Beginning treatment for back and neck pain

Before beginning any back/neck pain treatment program, be sure you know your diagnosis, and discuss the treatment plan with your doctor. There are some conditions that cause back/neck pain and require immediate treatment. For most cases of back/neck pain, the first treatments are as follows:

Rest
The first step in the treatment of back/neck pain is to rest the spine. Many cases of back and some neck pain are due to muscle strain so it is important to avoid further irritation to the spine and the muscles that surround the spinal column. Bed rest is fine but should not last longer than one to two days at most. Prolonged bed rest may actually lead to more persistent back/neck pain. Consult a physician for immediate evaluation if back/neck pain persists for more than one to two days following bed rest. If acute back pain eases up after bed rest, avoid bending, lifting, twisting or stressful physical activity. It will likely be okay to gradually resume regular activities within two to four weeks.

Anti-inflammatory medications
These medications are helpful in the treatment of both back/neck pain and inflammation. There are both over-the-counter and prescription anti-inflammatory medications you can take in the treatment of back/neck pain. These medications should be avoided in patients with stomach ulcers or allergies to these medications.

Heat application
Heat packs can help ease discomfort associated with muscle spasms causing low back/and neck pain. Patients can use heating pads, hot water bottles or even a hot bath or hot shower to help ease muscle discomfort that often causes low back/and neck pain.

Exercises
Strengthening back muscles is an important step in treating most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine. It is important to safely exercise on a regular basis. Exercise is more effective and beneficial when done consistently rather than in episodes.

Chiropractic manipulations
Manipulations are usually safe and have been shown to be as effective as more conventional treatments for some types of back/neck pain. There are situations when spinal manipulations can be dangerous and should be avoided. Your chiropractor should know the effective limits of their treatment program. Patients should have an x-ray of their spine to assess for instability before beginning chiropractic treatment. In addition, patients who have any leg/arm pain or symptoms such as weakness or numbness associated with their back/neck pain should consider being evaluated by a doctor before receiving chiropractic manipulation.

Massage
Massage offers some relief for back and neck pain caused by muscle spasm. It is, in general, safe but overall effectiveness may vary.

Narcotic pain medications
Narcotic pain medications are excellent at relieving pain, but these can be dangerous, addictive medications. You must be under close supervision when using narcotic medications and should only use them for a limited period of time. Long term pain medication usage is debatable and best addressed by a pain management physician and/or clinic.

Muscle relaxers
Muscle relaxing medications are helpful in relieving some types of back and neck pain. These medications help to relieve muscle spasm but may also make patients very drowsy. Their usage should be limited and the source of spasm should more directly be addressed by a physician.

Physical therapy
Back and neck exercises are the focus of physical therapy. If the exercises alone are not enough, there are other physical therapy modalities that can be offered such as: water therapy (whirlpool), ultrasound, electrical stimulation and others. Physical therapy is a mainstay of a healthy spine.

Epidural steroid injections/blocks
Epidural steroid injections are an option for back and neck pain treatment and inflammation around the spinal nerves. An injection is performed using an x-ray to guide the needle and medication to the area adjacent to the inflamed spinal nerve. This procedure is performed by a physician in a hospital setting or in a similar medical facility. The steroid medication serves simply to “block” and/or reduce the back/neck pain felt by the patient. Positive effects may take a few days to be felt and may last several days, weeks, or even months before wearing off. Patients may require more than one steroid injection in order to gain optimal benefits from this procedure. Typically, a maximum of 3 to 4 injections are performed in a 12-month period. Side effects should be discussed with your physician.

Spine surgery
Although some spinal disorders may require immediate surgical intervention, most spine surgery should take place only after other forms of conservative back/neck pain treatment have failed to relieve pain symptoms. In the “proper” patient with the appropriate problem, surgery will generally be quite effective. The best reasons to have surgery are listed in our services offered tab.