Non-Operative Treatment/Work Up

Non-Operative Treatment/Work Up

Treatments for back pain are multiple and varied. At times, counseling and education about the problem to ease a person’s anxiety is enough to make it tolerable until the episode resolves. A few days of rest can often calm the pain down as well. Prolonged bed rest (more than 2 to 3 days) is no longer generally recommended. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDS) or acetaminophen (Tylenol) can be helpful. Occasionally stronger medications, such as muscle relaxants and narcotics, are used for a short period.

Although there is minimal scientific evidence of their effectiveness in treating low back pain, back braces are commonly used. Most common is a corset type brace that can be wrapped around the back and abdomen. People who use them sometimes report feeling better supported and more comfortable. Although there is little definite proof that they help, there is also little risk to using them.

A number of treatments called passive modalities are also used frequently. These are treatments in which the patient isn’t required to actively do anything. Passive modalities include heat, cold, massage, ultrasound, electrical stimulation, traction and acupuncture. All of these measures can help some people with back pain. How long the benefit will be or what the chances are of receiving benefit from any of these treatments isn’t completely known.

Another form of passive treatment is spinal manipulation. There are many different practitioners of spinal manipulation, each with their own style of manipulation, which may improve symptoms of back pain.

Injections are sometimes used as well. The most commonly used medications are local anesthetic and/or steroids. They are usually given either in the area that is felt to possibly be the source of the pain, such as into a muscle or facet joint, or around the nerves of the spine (an epidural or nerve root injection). Injections are occasionally placed into the disc, but this is done far less frequently.

What is generally felt to be most appropriate and effective for patients with back pain is a good course of exercise and stretching. Restoring motion and strength to a painful lumbar spine can be very helpful at improving pain. Although there is controversy as to what the best spine exercises are, it is generally agreed that exercise should be both aerobic (aimed at improving heart and lung function) as well as specific to the spine. Aerobic exercises include activities such as walking, jogging, swimming and bicycling.

Instruction in lifting techniques can be helpful as well. Improperly bending over to lift objects can cause an increase in strain on the low back. Proper lifting techniques keep the back straight while bending the knees.