Non Surgical Treatments
There are a wide variety of non-surgical options for back pain treatment of the lumbar spine. The more common treatment approaches include:
Typical pain medications used to treat the lower back pain include acetaminophen, NSAIDs, oral steroids, narcotic drugs, muscle relaxants, and anti-depressants. Each type of medication has strengths, limitations, and risks, and the patient’s particular problem in the lower back and overall health will determine which pain reliever, if any, is indicated.
Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.
Injections offer relief for some - but not all - patients, and they can be used to help identify the source of pain.
Heat or ice
Application of a cold pack or heating pad can help relieve low back pain. Some people find that alternating between the two works best.
This treatment maybe applied by a chiropractor, osteopathic doctor, or other qualified health professional. It is thought to help relieve lower back pain by reducing pressure on sensitive structures, increasing flexibility, improving blood flow and reducing muscle tension.
After an episode of low back pain has lasted between two and six weeks, or if there are frequent recurrences of low back pain, physical therapy is often recommended.
In general, the goals of physical therapy are to decrease pain, increase function, and provide education on a maintenance program to prevent further recurrences.
A physical therapy program for back pain usually has two components:
- Passive physical therapy to help reduce the patient's pain to a more manageable level
- Active exercises
Massage therapy is thought to improve blood flow, reducing muscle stiffness, and decrease stiffness.
Exercise. A program of back exercises and physical therapy will usually include a combination of strengthening, stretching, and low-impact aerobic exercise.