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Most cases of back and neck pain resolve alone and very few people with back
pain need surgery. There are a wide variety of non-surgical treatments that
are usually successful in treating back and neck pain. Some of the most common
non-surgical treatment options are physical therapy/exercise, medication, spinal
injections, chiropractic, and alternative medicine.
#1. Physical Therapy/Exercise
Physical therapy combines passive modalities with therapeutic
exercise to rehabilitate the spine and other parts of the body. Examples of
passive modalities that physical therapists administer to patients include:
Heat/Cold Therapy: Helps to reduce inflammation, muscle spasm,
and pain.
Ultrasound: The therapist uses a smooth rounded device that
is applied to the skin in a circular movement to transmit sound waves into underlying
tissues. The sound waves create a deep heat that promotes circulation while
helping to relieve inflammation, muscle spasm, and pain.
Spinal Traction: Gentle force is applied to stretch and mobilize
the spine to alleviate back pain and spasm.
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Transcutaneous Electrical Nerve Stimulation (TENS): A small
controllable device delivers a painless electrical current through skin patched
to specific nerves. TENS can be used to relieve pain and improve mobility.
Massage: Trained therapists use their hands, fingers, thumbs,
and sometimes their elbows or specialized tools to rhythmically knead, rub,
and stroke muscles. Various types of massage help to increase circulation and
relieve muscle tension, spasms, inflammation, fluid retention, aches, stiffness,
and pain.
Aquatic Therapy: Water therapy includes Whirlpools, water
spas, Roman tubs, common bathtubs, and swimming pools. Water temperature and
movement is varied to help soothe and relax muscles. Examples of therapeutic
exercise physical therapists teach patients include:
- Stretching exercises to increase flexibility.
- Strengthening exercises to improve the spine's ability to absorb stress and
strain.
- Postural modification to rehabilitate the spine and prevent re-injury.
#2. Medication
Today, patients have a wide variety of medications to choose from to treat their
back pain. Some medication is available over-the-counter (OTC) and other types
must be prescribed. In general, medications to relieve back and neck pain include:
NSAIDs (Non-Steroidal Anti-Inflammatory drugs) help to decrease
inflammation and promote healing.
COX-2 Inhibitors (a type of NSAID) may allow patients to
take higher doses without the accompanying gastrointestinal side effects from
conventional NSAIDs.
Acetaminophen, an analgesic used exclusively for acute pain.
It can be used alone or in combination with NSAIDs.
Muscle relaxants are often prescribed for severe pain. However,
some experts believe that NSAIDs are just as effective.
Opioids are carefully prescribed for back pain due to their
addictive nature. These drugs are not a first line of treatment, but may be
used in select situations.
Keep in mind that many of these medications, even those available without a
prescription, can have serious side effects. Talk to your physician before
taking any medications for back pain.
#3. Spinal Injections
Spinal injections serve two purposes - (1) to relieve pain and (2) as important
diagnostic tools doctors use to help determine the cause of the pain. Two common
spinal injections are:
Facet Joint Injections help to reduce inflammation and pain
originating from one or more facet joints. These joints are located at the
back of the spine and are important to movement.
Epidural Steroid Injections deliver pain relieving
medications into the epidural spaces. The medicine flows through the space,
coating the nerve roots and the outside lining of the facet joints.
Spinal injections should not be used as the only remedy to relieve pain. Rather,
spinal injections should be part of a treatment plan that includes other therapies
such as physical therapy and therapeutic exercise. Talk to your doctor to see
if spinal injections might be right for you.
#4. Chiropractic
Chiropractic is a branch of medicine based on the understanding that good health
depends, in part, on a healthy spine. Chiropractors also believe one of the
main causes of pain and disease is the misalignment of the vertebrae in the
spinal column. To address this problem, chiropractors use some of the following
techniques to relieve pressure on the spinal nerves, restore joint mobility,
and help return the body to health:
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- Manual detection (palpation)
- Carefully applied pressure, massage, and manual manipulation of the
vertebrae and joints (adjustments)
- Manipulation under anesthesia
- Exercise programs and instruction
- Lifestyle and nutrition counseling
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#5. Alternative Medicine
Alternative medicine encompasses a wide variety of treatment options, many of
which originated centuries ago. A few of the most common alternative medicine
treatments used for back pain include:
Acupuncture: Thin, pre-sterilized, disposable needles are
placed in selected parts of the body to increase blood flow and Qi (the life
force that runs through the body). Some patients report that acupuncture has
provided relief from back pain and helps to promote healing.
Herbal medicine: Certain herbs have healing properties.
Individual herbs may be combined to create a formula with a specific function
(such as pain relief).
Biofeedback techniques: The practitioner teaches the patient
mental and physical exercises that are monitored by sensors applied to specific
points on the body. Each sensor is connected to a machine designed to monitor
physiological responses.
There are many other types of alternative therapies. If you decide to try one
of these, be sure that it is administered by a reputable practitioner. Also,
be sure to talk to your physician about any of these therapies before you begin,
to make sure they will not interfere with your other treatments.
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