The 6 Most Common Treatment Options for Back Pain Relief

Most people will experience some sort of back pain in their lifetimes, however the intensity and longevity of that pain can vary. Depending upon your level of pain, there are different levels of treatment.

Physical Therapy: Tailored Exercises for Core Strength (Conservative Treatment)

While there is no evidence that shows one type of exercise being superior to another, there is evidence that passive methods of recovery for back pain are associated with worsening of the condition. According to a study done in 2018, physical therapy is the first line of treatment that should be considered for chronic back pain (1).

A comprehensive report of recommended clinical guidelines was published in 2012 with a full list of potential diagnostic techniques and interventions for each type of pain (2). In every instance, some type of physical therapy was suggested as a primary intervention. Specifically, the recommendations that were made had all been tested in peer-reviewed literature and

1. Were matched to each individual subgroup of pain category.
2. Were shown to have an effect on recurrence prevention.
3. Were shown to influence the progression of back pain both acute and chronic.

Some of the exercises featured included trunk coordination, strengthening and endurance exercises, flexion exercises, and nerve mobilization procedures. The overall recommendation for these exercises was to focus primarily on interventions that would “prevent recurrences and the transition to chronic low back pain” from acute low back pain. 

While there are many avenues that a provider might take for physical therapy when it comes to back pain, the evidence is clear that physical therapy is one of the most effective ways to manage and treat back pain both acute and chronic.

Medications: Relief and Management (Conservative/Invasive Treatment*)

Medications can be helpful in the management of back pain, but don’t necessarily work towards long term relief or overall healing. Here is a list of potential medications that can help manage the pain along with their pros and cons (3).

Acetaminophen

• Pros: Stops the pain process, relieving pain temporarily
• Cons: Does not reduce inflammation

NSAIDs

• Pros: Anti-inflammatory, relieving pain temporarily
• Cons: Can cause upset stomach

Muscle Relaxants

• Pros: Ease spasms in the muscles
• Cons: Can cause drowsiness and dizziness

Antidepressants

• Pros: Can help with neuropathic pain
• Cons: No immediate pain relief, may experience drowsiness, dizziness, and constipation

Opioids

• Pros: Short term relief
• Cons: Addictive and can cause hormonal changes and stomach issues

When taken properly, medications can reduce pain and inflammation, however, they do not do anything to prevent further degeneration (4). In addition to the options listed above there have been limited studies done regarding the use of cannabinoids for back pain and while they may not be a front runner in recommendations for medication currently, there is a considerable possibility that they may be a prominent treatment modality in the future.

Acupuncture: Tapping into Ancient Practices (Invasive Treatment)

A variety of integrative treatment options like acupuncture, tai chi, and yoga have been shown to have an effect on the improvement of back pain. Overall, acupuncture has been shown to be effective, safe, and cost effective in ways that other treatments are not. There may be some debate amongst the general public about how effective acupuncture can be, however, studies show that it can make a significant difference.

“Beneficial effects of acupuncture on musculoskeletal pain are well-documented" (5). In analyses of clinical trials involving 18,000 to 21,000 patients with chronic musculoskeletal pain, acupuncture showed incredibly promising results. Additionally, in a study published in JAMA Internal Medicine, it was shown that “acupuncture was more effective in improving pain than no acupuncture treatment in patients with chronic low back pain" (6).

Chiropractic Adjustments: A Spinal Solution for Back Pain (Conservative Treatment)

“Among people seeking back pain relief alternatives, most choose chiropractic treatment" (7). Using manual adjustments and manipulation of the joints, chiropractors attempt to create ideal situations for the body to heal itself without medication or surgery. While generally considered safe, it’s extremely important to be honest with the chiropractic professional about diagnoses since certain conditions such as osteoporosis can make spinal manipulation dangerous.

Typically, chiropractic treatments are most effective for acute back pain, but can be helpful in chronic cases as well. At the end of the day, chiropractic work is not a magic bullet, however, understanding the ideas behind setting the body up for success to heal itself is a very important component in treatment and can make a considerable difference (8).

Lifestyle Modifications: Small Changes, Significant Relief for Back Pain (Conservative Treatment)

While it’s always important to see a medical professional when experiencing pain, there is something to be said about allowing the body to heal itself the best it can. Setting your body up for success can be as easy as eating better foods and getting more, high quality sleep (9). Some specific changes that can be integrated into your daily life include:

• Eating food with varying colors, as different colors indicate a variety of nutrients.
• Eat moderate amounts of protein; substituting skinless chicken and fish for red meat.
• Avoid simple carbs like sugar and flour especially.
• Cut back on dairy products.
• Eat healthy fats, like wild salmon, nuts, and avocado.
• Avoid alcohol consumption and smoking (10).
• Manage stress levels through exercise, hobbies, and/or therapy.

The more you understand your body and how it’s supposed to work, the better you will be able to cater to what it needs. While these lifestyle modifications may not always help with immediate pain relief, they can certainly help with healing over time and future prevention.

Surgery: The Last Resort (Invasive Treatment)

Despite every best effort to manage pain, sometimes surgery is necessary. While it should very rarely be a first choice, it is important to recognize the instances where it would be the best option. 

The primary reason that individuals would want to consider back surgery would be if other treatments haven’t worked and the pain is disabling (11). Some of the more common back surgeries include:

• Diskectomy: The removal of the herniated portion of a disk.
• Laminectomy: The removal of bone at the back of the spine.
• Fusion: The removal of arthritic joints through permanently connecting two or more bones in the spine.
• Artificial Disks: The addition of plastic and metal between two spinal bones, replacing the damaged disk.

Typically, low back surgery is considered safe (12). However, of course, like any surgery there may be complications and the recovery can be long and arduous. Back surgery can also have higher risks than certain other types of surgery exclusively due to the proximity to the nervous system; the more serious of these being paralysis and infections (13). Additionally, back surgery can cause a significant amount of postoperative pain, resulting in the need to temporarily increase pain medications.

However, some of the benefits to receiving the surgery can include long term results such as (14):

• Improved locomotion
• Reduction in daily pain medication
• Ability to return to work
• Improved mood

There are pros and cons for every surgery, but the most important part is communicating with your doctor and understanding that there’s always a possibility that the surgery will not work as planned.

The Future of Treating Back Pain

An individual’s ability to get rid of their back pain depends greatly upon the cause of the pain and the resources available. 

Aside from the options mentioned above, there has been some success regarding physical therapy mixed with electrostimulation with programs such as, ARPwave NeuroTherapy. ARPwave’s RxBlack uses electrical waves that are similar to those the nervous system uses to help promote natural healing and encourage a relearning process to occur, allowing the body to revert back to the ways in which it is supposed to move. 

There are many ongoing studies currently being conducted to explore the full extent of improvements this type of therapy can result in. However, ARPwave has been treating individuals with back pain for years and has seen positive results after even just one session. If you are interested in daily exercises designed to help with back pain as well as the full ARPwave NeuroTherapy treatment, click here.

*The determining factor of whether or not a medication is a conservative or invasive treatment depends upon the medication strength, qualities, and delivery method.