Based on my experience-
1) find a reputable spine care dr and figure out if structural issue
2) physical therapy and maintenance
2.5) loose weight. It helps a lot. Eat less, drink less.
3) get out and move within your limits. Walking, tai chi, swimming, stretching, all can help.
4) don’t sit for more than 30 minutes at a time without activity break for 5-10 min. Stretch, walk, move. Don’t eat.
if chronic, Gabapentin can help calm the nerves, releasing strain from muscle contraction.
surgery should be last resort for pain and only if your situation gives high chance of success. Then get a second or third opinion.