Nonsurgical pain relief
Return to activity | Diagnostics | Pain
relief | Time | Limiting
rest | Physical therapy | Exercise | Injection
therapy | Types of medication | Massage | Biofeedback | Acupuncture
structures to heal, good blood supply is essential for repair
and to remove waste products. The bones, ligaments and muscles
in the back have a good blood supply, so the back can heal reasonably
well. The problem is that they usually heal with a special type
of tissue called scar tissue, which is strong but not as flexible
as normal muscles, ligaments, etc. However, discs have a poor
blood supply and this often results in slower healing. Discs,
therefore may be more easily damaged if care is not taken to
prevent this. The most common type of injury to the back is to
the soft tissue – the muscles, tendons and ligaments. Most
of these soft tissue injuries heal well, and this is why most
people with back injuries recover.
Back pain is often an unseen injury to others.
As such, it is sometimes difficult to understand the problems
that a person with back injury has to live with daily. To help
yourself, it is important to keep as mobile as possible and learn
how to move your body to prevent strain on your back.
The primary goal of treatment is to get you back to your everyday activities.
During your initial visit, the physician will assess
your medical history and collect more specific information during the
exam. In order to better understand your back or neck problem, the
physician may gently move your joints and limbs. It is important to
answer all the physician’s questions honestly, because your answers
help determine a correct diagnosis.
- X-rays show bones and the space between
bones. Although X-rays are of limited value to muscle-related back
pain cases, your physician may conduct X-rays to detect possible
fractured vertebrae or narrowing of disc space.
- MRIs (Magnetic Resonance Imaging)
and CT scans provide images of soft tissues and nerves in the spine,
including discs and joints. This is valuable information to your
physician in determining the cause of your pain. These tests provide
a medical photograph of your body and are painless.
- Pain-relieving injections can relieve
back pain and provide important information about your problem.
- Myelograms can reveal the amount
of damage in the spine. They are used to determine if surgery is
necessary. If it is, myelograms provide a surgeon with key information
to ensure the success of surgery.
Click here for more information on diagnostics.
Doctors who focus mainly on pain symptoms often recommend the
exact opposite course of action that is optimal for recovery
from a back problem. For example, years ago, doctors treated
back pain with bed rest and heavy drugs in order to mask the
patient’s discomfort. Patients became sedentary and increasingly
dependent on drugs. It was later discovered that this treatment
was actually damaging to the back, because it weakened muscles
and caused more pain.
Pain is a signal from the body to the brain that something
is wrong. Either a certain motion placed too much strain on the back,
or the back is too weak or inflexible. Your specialist will help determine
the origin of your pain and the best treatment for it. Click here for more information.
Time is your most valuable asset. In cases where
pain is focused in the low back or when there are red flag symptoms, take the time to help yourself. Check out the home
remedy section of this Web site for ways to treat your
Studies have reported that rest and inactivity should
be limited to two days at most. After that time, patients should be
encouraged to start moving and exercising to strengthen the back muscles
and increase flexibility. And part of the rehabilitative process can
require a commitment on the part of the patient to work closely with
the therapist during those first few weeks to ensure a successful long-term
While drugs and manipulation may relieve initial pain,
neither of these alters the musculature of the back, which is essential
for long-term recovery. Only exercise can strengthen the back muscles
and make them more flexible and resistant to future strain.
Physical therapy increases flexibility and strengthens muscles
that support the spine.. Greater strength and flexibility will
help prevent future back strain. A therapist may use ultrasound,
electrical stimulation, heat or ice, mobilization and exercises
to reduce pain and the likelihood of future injury. Click here for more information.
Years ago, the prescription for pain was bed rest. However, we
know today that more than a few days of bed rest after an injury
can be counterproductive to rehabilitation.
Exercise and movement actually help tissues in
the back become stronger, more supportive of the back and resistant
to additional injury. Specific exercises can be used to target
particular types of back pain. Engaging in activity acts as a
lubricant to the back muscles and joints, and it is as necessary
to recovery as oil is to the hinge in a squeaky door.
It is important to work with a therapist to make sure
exercises are done properly. Never do any exercise that causes pain
to your back.Click
here to learn about specific back pain exercises.
For years, spine physicians have used cortisone injections, epidural
steroid injections, trigger point injections and nerve blocks to relieve
pain in the spine. They are often provided in a series of three or
four injections spanned over a couple weeks.
These injections are
intended as a means to an end. The goal is to provide enough
pain relief to bridge the patient from being inactive to being
able to attend physical therapy, where they can better treat
their back problems with special exercises.
There has been conflicting research about the value
of injection therapy. Some studies have questioned the benefit
of epidural steroid injections. In 1997, Britain's Royal College
of General Practitioners noted in its back care guidelines that
epidural steroid injections relieve low back pain with sciatica
(leg pain) better than some other treatments. The Royal College
is less supportive of facet joint injections and trigger point
injections. It sees little evidence that these injections improve
clinical outcomes. With that said, many spine specialty centers
believe in the benefit of injections and continue to use them.
To come to a definitive conclusion regarding its proven
benefit, injection therapy needs to undergo further testing. Some experts
theorize that there may be some placebo effect associated with the
relief that accompanies an injection. In any case, when a patient gains
relief from an injection, it reinforces a physician's desire to use
that treatment again.
Common types of injections for back pain relief include:
- Selective nerve root block (SNRB)
- Facet joint block
- Sacroiliac joint
For more information on the common types of injections for back and pain relief click here.
Medications can lessen swelling and reduce pain in the back and neck.
The type of medication your physician recommends depends on your
symptoms and your level of pain.
At home, pain can be relieved with Non-Steroidal Anti-Inflammatory
Drugs (NSAID), such as ibuprofen products like Motrin or Advil. Aspirin
may also be recommended to ease pain.
Not only is it relaxing, but massage has notable health benefits that
are an important part of back rehabilitation. Massages release toxins
in muscles, increasing circulation, releasing endorphins, reducing
inflammation, alleviating muscle cramps, breaking down scar tissue
and calming the nervous system.
Aside from the physical health benefits, massage has
a psychological impact by teaching the patient to feel relaxed. For
the chronic back pain sufferer, even the simple luxury of drifting
off to sleep may not be a reality. Massage can provide that feeling
For thousands of years, Eastern medicine has emphasized the importance of the
mind in controlling physical health. In the West, these ideas were touted as
mystical and scientifically unfounded. Recently, however, as more scientific
connections are being made between mind-body healing, Western science is starting
to appreciate and incorporate this type of therapy into pain rehabilitation.
Due to its objective means in tracking progress, biofeedback
is one of the more popular mind-body therapies in pain rehabilitation.
During biofeedback sessions, electrodes are attached to the body to
monitor body temperature, heart rate, muscle tension, skin resistance
Through biofeedback, the patient is taught to recognize
how stress and relaxation chemically alters the body's functions. The
patient can learn to lower heart rate and muscle tension. The biofeedback
equipment records statistics and gauges progress as the patient learns
to control the body, thus controlling pain.
After recognizing the
body’s signals during
biofeedback sessions, the patient is able to recognize them in
daily life and arrest the onset of muscle spasms or high blood
pressure. This can reduce pain and even eliminate it.
Traditional acupuncture is based on the ancient Chinese theory
that there are energy pathways that run throughout the body.
These pathways, called meridians, carry the body's vital energy,
or chi (pronounced "chee"). The principle behind
acupuncture is that disease and pain are a result of an imbalance
in the body's energy flow (chi). Through the insertion of thin
needles at specific points along meridians, the flow of energy
is controlled and rebalanced in the body.
Acupuncture dates back to the first century B.C. in China,
during the era of the Han dynasty (206 B.C. - 220 A.D.). Because Western
physicians in the United States have difficulty understanding the correlation
between acupuncture philosophies and traditional physiology, acupuncture
has not been readily accepted in the United States.
Modern scientists have attempted to explain how acupuncture
can relieve pain. Some observe that the traditional Chinese "meridians" overlap
with pathways of the central nervous system. By using needles, an acupuncturist
can stimulate the nervous system to release endorphins (morphine-like
chemicals) in the muscles, spinal cord and brain. These chemicals either
relieve pain symptoms or trigger other chain reactions that relieve
Acupuncture is nonsurgical, does not involve drugs, and
has no extremely negative side effects or permanent complications.
It may be worth exploring as a nonsurgical option, particularly if
you have exhausted the traditional remedies of Western medicine.
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