Conservative Treatments

 

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. The term "non-steroidal" is used to distinguish these drugs from steroids, which (amongst a broad range of other effects) have a similar eicosanoid-depressing, anti-inflammatory action. NSAIDs are sometimes also referred to as non-steroidal anti-inflammatory agents/analgesics (NSAIAs). The most prominent member of this group of drugs is Ibuprofen (Advil and Motrin). Also included in this group of drugs are Naproxen (Aleve and Naprosyn) and Celebrex

 

 

Exercise

Conditioning through low-impact aerobic exercise is very important for both rehabilitation and maintenance of the lower back. Aerobically fit patients will have fewer episodes of low back pain and will experience less pain when an episode occurs. Well-conditioned patients are also more likely to maintain their regular routine, whereas patients with chronic low back pain who do not work on aerobic conditioning are likely to gradually lose their ability to perform everyday activities.

 

Examples of low impact aerobic exercise that many people with back pain can tolerate include:
• Water therapy (also called pool therapy). For people with a great deal of pain, water therapy provides a gentle form of conditioning as the water counteracts gravity making many stretching movements easier and provides buoyancy as well as mild resistance.
• Walking. Many people think that walking as part of their daily routine (e.g. at work or while shopping) is enough. However, this stop-and-start type of walking is not adequate for aerobic conditioning. Instead, continuous walking at a sustained pace for a minimum of twenty to thirty minutes is required to provide aerobic conditioning.
• Stationary biking. Riding a stationary bicycle provides aerobic conditioning with minimal impact on the spine. This is also a good exercise option for people who are more comfortable positioned leaning forward.

 

 

Physical Therapy

To help you regain strength and movement, physical therapy may be prescribed. A physical therapist may teach you special exercises to improve your spine’s strength and range of motion. Posture and movements that can affect your spine may be evaluated and corrected. Therapies such as heat and massage may help relieve your symptoms.

 

 

Rhizotomy

Rhizotomy is an x-ray guided procedure where heat is applied to the nerves in the area of your pain. The purpose of Rhizotomy is to decrease back pain and improve function. The heat causes a lesion which interrupts the pain pathway to the facet joint in your spinal column. These joints provide stability and guide motion in your neck and lower back. This procedure is done only if pain is relieved temporarily by facet joint block injections or medial branch block injections. The rhizotomy is very similar to a facet joint block injection.

 

 

Epidural

An Epidural Steroid Injection is an injection of a local anesthetic into the epidural space in the back. The epidural space is located in the spine just out the sac containing spinal fluid.
When is an Epidural Steroid Injection used?
An Epidural Steroid Injection is used for back pain caused by:
• Disc problems
• Spinal stenosis
• Pain that radiates to your arms or legs

 

 

Medial Branch Block

Physicians commonly use this type of injection to help diagnose lower back pain. It is used to diagnose low back pain that stays above the knee. During a medial branch block injection numbing medication or local anesthetic is placed directly around a medial branch nerve. Medial branch nerves are the very small nerve branches that controls sensation to a part of the spine called the facet joint. They do not control any muscles or sensations in your arms or legs. The facet joint is where each bone of the spine (vertebrae) connects with the next. Sometimes, these facet joints can develop arthritis and be a source of pain.