In most cases, back pain can be resolved without surgery. The conservative treatment involves the use of pain medications and other methods to reduce inflammation and restore normal function. Usually, some self-care methods and medications can help to overcome back pain, but if pain and inflammation persist over 72 hours, it is necessary to consult your physician.
What are Home Care methods?
Ice and Heat: Use of cold and hot compresses over the affected area helps in relieving the pain and swelling, and also in improving mobility. A cold pack or compress should be applied to the affected area immediately following trauma and kept there for at least 20 minutes. This can be done several times a day. Heat treatment should be started after 2–3 days of cold compresses. This helps to relax the muscles and increase the blood flow.
Bed rest: Bed rest is recommended for 1–2 days and you should resume normal activities as soon as possible. While sleeping, you should lie down on one side, with a pillow kept between the knees or you can rest on your back with a pillow below the knees.
Exercise: Appropriate exercises ensure fast recovery and also help to strengthen the back muscles. Your physical therapist can advise some gentle stretching exercises to relax the back muscle and relieve pain. If your pain increases and lasts for more than 15 minutes during exercise, you should stop exercising and consult a doctor.
What are the medications used?
A combination of over the counter pain medications and prescription drugs offer effective pain relief. Certain medicines may be unsafe to be taken during pregnancy or may have interaction with some other medicine you are taking, so it is best to consult your doctor before taking any medications.
- Nonsteroidal anti-inflammatory drugs – Aspirin, naproxen, and ibuprofen.
- Anticonvulsants – Carbamazepine, gabapentin, and pregabalin.
- Antidepressants – Amitriptyline and desipramine
- Opioids – Codeine, oxycodone, hydrocodone, and morphine. Care should be exercised for these drugs as you may develop an addiction.
What are the non-invasive therapies?
There are several options of non-invasive techniques that can be considered when the more conservative methods fail to respond. These include:
Spinal manipulation: Spinal manipulation or osteopathic manipulation is a non-surgical "hands-on" technique in which professional chiropractic specialists use leverage and exercises to adjust spinal structures and restore mobility of the back. During pain, the nerve that is interconnected with the muscles, joints, becomes weak and loses its ability to function. With this therapy, the nerve will be made to work normally and the blood circulation in these areas also increases. Osteopathic manipulation is not recommended in certain conditions. Therefore, discuss in detail with your doctor for more information.
Acupuncture: Acupuncture is the procedure that involves the insertion of fine needles into specific points throughout the body in order to relieve pain. Insertion of needles at specific points releases chemicals called peptides in the muscles, brain, and spinal cord which provide local inhibition to the incoming pain signal. It is a method of encouraging the body to promote natural healing and to improve functioning. This procedure may involve the insertion of needles at appropriate points or maybe twirled or energized electrically to intensify the effect of the treatment. The tingling sensation is common when electricity is applied.
Biofeedback: Biofeedback can be used to treat most acute pain including back pain. A special electronic machine is used and the patient is trained to be aware of and to follow and gain control over body functions such as muscle tension, heart rate, and skin temperature (done by controlling local blood flow). The patient is also taught to change his or her response to pain by using relaxation techniques.
Interventional therapy: Interventional therapy is used to treat chronic pain by blocking the nerve signals between specific areas of the body and the brain. The treatment approach involves injections of local anaesthetics, steroids, or narcotics into the affected soft tissues, joints, or nerve roots. It may also involve complex nerve blocks and spinal cord stimulation.
- Proliferation Injection: Proliferation injection is also known as sclerotherapy and is a non-surgical treatment for musculoskeletal injuries. It involves injecting the dextrose solution (irritant) into the damaged or injured ligaments and tendons. Macrophages, the defence cells of the body, reach the site of injection to attack the irritant. Meanwhile, the body brings in ‘fibroblasts’ which heal the damaged ligaments and produce connective tissue. This injection helps in the proliferation of new cells and helps in the repair of connective tissue.
- Neural Prolotherapy: In neural prolotherapy, an irritant solution is injected into the painful areas where the ligaments and tendons are injured. The irritant solution irritates the local area causing inflammation. The macrophages arrive at this site to dispose of the irritant solution. This encourages the repair process where the fibroblasts, the connective tissue builder cells, stimulate the production of connective tissue. Release of growth factors at the site of injury may help in strengthening the ligaments and tendons, reducing the pain and inflammation.
Traction: In this therapy, a continuous or intermittent force is applied to the skeletal structure in order to bring it into alignment. Force is applied using some weights. This treatment is not recommended for acute back pain.
Transcutaneous electrical nerve stimulation (TENS): This technique uses a device to send electric pulses along the nerve fibres so that the pain signals to the brain are blocked. Small electrodes are placed on the skin at or near the site of pain. Mild nerve impulses are produced which block the pain signals coming from the peripheral nerves. TENS may also stimulate the production of endorphins (chemicals produced in the brain having pain-relieving properties).
Ultrasound: Ultrasound is a non-invasive technique that uses sound waves that can pass through the skin and injured muscles. It can cause the soft tissues to warm up and thus relax the muscles and ease some amount of pain.
Non-Surgical Spinal Decompression: Spinal decompression is the use of a machine or a treatment to relieve pressure on one or many “pinched nerves” of the spinal column. It is used to treat conditions which cause chronic backache like herniated disc, disc bulge, sciatica, spinal stenosis. It is the safest and non-invasive form of spinal decompression therapy performed using a decompression machine. By this method, more room is created in the spinal column thus relieving the spinal cord and nerves from pressure. Although a single treatment session offers you relief to an extent, completing the full treatment cycle offers you complete healing of the injured disc and full benefit.