Association of Acupuncture and Oriental Medicine, 866-455-7999, www.aaaomonline.org.

If your back pain persists, consult a neurologist, orthopedist or osteopathic physician. She may prescribe medication, such as a muscle relaxant, nonsteroidal anti-inflammatory drug (NSAID) or narcotic analgesic.