The cause of low back pain especially in young adults leading into old age is commonly degeneration of the discs in the low back. Although pain can occur on and off over a lifetime the pain is usually manageable without having surgery.  For most people that suffer from chronic back pain the goals are usually
• Achieving enough pain relief to be able to engage in exercise and rehabilitation
• To prevent excess stress on the disc through proper ergonomics and exercise
• Trying to manage the pain and function at home and work
Inter-vertebral discs are located in-between the bones of the spine. They act as shock absorbers or cushions and prevent contact and friction between the vertebrae.

Normal Disc
Each disc is made up of two parts. The external ring called the annulus fibrosis, a tough substance that forms the outer two-thirds of the disc and the nucleus pulposis, a fluid like centre.

The central nucleus is pushed the opposite way to which the spine bends during movement, like the way a waterbed displaces to the other side when a person lays on it. Altogether discs make up approximately one quarter of the height of your spinal column. They are at their best condition at birth. Discs are slightly larger in the morning after sleeping because they have absorbed fluid whilst you have been lying down. As the day progresses gravity compresses the disc causing it to become slightly thinner. You are approximately 2cm taller in the morning.

Disc Degeneration
Over time everyday wear and tear causes degeneration, or narrowing of the disc. This is further compounded with injury. Probably the earliest changes that occur in the disk are tears in the annulus portion of the intervertebral disk. These tears in the annulus heal the same way tears in other ligaments do: by scar formation. Scar tissue is not as strong as normal tissue. The repeated cycle of many annular tears healing by scar tissue leads to a disk that finally begins to degenerate. As the degeneration of the disc progresses the nucleus pulposus loses some of its water content. It becomes stiff and loses the ability to act as a shock absorber. This process may continue until the disc is collapsed. Bone spurs may form as the body’s response to this degeneration. Eventually bone spurs form around the nerves of the spine as well.

Low back pain treatments
Pain from degenerative disc disease is caused by a combination of instability at the motion segment and inflammation from the degenerated discs. Both the instability and the inflammation have to be addressed for the treatment to be effective.
The treatments for degenerative disc disease are either passive (done to the patient) or active (done by the patient). Usually a combination of treatments is used to help control the symptoms. Passive treatments are rarely effective on their own—some active component, such as exercise, is almost always required.

Passive treatments for low back pain from degenerative disc disease may include:
Pain medication. Typical pain medications used to treat the low back pain include acetaminophen, NSAIDs, oral steroids, narcotic drugs, and muscle relaxants. Each type of medication has strengths, limitations, and risks, and the patient’s particular low back problem and overall health will determine which pain reliever, if any, is indicated.
Osteopathic manipulation. Manual manipulation by a osteoapth or other qualified health professional is thought to help relieve low back pain by taking pressure off sensitive neurological tissue, increasing range of motion, restoring blood flow, reducing muscle tension, and creating a series of chemical reactions in the body (such as endorphin release) that act as natural painkillers.
Massage. Therapeutic low back massage is thought to provide low back pain relief by improving blood flow, reducing muscle stiffness, increasing range of motion, and raising endorphin levels in the body. International research now indicates that massage is helpful for both acute and chronic back pain.
In addition, heat and/or ice therapy, acupuncture, behavioral therapy, and other therapies often provide enough low back pain relief to allow the patient to progress with his or her exercise and rehabilitation program.

Active treatments for low back pain may include:
Exercise. For the vast majority of patients, the only way to achieve long-term healing is active exercise, which usually includes a combination of strengthening, stretching, and low-impact aerobic exercise.
Quitting smoking. For patients who smoke, doctors recommend quitting smoking to improve blood circulation and healing. Chronic tobacco use is closely linked to chronic low back pain.
Weight loss can reduce low back pain in overweight people by lessening the amount of stress on the low back’s muscles and ligaments.
Ergonomics. Proper lifting techniques, ergonomic furniture, supportive footwear, and avoiding static posture for prolonged periods of time can help take pressure off the low back.