What are some Nonsurgical Treatment Options for Back Pain?

October 28, 2019 | By: Raleigh Orthopaedic Team

Not all back pain requires back surgery. A majority of patient with back pain can use nonsurgical, conservative treatments to experience successful results. Raleigh Orthopaedic spine surgeons will only consider spine surgery as an option when other medical and conservative treatment options have failed. Conservative and nonsurgical interventional options for treating back pain are:

Conservative Therapies


Nonsteroidal anti-inflammatory drugs, such as naproxen or ibuprofen are generally attempted. Additionally, a prescription for steroids is sometimes useful. Pain medications are only prescribed as the last effort to help control back pain and are usually prescribed by a pain management physician or physiatrist.

Heat or ice

Using a heating pad, cold pack or alternating between the two is often helpful to relieve back pain.

Hot compresses are recommended to use on muscle injuries or common aches and pains from moving around a lot. Heat is good for back stiffness and muscle spasms as it can help loosen up the back muscles and relieves tension, which helps ease pain in the back. Warm compresses are placed on the affected area every couple of hours throughout the day until the pain and discomfort becomes more tolerable or relieved.  Common heat compresses are heating pads, hot patches and body wrap warmers, or warm baths.

Physician will usually prescribe cold compresses for a broken bone or other kind of physically injury. Cold compresses help relieve inflammation and swelling, aches and pain and can assist in relieving back pain by applying one every twenty to thirty minutes until the pain and until the pain and discomfort becomes more tolerable or relieved. Common cold compresses that can be useful for easing back pain are ice packs, cold cloths, cooling body wraps and cold baths.

A combination of heat and ice also help with back pain. Start with a cold compress first for twenty minutes and then introduce a hot compress an hour later for twenty minutes. This should be repeated throughout the entire day until the pain and discomfort becomes more tolerable or relieved.


Although it is best to avoid aggressive exercise after a back injury, using exercise to stretch your back and strengthen your core will help decrease back pain.

A physical therapist can help determine the best exercise plan for your back pain. Raleigh Orthopaedic has certified physical therapists that are trained to specifically treat the spine and will outline a plan that includes a combination of strengthening, stretching and low-impact aerobic activity.

Massage therapy

Research shows that massage therapy has several potential health benefits for treating back pain, including:

  • Increased blood flow and circulation, which aids in recovery of muscle soreness from physical activity or soft tissue injury (such as muscle strain).
  • Decreased tension in the muscles. This muscle relaxation can improve flexibility, reduce pain caused by tight muscles and even improve sleep.
  • Increased endorphin levels. Otherwise known as the “feel good” chemicals in the brain enhance mood to ease depression and anxiety, which can help reduce pain and speed recovery.

Nonsurgical/Interventional Therapies


A variety of injection options are available to help reduce pain.

  • Epidural steroid injections. When inflammation within the spinal column causes nerve-root irritation and swelling, and anti-inflammatory medication can be injections to reduce inflammation and ease pain. Pain relief typically begins in less than a week and lasts anywhere from several days to a few months.
  • Selective nerve-root block. When a nerve root is compressed or inflamed, it can cause pain in the back and leg. A selective nerve-root block is an injection of a steroid and/or numbing agent into the area of the nerve where it exits the spinal column between the vertebrae. Pain relief begins within a few days to a week and may last up to a few months.
  • Facet joint block. If the source of back pain comes from the facet joints, where the vertebrae connect to one another, a facet joint block may be recommended. In this procedure, a steroid and/or anesthetic medication is injected directly into the facet joint. Pain relief may last several weeks or months.
  • Trigger point injections. These injections involve injecting a small amount of local anesthetic, sometimes along with a steroid medication, directly into painful trigger points, specific sites on the muscles that cause pain (both locally and throughout the back) when pressed during a physical exam. These injections may be helpful if you experience back pain when pressure is applied to certain areas.

Lifestyle Therapies

Stop smoking

Smoking leads to faster degeneration of the spine and increased back pain. According to a study performed by the National Center for Biotechnology Information in 2012, patients who never smoked experienced significantly less pain than those who did, and that patients who quit smoking over the course of their pain management treatment experienced better outcomes than patients who continued smoking.

Click here for more information about smoking cessation and helpful resources to quit smoking.

Lose weight

Being overweight has been linked to increased pain. Maintaining a healthy weight is always recommended and can have numerous other health benefits besides helping with back pain.

Click here to calculate your body mass index (BMI)

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