Only about half of americans with chronic back pain were assigned to exercise, the series reported.
"In many countries, the positive effect of pain relievers on lower back pain is limited, but there is little emphasis on evidence-based interventions such as exercise," said study co-author Nadine foster.
She is professor of primary care musculoskeletal health at keele university in the UK.
A study last year reported that back pain was the leading cause of disability in almost all high-income countries, as well as in central and eastern Europe, north Africa and the Middle East, and parts of Latin America.
Worldwide, disability caused by chronic back pain has increased by more than 50% since 1990, a trend that is expected to continue as the number of older people increases.
Low back pain mainly affects working-age adults, and few specific causes are known.
Although most cases are transient, about one-third of patients have recurrent bouts of low back pain within a year. This is increasingly seen as a long-term condition, researchers say.
They say patients and health care professionals need to be educated about the causes and effects of lower back pain and the effectiveness of different treatments.