Conservative Management of Pain in the Back at KBNI

In a majority of cases, back pain can be treated without surgery. Dr. Kraus may suggest a conservative approach based on your medical history, previous treatment information, and results of imaging studies.

Conservative management is an non-surgical approach to treat back pain by using alternative approaches such as physical medicine and pain medications.

Physical medicine alternatives include:

• Braces to restrict movement and support the affected area
• Electrical stimulation therapy to promote healing and reduce pain and swelling
• Epidural steroid injections
• Ice and Heat: Use of cold and hot compresses over the affected area helps in relieving the muscle spasm and swelling, caused by strain. A cold pack or compress should be applied to the affected area within 48 hours following trauma and hot compress should be started after 48 hours.
• Exercise: Follow a specific exercise program in order to alleviate pain, strengthen the back muscles and prevent the recurrence of pain.
• Massage therapy helps relieve pain and muscle spasms
• Traction: Traction increases the space around the compressed spinal cord
• Ultrasound therapy may be used to provide warmth to the deep tissues and relax the muscles to ease pain.

Pain medications and several forms of injection therapy include:

• Antidepressants may provide relief from neuropathic pain
• Analgesic medications (oral) - Aspirin, naproxen, ibuprofen, acetaminophen and muscle relaxants
• Narcotic analgesics may be prescribed for a short duration to provide relief from severe or chronic pain
• Nonsteroidal anti-inflammatory drugs - Aspirin, naproxen, and ibuprofen may be prescribed to reduce swelling and inflammation
• Corticosteroid medications which have very powerful anti-inflammatory action may be prescribed, either orally or by injection, for severe back and leg pain.
• Epidural Injections involve injecting a steroid into the epidural space, area around the spinal nerves, to treat severe leg pain
• Facet Joint Injections - Injection of local anesthetic and steroid into or around the painful facet joints
• Sacroiliac joint injections (SI) - A local anesthetic and a steroid are injected directly into the sacroiliac joint under fluoroscopic guidance. Injections are usually followed by physical therapy to improve mobility and range of motion
• Selective nerve root block - Nerve blocks are often used to reduce inflammation around the nerve root and also to determine if a specific nerve root is the cause for your pain.
• Trigger point Injections - A combination of a corticosteroid and an anesthetic is directly injected into the affected muscle or soft tissue