TREATMENT FOR BACK PAIN

Treatment for back pain

Medications and therapies
Physical therapy and exercise. A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation, and muscle release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help pain from recurring.

Prescription medications. Your doctor may prescribe nonsteroidal anti-inflammatory drugs or in some cases, a muscle relaxant, to relieve mild to moderate back pain that doesn't get better with over-the-counter pain relievers.

Cortisone injections. If pain isn't relieved using other measures and you have pain radiating down your leg from a "pinched nerve," your doctor may prescribe cortisone injections — an anti-inflammatory medication — into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots.

Electrical stimulation. A procedure called transcutaneous electrical nerve stimulation (TENS) uses a unit that sends a weak electrical current through specific points on the skin to nerve pathways. This is thought to interrupt pain signals, preventing them from reaching your brain. Although safe and painless, TENS doesn't work for everyone or for all types of pain. It's generally more effective for acute pain than for chronic pain and is often used with other treatments. TENS may be a good option to try for people who can't take or don't get relief from medications.

Other treatments. These may include anesthetic injections or self-administered pain medications that are sent directly to the spinal cord through a thin tube (catheter) attached to a programmed pump.
Surgical and other proceduresFew people ever need surgery for back pain. There are no effective surgical techniques for muscle- and soft-tissue-related back pain. Surgery is usually reserved for pain caused by a herniated disk. If you have unrelenting pain or progressive muscle weakness caused by nerve compression, you may benefit from surgery. Types of back surgery include:

Laminectomy and laminotomy. These procedures involve removing part of your vertebra — the bony part of your spinal column. This procedure may relieve leg pain caused by bone spurs or disk fragments that protrude into your spinal canal or press on nerve roots within your spine.

Fusion. This surgery involves joining two vertebrae to eliminate painful movement.

Intradiscal electrothermal therapy (IDET). In this treatment, doctors insert a needle through a catheter into the disk. The needle is heated to a high temperature for up to 20 minutes. The heat thickens and seals the disk wall, reducing disk bulge and the related spinal nerve irritation. It's unclear whether this treatment is effective for back pain.
By Mayo Clinic Staff

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