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Non-Surgical Management of Back Pain - Activity Modification and Drugs

Written by
Dr. Shakti A. Goel
and medically reviewed by iCliniq medical review team.

Published on Oct 30, 2016 and last reviewed on Sep 07, 2018   -  2 min read



A study was published that about 73 % of back pain patients may get relieved by non-surgical methods. Here, I have discussed various non-surgical methods to deal with back pain in individuals.

Non-Surgical Management of Back Pain - Activity Modification and Drugs

There are a number of causes for back pain and patients are usually confused about their management and treatment options. The question that makes many ponder is if there is really an effective way to reduce the pain without undergoing surgery. There are various non-surgical modalities that are sufficient to control the symptoms and surgery may be deferred.

Activity Modification

Activity modification is of prime importance. Decreased lifting, twisting, and forward bending are the mainstay in non-surgical management.

A period of relative rest may be needed for acutely flared-up symptoms.

A period of rest to reduce the pain should always be followed by exercise. Stationary bicycle riding, aquatic exercises, and partially unloaded treadmill exercises are well tolerated.

Hyperextension regimens should always be avoided. Flexion exercises are preferred as they increase the flexibility of lumbar soft tissues.

Medication (Drugs)

A lumbar corset decreases movement and hence the pain is reduced. However, it may lead to weakness and is therefore advised based on the individual condition.

Various medications can be used to reduce the pain and symptoms. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been frequently used. However, these should be taken with precaution. NSAIDs may lead to gastrointestinal problems and hence may be avoided in elderly individuals.

Narcotics may be used in acute flare-up cases.

Muscle relaxants and oral steroids are controversial, except in acute cases.


Injection therapies are variably recommended for back pain, trigger points, and nerve root sleeves. Epidural injections are more common, yet also remain controversial. Such injections and blocks are mainly helpful in acute conditions to reduce the pain.

Typically, three-weekly injections of Depo-Medrol (Methylprednisolone acetate) and Xylocaine (Lidocaine) are given through the sacral hiatus.

Other Modalities

Other modalities of non-surgical treatment include manipulation, stress reduction, acupuncture, ultrasound and transcutaneous electrical nerve stimulation units, thermal modalities, and traction.

It is important to know whether a person would require a surgical or non-surgical modality. Hence, proper X-rays or MRIs may be needed before coming to a definite conclusion.

In a study, it was published that about 73 % of back pain patients may get relieved by non-surgical methods. However, 27 % would still require surgery. So, it is important to find out the group one belongs to, before starting medications.

For more information regarding the non-surgical modalities consult an orthopaedician and traumatologist online -->


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Last reviewed at:
07 Sep 2018  -  2 min read


Dr. Shakti A. Goel

Dr. Shakti A. Goel


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