Conservative/Non-operative
Many patients with back pain improve with conservative treatment and do not require surgery.
After examination and investigations, your spine specialist may recommend either surgical or non-surgical back pain treatment depending on the cause and severity of your symptoms.
Non-surgical treatment is usually recommended initially, except in cases where surgery is absolutely necessary. This conservative or non-operative approach to back pain management includes various treatment modalities.
Lifestyle Modifications
Modifying activity levels may help keep back pain symptoms stable over the longer term. However, this does not mean that all activities should be stopped because of back pain.
Completely restricting activities may weaken the muscles supporting the spine. Current recommendations are to continue activities within tolerable pain limits, which may differ from person to person.
It may also be advisable to rest briefly after walking certain distances so that the affected spinal structures can rest. Avoid sitting in the same posture for prolonged periods. Changing posture regularly before pain develops may help distribute stress across different spinal segments.
Strenuous activities such as shopping and driving may also need to be modified accordingly.
Stop Smoking
Smoking cessation may help slow the wear and tear of the spine and may reduce progression of spinal degeneration.
Physiotherapy
Non-surgical back pain treatment such as physiotherapy may include electrical stimulation, heat therapy, stretching, and strengthening exercises to improve spinal support and mobility.
Physiotherapy also incorporates strengthening exercises involving the abdominal core muscles and muscles supporting the spine, hips, and thighs. Learning correct posture and body mechanics during daily activities may also help in the long term.
Acupuncture
Acupuncture may help as a non-surgical option for back pain management. It may help release certain chemical mediators (endorphins) that promote relaxation and alter how pain signals are processed by the brain.
Medicines
Your doctor may prescribe painkillers and anti-inflammatory medications for short-term symptom relief.
In some cases, nerve stabilising medications such as Lyrica or Gabapentin, as well as neuro-vitamins such as Vitamin B12, may also be prescribed.
Calcium and Vitamin D supplements may be recommended for osteoporosis or weakening of the bones.
Patients with chronic pain may occasionally require sleep medications or antidepressants as part of their pain management plan.
When to Consult a Spine Specialist
Persistent back pain, leg pain, numbness, or reduced mobility may require further assessment by a spine specialist. Early evaluation may help determine whether conservative treatment, physiotherapy, spinal injections, or other forms of back pain management are appropriate.
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Dr Hee Hwan Tak
Orthopaedic Surgeon & Spine Specialist MBBS (Singapore) | FRCS (Edinburgh) | FRCS (Glasgow) | FAMS (Ortho) |
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