Conservative Treatment for Back and Neck Pain

September 2019

By: Ross Jones, DO – Spine Surgeon

As a spine surgeon, I love operating on the neck and back, but it is not always the right answer for every situation.  I am a very big believer in all patients trying conservative treatment before making the decision to do an operation.  The following is a list of many conservative treatment options that are available for patients with spine problems.

Activity modifications–these can be things like changing positions more frequently at work from sitting to standing, obtaining a new chair that is more comfortable, purchasing a new pillow, placing a high stool in an area of the house where you do a lot of activity allowing you to rest while continuing to do those activities.

Prescription anti-inflammatory–these take the place of over-the-counter anti-inflammatories.  Most of these are taken once or twice a day and are easier on your stomach and kidneys.

Muscle relaxants–there are many classes of muscle relaxers and these are meant to help the muscles around the spine release tension.  One side effect is that they make you sleepy so taking them during the day is not always a good idea if performing normal daily activities.

Steroids–this is a very strong anti-inflammatory that helps take away nerve and back pain symptoms very quickly.  You start at a higher dose and decrease by 1 pill each day until the pills are gone.  This is a medication we usually use for flareups. 

Nerve medication–these medications help calm irritated nerves but also have the side effect of sleepiness. 

TENS unit–these can be purchased over the counter in a pharmacy.  It will come with 2 small patches or one larger patch that hooks up to a battery pack and sends an electrical stimulation to the muscles and deep structures.

Traction–physical therapists and chiropractors have traction tables in their offices, or you can purchase an inversion table or other traction device.  This will give temporary relief by separating the vertebrae to help increase the space for the nerves being pinched.

Physical therapy–this is a great way to increase core and spine muscle strength that will help stabilize arthritic segments or painful areas.  Physical therapist can also do dry needling which is a deeper form of acupuncture to help relieve pain.

Chiropractor–chiropractors can adjust certain areas of your spine to help decrease the pain and increase alignment.  They also perform electrical stimulation, manual therapy, and traction.

Bracing–I prefer to use soft neck and lumbar braces.  The hard plastic and metal can be cumbersome and rub causing sores in certain areas.  For this reason, soft braces are safer and can give good support and relief.

Massage therapy–this will give temporary release of muscular pain.

Acupuncture–Acupuncture has worked for thousands of years to give pain relief for many types of ailments but especially for spine and muscular issues.

Medial branch block injections–these injections are meant to treat back pain and they are meant to deaden the small nerves that gives sensation to the spine.  My partner Dr. Marshall Meier, who is a non-surgical spine specialist, performs these injections for our practice.

Epidural injections–these injections are meant to treat limb pain from a pinched nerve and can be done in any area of the spine.  You can have up to 3 injections in a 12-month period in each individual location of the spine. My partner Dr. Marshall Meier, who is a non-surgical spine specialist, performs these injections for our practice.