Get Back Pain Relief Without Surgery

Doctors classify the two types of back pain based on how long they last:

• Acute back pain comes on suddenly and may last a few days or weeks. Pain might be from lifting something too heavy or twisting or bending.
• Chronic back pain lasts 12 weeks or longer and may continue even after you treat the initial cause. Chronic back pain often results from wear and tear of spinal vertebrae (back bones) over time – such as arthritis.

If you have pain after an accident or injury, or the back pain is severe or lasts for more than a few weeks, it’s a good idea to see a doctor.

Choosing A Provider

“Seeing a doctor can help prevent an acute back injury from becoming chronic,” said John Kihlken, MD, an Indianapolis pain management specialist with a background in anesthesia with Franciscan Physician Network Neuroscience Specialists. “You should see a doctor if you have severe back pain, numbness and tingling, trouble urinating, weakness or weight loss.”

“Look for a provider or organization with a broad scope of back pain care, including physical therapy, minimally invasive approaches and surgery,” Dr. Kihlken said. “At Franciscan Health, we use different physical therapy approaches – including soft-tissue manipulation, dry needling and core strengthening exercises – and nonsurgical medical approaches like nonopioid medicines and spinal injections. Our surgeons also offer minimally invasive treatments and higher-level care if needed – including various implantable devices, such as a spinal cord stimulator or pain pump.”

Physical Therapy For Back Pain

Often, doctors recommend physical therapy as the first treatment for back pain. Physical therapy can help relieve pain and swelling, improve range of motion, strength and stamina – and even help prevent future back injuries.

“I find most people benefit from using  a multi-modal approach to care,” said Kenneth Reynolds, DPT, a physical therapist with Franciscan Health Rehabilitation Services. “These can include manual therapy, exercise and lifestyle changes.”

What To Expect

Your first appointment with a physical therapist helps set a baseline for treatment. It helps your therapist understand your symptoms, assess your strength and mobility and learn about your goals and expectations.

“During the evaluation, we learn about your pain – the level, what makes it better or worse and how it fluctuates during the day,” Reynolds said. “We also screen for underlying medical issues and perform a neurological screening. Then, we use this information to develop an initial treatment plan, which we adapt as pain levels and functioning improve.”

Follow-up appointments offer a chance for feedback.

“We evaluate how you’re responding to treatment or a new exercise to make sure you’re getting the most from therapy,” Reynolds said.

Sessions may include manual therapies, stretching, core strengthening exercises and education. Physical therapists also educate you about lifestyle changes that can boost healing, such as eating right.

“A diet low in sugar and processed foods can be very powerful in lowering inflammation in the body and helps with recovery,” Reynolds said.

Physical therapists use a variety of treatments, including:

• Application of ice (best for acute back injuries) and heat
• Aquatic therapy (low-impact, gentle resistance exercise in a pool)
• Cupping (applies suction to the skin to increase blood flow and promote healing)
• Dry needling (uses ultra-thin acupuncture needles to relieve pain and swelling)
• Electrical stimulation (uses electrodes on the skin to stimulate underlying muscles and improve blood flow)
• Joint mobilization (gentle movement of joints to increase range of motion)
• Soft-tissue manipulation (often with metal or plastic massage tools) to ease tightened muscles and improve circulation
• Supervised exercise and assisted stretching

How Important Is Exercise?

Exercise is a key part of physical therapy – both during your PT session and at home.

“For many people with back pain, walking is like ‘nature’s back balm,’” Reynolds said. “When you walk and swing your arms, a hydraulic pumping action takes place in your spine, low back and surrounding soft tissue that can be very therapeutic.”

Walking is great for rehabilitation and prevention and can lower blood sugar and cortisol levels, which rise when you’re injured. “Aim for about 8,000 steps a day to get maximum benefits,” Reynolds said. 

According to Reynolds, exercise for back pain should also include strengthening  abdominal muscles to help protect the spine.

“Abdominal exercises strengthen muscles around your trunk and protect your back – essentially making your own back brace,” he said.

You also can protect your back long-term by strength training three days a week.

“If you find this intimidating, work with a coach,” Reynolds said. “Strength is tied to lower rates of frailty, greater longevity and lower rates of metabolic disease.”

How Long Does Physical Therapy Take To Work?

How often and how long you see a physical therapist depends on the type and severity of your back pain.

“Physical and manual therapy can be helpful for acute low-back pain. You can often get relief in one session or within a few weeks,” Reynolds said. “Chronic low-back pain is more challenging. But, with manual therapies and resistance exercise, many people begin to see improvement within about six weeks.”

The body needs time to respond, added Reynolds. “There may be ‘good days’ and some ‘not-so-good days.’”

Quality physical therapy also considers your psychological or emotional health and your social environment.

“Understanding these factors allows us to develop the best plan to meet your recovery goals,” Reynolds said. “Physical therapy isn’t a one-size-fits-all approach. It’s a dynamic process that considers the whole person to achieve the best outcome.”

Back Pain Treatment With Spinal Injections

For severe back pain or pain that hasn’t responded to physical therapy or other conservative approaches, doctors can inject medicines directly into the spine to relieve back pain. It takes anywhere from a few days to a week for an injection to take effect.

“Typically, we use injections for chronic back pain, such as pain caused by disc degeneration,” Dr. Kihlken said. “We use many types of injections – most commonly epidural steroid injections to relieve swelling and pain. Spinal injections can also treat symptoms like tingling, weakness or radiating pain. Steroid injections usually relieve symptoms for one to three months, and the injections must be given at least three months apart.”

Other spinal injections include facet joint injections, which treat pain in the small joints between vertebrae. Trigger point injections relieve muscle pain and swelling, such as for fibromyalgia (fatigue and widespread muscle pain and tenderness) or myofascial pain syndrome (long-lasting muscle pain).

“We also use radiofrequency ablation (RFA) to treat chronic back pain, such as arthritis in the facet joints in the back,” Dr. Kihlken said. “This procedure applies heat to the joint’s nerve tissue to block pain signals. RFA can relieve pain for six to 12 months.”

You don’t have to live with back pain. Franciscan Health offers a variety of nonsurgical treatments. The sooner you talk to your doctor, the sooner you can move without pain – and feel your best.

If back pain stops you from feeling your best, Franciscan Health can help. We offer a full range of nonsurgical back pain treatments to let you live without pain. Schedule an appointment today.