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What are Non-Operative Treatments for Lower Back Injuries?

Non-operative treatments for lower back injuries are conservative or non-surgical remedies employed for the treatment of lower back injuries. 

Lower back injuries are defined as damage sustained by muscles, nerves, bones, or joints in the lumbar spine (lower back) as a result of physical trauma or overuse. Common lower back injuries include sprains and strains, fractured vertebrae, or herniated discs. The lumbar spine is most often the location of lower back injuries as it bears most of the upper body’s weight and is involved in other movements such as lifting, pulling and twisting due to its high flexibility.

Indications for Non-Operative Treatments for Lower Back Injuries

Lower back injuries can be disabling; however, most cases heal with conservative therapy or non-operative treatments. Non-operative treatments may be indicated for treating various low back conditions such as:

  • Spinal fractures 
  • Degenerative disc disease 
  • Nerve compression 
  • Stenosis (narrowing of the spinal canal) 
  • Tumors 
  • Infection 
  • Instability 

Types of Non-Operative Treatments for Lower Back Injuries

Some of the types of non-surgical remedies for lower back injuries include:

  • Ice and Heat Treatment: Ice causes vasoconstriction which minimizes the flow of blood and lymph fluids to the area thereby reducing inflammation and pain. Application of an ice pack over the injured back area can help reduce inflammation and pain in the back region. Once the inflammation recedes, the application of heat can help improve the blood flow around the region to promote healing.
  • Medications: This often involves the use of analgesics and anti-inflammatory drugs to help relieve pain and swelling from back strains and sprains. In some cases, oral steroids may be prescribed to ease the pain and reduce inflammation. 
  • Cortisone Injections: Cortisone injections are steroids that are injected into the concerned joint space, bursa, or the region around a swollen tendon. This helps in reducing the inflammation quickly and easing pain. In some cases, imaging techniques such as ultrasound may be used by your doctor to guide the needle to the exact location while injecting the medication.
  • Physical Therapy: Physical therapy can help in strengthening the back muscles and joints and restoring their functionality after sustaining an injury. It can also help with the prevention of recurring back pain after the injury is treated. Moreover, physical therapy can help you learn proper back movements, lifting techniques, and exercises that help reduce unnecessary strain on the joint during every-day activities and preventing future discomfort or injury.
  • Acupuncture: This treatment involves the insertion of thin needles into specific parts of your body, corresponding to nerve pathways. The needles are left in for about 20 to 40 minutes. Acupuncture is believed to work by increasing blood flow or causing the release of endorphins, the body’s natural pain relievers. A modification in acupuncture is electro-acupuncture where the needles are stimulated by an electro-stimulator.
  • PRP therapy: Platelet-rich plasma or PRP is a non-surgical regenerative therapy that uses a high concentration of platelets and plasma to promote regeneration and self-healing in many orthopedic injuries and conditions. A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus allowing greater healing properties. PRP is a relatively new method of treatment for several orthopedic conditions such as muscle, ligament, and tendon injuries, arthritis, and fractures.
  • Spinal manipulation: Spinal manipulation or osteopathic manipulation is a non-surgical "hands-on" technique in which professional chiropractic specialists use leverage and exercises to adjust spinal structures and restore mobility of the back. During pain, the nerve that is interconnected with the muscles and joints becomes weak and loses its ability to function. With this therapy, the nerve will be made to work normally and the blood circulation in these areas also increases, relieving pain and promoting healing.
  • Transcutaneous electrical nerve stimulation (TENS): This technique uses a device to send electric pulses along the nerve fibers so that the pain signals to the brain are blocked. Small electrodes are placed on the skin at or near the site of pain. Mild nerve impulses are produced which block the pain signals coming from the peripheral nerves. TENS may also stimulate the production of endorphins (chemicals produced in the brain having pain-relieving properties).
  • Non-Surgical Spinal Decompression: Spinal decompression is the use of a machine or a treatment to relieve pressure on one or many “pinched nerves” of the spinal column. It is used to treat conditions that cause chronic backache like herniated disc, disc bulge, sciatica, spinal stenosis. It is the safest non-invasive form of spinal decompression therapy performed using a decompression machine. By this method, more room is created in the spinal column thus relieving the spinal cord and nerves from pressure and promoting complete healing of the injured disc.
  • Radiofrequency Rhizotomy: Radiofrequency ablation (RFA), also called rhizotomy or neurotomy, is a novel non-surgical technique of treating pain. This technique employs radiofrequency waves to produce heat and the heat produced damages the nerves transmitting pain signals to the brain. This procedure is performed to treat painful facet joints in the spine that usually cause chronic low back pain and neck pain.

Prevention of Lower Back Injuries

Some of the preventive measures that can help prevent low back injuries include:

  • Maintenance of a healthy body weight
  • A healthy well-balanced diet
  • Regular stretching and strengthening exercises
  • Proper lifting technique
  • Proper sitting posture

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