Nonsurgical Pain Treatment Options

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During your initial visit, the doctor will assess your medical history and collect more specific information during the exam. In order to better understand your pain symptoms, 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.

Types of diagnostics you may encounter:

  • 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.

Injection Therapy

For years, physicians have used cortisone injections, epidural steroid injections, trigger point injections and nerve blocks to relieve pain symptoms. They are often provided in a series of three or four injections spanned over a couple weeks.

In many cases, 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.

Types of Medication

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..


Self-care measures can help ease some common pain symptoms. Try these helpers:

  • Keep a diary. A diary can help you determine what triggers your pain. Note when your pain starts, and what, if anything, provides relief. Be sure to record your response to any medications you take. Also pay special attention to foods you ate in the 24 hours preceding pain attacks, any unusual stress, and how you feel and what you're doing when pain (such as headache) strikes. If you're under stress, tell your doctor.
  • Try muscle relaxation exercises. Progressive muscle relaxation, meditation and yoga don't require any equipment. You can learn them in classes or at home using books or tapes. Or spend at least a half-hour each day doing something you find relaxing — listening to music, gardening, taking a hot bath or reading.
  • Get enough sleep, but don't oversleep. The average adult needs seven to nine hours of sleep a night.

Coping skills

Living with pain is a daily challenge. Chronic pain can be both incapacitating and unpredictable and may interfere with your job, your relationships with family and friends, and your overall quality of life. Although new treatments offer more options for pain management, you may still experience disabling pain. You may also occasionally feel anxious or depressed. These options may help you cope:

  • Counseling. A counselor or therapist can teach you techniques for managing stress and coping with pain. Family therapy may help the people in your life understand more about your pain.
  • Support groups. Like many people with migraines, you may find that these groups are a good source of useful information as well as support. Group members often know about the latest medical treatments and self-care or complementary remedies. Your doctor may put you in touch with a group in your area. The American Council for Headache Education Web site also provides referrals to support groups nationwide.
  • Balance. Try to balance the use of medications with regular exercise, relaxation techniques, nutritious meals and adequate rest. Allow yourself at least a half-hour every day for relaxation.

Alternative medicine

Nontraditional therapies may be helpful if you have chronic pain:

  • Acupuncture. Among other benefits, acupuncture may be helpful for some pain sufferers. This treatment uses very thin, disposable needles that generally cause little or no pain or discomfort. Dr. Lein
  • Biofeedback. Biofeedback appears to be especially effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses, such as muscle tension.
  • Massage. For people who have tight, tender muscles in the back of the head, neck and shoulders, massage may help relieve headache pain.
  • Herbs, vitamins and minerals. There is some evidence that certain herbs such as feverfew and butterbur may prevent migraines or reduce their severity. A high dose of vitamin B-2 may correct tiny deficiencies in the brain cells and thus prevent a migraine. Oral magnesium sulfate supplements can help reduce the frequency of headaches in some people. Additionally, magnesium sulfate infusions may help some people during an acute headache. Ask your doctor if these treatments are right for you. Pain sufferers that are pregant or might be pregnant should not use feverfew or butterbur.

Give it Some Time

Time is your most valuable asset. In cases where pain is focused in the low back or when there are warning symptoms, take the time to help yourself. Check out the home therapy section of this site for ways to treat common pain symptoms yourself.

Limiting Rest

In 1986, the New England Journal of Medicine released that the treatment of most back pain cases should involve no more than two days of rest and inactivity. After that, patients should start moving and exercising to strengthen back muscles and increase flexibility. The rehabilitative process requires a commitment on the part of the patient to work closely with a therapist during the first few weeks to ensure a successful long-term recovery.

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.


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’s 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.

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