Chronic back pain can be a debilitating problem that takes a toll on your body, and your emotions as well. In some instances, it can take over your entire life as it dictates every aspect of it.

Dr. Stephen Reed and Penny Kendall-Reed, co-authors of The Complete Doctor's Healthy Back Bible, joined Dr. Marla Shapiro in the Balance Television studio with some advice on how to manage chronic back pain.

Almost 90 per cent of people will experience an episode of acute back pain in their lives, Reed said, but only a small number of them will go on to experience chronic or persistent pain. Acute pain defines a period of pain that lasts up to six weeks. Persistent pain continues beyond that timeframe. After that things are considered more serious.

"Then we talk about recurrent pain, where people have good pain-free intervals and then will have another episode of acute pain," Reed said. "Chronic is when people get into the cycle of having the pain go on and on, it's pretty much always there, and it gets to the point where it dictates their lives."

The duration of pain is the main factor in determining whether back pain can be considered chronic, said Reed.

Living with that kind of continuous pain can be draining. Feeling emotionally beaten up as a result of the physical pain isn't uncommon, and the psychological factors have a toll on the physical as well.

Depression and/or anxiety are two main emotional side effects of back pain, Kendall-Reed said. People get nervous about bringing on the pain, and depressed about their inability to move around or engage in their favourite activities without pain.

It really is a vicious cycle, said Kendall-Reed. She said depression and anxiety are quite prevalent in cases of chronic back pain. "This is a result of a fluctuation in hormones, predominantly cortisol, one of the major stress hormones and serotonin, the happy hormone," she said. "Unfortunately when these hormones are out for a long period of time, it actually increases the inflammation and nerve stimulation to the injured area. So it actually augments the pain."

The pain will lead to decreased sleep, which will in turn stimulate the hormones that lead to inflammation. "They just keep feeding off of each other," Kendall-Reed said.

When the pain is bad, it's hard to know where to turn for advice. Back specialists, acupuncturists, orthopaedic surgeons -- there seem to be millions of people who claim to be experts in dealing with back pain. Rather than trying to decide what option is best for you, Reed said, incorporate a number of different approaches. Your family doctor should organize this, Reed warned, to avoid any harmful overlap of treatments.

So when should you start seeking treatment? Reed recommends getting tested after six weeks of acute back pain. After six weeks has passed with no improvement, it may be time to get a definitive diagnosis, with simple X-rays and blood tests.

Emotionally, it's hard to absorb that the physical pain will continue to be a part of your life, Kendall-Reed said. "People don't want to hear that they may have pain for the rest of their lives," she said. "It may not be as severe as but most often in chronic back pain you are going to live with some degree of pain for the rest of your life."

Once you've accepted that, it will be easier to look at your options; to see how you can best control that pain so it doesn't take over your life. "You need to learn how to manage it," Kendall-Reed said. Dealing with chronic back pain means understanding how to lessen the frequency and intensity of your pain. Learn how to sleep better, what exercises help and what supplements you can take.