Georgia Richardson has been fighting back pain for a long time. Arthritis, fibromyalgia, and the effects from a fall down the stairs have created such a painful condition for her that she hasn't been able to continue to work as a teacher in the Philadelphia school system.

Fifteen years ago, her pain specialist suggested she try aquatic therapy because medical treatment couldn't bring her relief. The exercises got her moving, but the day after a session, the extra activity just added to her pain.

But as a patient of the Center for Integrative Medicine at Thomas Jefferson University Hospital, she now is receiving two hourly sessions of massage therapy each week, right along with her medications and herbal therapy. The strategy, she says, has allowed her to return to the pool three times a week to continue her aquatics in the longest sessions she's ever had.

"I feel great. I know, definitely, massage has been great for me," says the energized patient -- who first says she is "39 and holding," then later adds that she'll be 60 this August. All told, her routine has cut her pain in half, Richardson says.

For those who want to go the alternative route to treat their back pain, massage may be the best bet. A new study demonstrates that it is superior to both acupuncture and self-care for this frustrating and debilitating condition. Experts agree that often the best way to manage chronic back pain is to use several therapies at once, and therapeutic massage may be an important part of the package.

"This provides some scientific evidence that massage may be useful for people with chronic back pain," investigator Daniel C. Cherkin, PhD, tells WebMD. "Therefore, it's certainly something that one with chronic back pain should consider trying."

Back pain is one of the most common health problems facing Americans and is frequently the cause for visits to a physician, says Cherkin, acting director of the Group Health Center for Health Studies in Seattle. According to the National Institutes of Health, 70-85% of people experience back pain at some time in their lives, and it is the most frequent cause of limited activity in people under the age of 45.

Back pain comes in all shapes and sizes and can affect anyone, but Anne Kanter, 56, of McLean, Va., is a fairly typical sufferer.

"I have an arthritic hip, and I compensate for it, then I pull muscles in my lower back," she tells WebMD. "I probably had my first real attack five or six years ago. I would get muscle spasms that involved spending a couple of days in bed and taking [medication]."

Kanter's back-pain triggers include standing for long periods of time (especially in high heels), gardening, and shoveling snow.

"Millions of people use massage therapeutically, and there's not a lot of hard evidence that it works," Michael Hirt, MD, tells WebMD. "This is one of the few well-conducted studies that shows there's some significant benefit, and the benefit might be higher than for some other alternative therapies that we consider to be effective for pain, like acupuncture. ... Three out of four people who had massage therapy in this study showed benefit, and that's legions above the kind of benefits we see with physical therapy or medications."

Hirt is medical director of the Center for Integrative Medicine at the Encino-Tarzana Regional Medical Center in Los Angeles.

In his study, Cherkin randomly divided 262 people with persistent back pain into one of three groups. All the people were between 20 and 70 years old.

The first group was given acupuncture, the second self-care materials, and the third therapeutic massage. None of the patients had the kind of back pain associated with a serious disease, like a tumor, infection, or disk problem, and many were also taking medication for their back pain but were not satisfied with the pain control it offered.