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Non-operative treatments

Medications

Many types of medicines are available to help control pain. Some of these include:

  • STEROIDS: Cortisone, Prednisone, Methylprednisilone (Medrol Dose Pack), Triamcinilone (Kenalog), Celestone, Depomedrol.
  • NSAIDS: (Non-steroidal Anti-inflammatory) Celebrex, Vioxx, Aspirin, Ibuprofen(Advil, Motrin), Naproxen (Alleve), Diclofenac, Salsalate, Voltaren, Daypro, Indomethicin(Indocin)
  • OPIATES: Vicodin, Tylenol#3, #4, Percocet (Oxycodone and Tylenol), Percodan, Norco, Lorcet (Hydrocodone and Tylenol), Lortab, Darvocet (Propoxyphene and Tylenol), Darvon, MS Contin (Morphine SO4), Oxycontin (Morphine S04 sustained release), Duragesic Patch (Fentanyl)
  • MUSCLE RELAXANTS: Robaxin, Soma, Flexaril, Zanaflex, Baclofen, Parafon Forte, Skelaxin
  • OTHER: Elavil (Amytriptlilline), Neurontin, Paxil, Prozac, Zoloft, Remeron Sinequan, Deseryl

Physical Therapy

A person with chronic back pain is in too much discomfort to perform the exercise on their own. A physical therapist guides the process, stretching the muscles along the spinal column while the patient is in the specified positions.

  • Traction: Traction is performed for temporary relief of neck or back pain. Small amounts of weight are placed to create distraction forces in order to relieve pain and spasm.
  • Myofascial Release: This involves hands-on techniques that are somewhat similar to deep tissue massage. It is sometimes uncomfortable but is often helpful in reducing spasm in hard-to-stretch areas.
  • Postural education: One of the keys to preventing reinjury to the spine is education. Posture is a very important factor in avoiding a relapse of a spinal injury. During initial phases of physical therapy visits, patients receive instructions on proper posture.
  • Body Mechanics: This is another vital part of spine education. The average person does a great deal of bending, lifting, and possibly twisting on any given day. These movements are commonly associated with the onset of back pain or sciatic symptoms. Therapists give instruction on proper ways to perform these activities, and also point out movements that should be avoided at all times. It is important to continue to follow proper body mechanics after the injury and throughout the rest of your life.
  • Stretching and Stabilization: There are a number of exercises for the spine. Most of them require no special equipment, and can be performed on the floor either with the therapist or at home. They include stretching and stabilization exercises, which produce low amounts of stress and strain at the point of injury, yet help greatly with proper alignment and stabilization of the spine.
  • Resistance Training: Once a patient is showing improvement of pain and adequate efficiency of the basic stretches and stabilization exercises, it is time to move on the more intense muscle building routines. These include use of weight machines specifically designed to focus on the back, abdominal, and oblique muscles. During this phase, it is extremely important that a patient uses the proper technique with the machines in order to avoid making the injury worse.
  • Work Hardening: This is a work specific type of therapy that is usually implemented after the initial phase of physical therapy is completed. These programs are designed to simulate normal occupational activities in a controlled environment, under the supervision of a therapist.
  • Sports Preparation: Patients that have been active in sports prior to an injury can get help returning to their respective sport with a careful and sport specific training program after their initial spine problem has been addressed. This will help patients return to the previous level of activity, and decreases the likelihood of reinjury due to a particular sport (Golf, basketball, softball, football, etc.).
  • Aquatic Therapy: In some patients, land based physical therapy may make symptoms worse. These patients can often benefit from aquatic physical therapy, which reduces the mechanical stress effects of gravity. Aquatic therapy also helps with cardiac conditioning; cardiac workload increases by approximately 3 times once someone is submerged in water up to his or her neck. This is due to an increase in efficiency of blood return to the heart. Aquatic therapy allows you to get the same cardiac benefit as doing approximately one third of the exercise. This however does not translate to improved fat burning.

Chiropractic, Massage & Acupuncture

  • Chiropractic: Chiropractic has been shown to be helpful in both the acute and chronic patient with back and neck pain.
  • Massage: Massage, in the right hands with proper guidance can be helpful for the patient with chronic back pain. It works best when done in combination with exercise and education.
  • Acupuncture: Acupuncture has long been used as a treatment for pain in Asian culture. In recent times, western medicine has accepted it as a legitimate part of the treatment of pain. Many insurance companies are now accepting acupuncture as a reimbursable form of treatment.
    Acupuncture, one of the main forms of therapy in traditional Chinese medicine (TCM), has been practiced for at least 2,500 years. In acupuncture, certain points on the body associated with energy channels or meridians are stimulated by the insertion of fine needles. Unlike the hollow hypodermic needles used in mainstream medicine to give injections or draw blood, acupuncture needles are solid. The points can be needled between 15 and 90 degrees in range relative to the skin's surface, depending on treatment.

    Acupuncture is thought to restore health by removing energy imbalances and blockages in the body. Practitioners of TCM believe that there is a vital force or energy called qi (pronounced "chee") that flows through the body, and between the skin surface and the internal organs, along channels or pathways called meridians. There are 12 major and 8 minor meridians.

    Qi regulates the spiritual, emotional, mental, and physical harmony of the body by keeping the forces of yin and yang in balance. Yang is a principle of heat, activity, brightness, outwardness, while yin represents coldness, passivity, darkness, interiority, etc. TCM does not try to eliminate either yin or yang, but to keep them in harmonious balance. Acupuncture may be used to raise or lower the level of yin or yang in a specific part of the body in order to restore the energy balance.
    In Western terms, acupuncture is used most commonly as an adjunctive treatment for the relief of chronic or acute pain. In the United States, acupuncture is most widely used to treat pain associated with musculoskeletal disorders.