Pain Management

June 29, 2019

Non-Surgical Solutions for Back Pain


Chronic back pain can take a severe toll on your everyday life. Unfortunately, surgery is not always an option. For those who can’t undergo spine surgery, there are more conservative options that may help relieve pain.

Habits to Fix
Daily habits could be causing unnecessary wear and tear on your back. Fixing these habits is one of the simplest ways to attempt to relieve back pain. While doing so may be enough for temporary relief in some cases, they are not meant to serve as a permanent substitute for interventional pain management.

Sedentary Lifestyle
Spending several hours a day sitting at a desk, in your car, or on the couch takes a toll on your back muscles and spine—and slouching makes it even worse. Try to get up and move around at least once an hour, and if possible, implement an exercise regimen that works for you. Even if it just involves stretching, keep it up: movement is great not only for your spine, but for your overall well-being, too.

Poor Diet
Your diet may not be one of the factors you might consider as a cause of your back pain, but it can have quite an impact. For example, being overweight puts more pressure on your spine, making it more difficult for it to provide support.

Your spine also requires nutrients to stay healthy. Foods that provide your spine with the nutrients it needs include fruits, vegetables, whole grains, seeds, and nuts. By eating more of these foods instead of processed ones with lots of sugar, you can work towards losing weight and providing nutrients to your spine all at once.

For many people, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are enough to manage chronic back pain. If your pain becomes more severe, your physician may prescribe opioids, muscle relaxants, or even antidepressants that have been proven to help relieve back pain. Consult your doctor about which medication is best for you, and never self-medicate with a controlled drug that has not been prescribed to you by your pain management specialist.

Steroid Injections
Anti-inflammatory steroids such as cortisone are commonly used as non-surgical treatments for chronic back pain. Together with anesthetics, or numbing agents, steroids are used to reduce inflammation in your back, helping relieve your pain. The anesthetic provides immediate relief, while the steroid is time-released to keep inflammation from coming back for anywhere from a few weeks to a year.

Because steroids are injected directly into the problem area, they work much more quickly than oral medication and tend to have fewer side effects. However, some patients occasionally experience weight gain, headaches, water retention, high blood sugar, or fever. In addition, steroid injections can lead to fewer steroids being produced by your body naturally. Talk to your physician about the possible side effects you may experience when receiving steroid injections for chronic back pain.

There are a few different types of steroid injections:

Facet Injections
Facet joints lie at each segment of your spine, linking your vertebrae together. Age, injury, or degenerative diseases, including arthritis, can lead to your facet joints becoming inflamed.

Also known as facet blocks, facet injections are placed directly into a facet joint of your spine. If the facet joint is the source of your chronic back pain, relief should be immediate. For this reason, facet injections are also used as a diagnostic tool: if your back pain does not subside after receiving the injection, your pain management specialist can then move on to determining and treating another likely cause.

Epidural Injections
Another type of steroid injection is an epidural injection. One common epidural injection is a lumbar epidural steroid injection (LESI), which has been used since 1952 as a solution for chronic lower back pain and sciatica. Today, LESIs are used to treat pain caused by such issues as degenerative disc disease , osteoarthritis, herniated discs, spinal stenosis, compression fractures, and synovial cysts.

During an LESI procedure, steroids are injected into the epidural space of your back, which is a fatty area surrounding your spine. Within that space lies the dura sac, which contains nerve roots. The steroid injection reduces inflammation of the nerve roots to help relieve pain.

LESIs, which can provide relief for anywhere from one week to a few months, can be received up to three times in one year. They are often used alongside physical therapy designed to strengthen your core and back muscles. Another use of LESIs is to provide relief after surgery, allowing you to recover with less pain.

Nerve Root Blocks
Selective nerve root blocks are used to identify specific spinal cord nerve roots that are compressed or irritated as a result of herniated discs or bone spurs. Using a fluoroscope, a live x-ray machine, or a CT scan, your doctor will view images of your nerve roots to determine where to administer the injection.

Unlike epidural injections, which target a larger area of your back, nerve root blocks allow your pain management specialist to target an extremely specific area: the exact nerve root that is causing pain. This reduces the total area of your body that is affected by medication while providing the same pain-relieving anti-inflammatory treatment.

Radiofrequency Rhizotomy
Instead of steroids, radiofrequency rhizotomy uses heat via radio waves to reach and cauterize medial nerves in degenerative facet joints of your spine. Cauterization deadens nerve endings, making them unable to send pain signals from your spine to your brain.

While the injection isn’t painful—an anesthetic is administered—you may feel pain about eight hours after the treatment as the numbness wears off. Then, scar tissue forms over the cauterization, and within about a week, there should be no pain.

The results of radiofrequency rhizotomy are not immediate and not permanent. It could take up to four weeks for you to feel complete relief, and your nerve will eventually grow back. For this reason, physical therapy is often prescribed as a part of the treatment. The pain relief will allow you to strengthen your back and core muscles, giving you more stability and making it less likely that you will need back treatment again.

Living with Chronic Back Pain
If you are living with chronic back pain and want to learn more about non-surgical options, contact Arkansas Surgical Hospitalat (877) 918-7020 to make an appointment with one of our interventional pain management specialists.

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