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What Treatments Are Available?

Treatments for chronic back pain can vary greatly depending on the type and source of the pain. If a treatable source of the pain is found, then the underlying process should be treated. When the underlying cause is either not known or not treatable, then the symptoms are treated. The goals of the treatment are to reduce pain, improve quality of life and increase function.Treatment for chronic pain includes several different general categories. These categories include physical therapy, medications, coping skills, procedures and complementary medicine treatments. Your health care provider will tailor a program involving a combination of these general options which best addresses your needs

Physical therapy

 includes patient education and a variety of stretching and strengthening exercises, manual therapies and modalities (ice, 
heat, transcutaneous electrical nerve stimulation [TENS], ultrasound, etc.) to treat pain. Active therapies which you can continue on your own, such as exercise and strengthening, usually have the most permanent and long lasting effects. Exercise and strengthening are designed to increase stability and strength around the structures in the back that are being stressed. They also work to avoid deconditioning that results from decreased activity. Exercises are tailored specifically to your abilities and the type of back pain being addressed.

Treatments... Continued

Medications used for treatment of pain are mul-tiple and varied. They fall into several different 
categories. Both non-narcotic and, rarely, narcot-ic pain medications may be used in the treatment of chronic back pain. 
Nonsteroidal antiinflammatory drugs (NSAIDs) are helpful with pain control and may help 
reduce inflammation. (See the NASS Patient Education Brochure on NSAIDs for more infor-mation on their proper use.) Muscle relaxants can also help with chronic pain and may enhance the 
effects of other pain medications. Nerve stabiliz-ing drugs (antidepressants and antiseizure medi-cations) are used to treat nervemediated pain. 
All these medications have different potential side effects and interactions and should be care-fully monitored by your health care professional.Coping skills are extremely important in the management of chronic back pain. Chronic pain directly affects all areas of your life. Pain affects mood, and your mood affects your ability to cope with pain.  Pain also affects how you inter-act with other people.  For this reason, learning appropriate coping skills for dealing with anxi-ety, depression, irritability and frustration can be invaluable. Visiting a trained pain specialist, psychologist or psychiatrist greatly enhances the treatment of chronic back pain. (See the NASS Patient Education Brochure on Back Pain and Your Emotions for more information.)

Procedures ranging from minimally invasive in-jections to surgery may be used in chronic pain. Sometimes, implantable devices are beneficial in treating chronic pain. You should discuss the potential risks and benefits of any procedures considered with your health care provider. Often a second opinion is beneficial.Complementary medicine also provides a variety of treatments often helpful in the treatment of chronic pain. These treatments include acupunc-ture, dry needling, nutrition, magnets and many others. It is important for you to discuss these treatments with your health care provider. It is important to be sure that any complementary 
medical interventions work well with your other 
treatments.Make certain you fully understand any treat-ment option that you are given.  Ask questions if something is not clear. The North American Spine Society also offers a wide range of patient education brochures on spine procedures to help you be an informed participant in your care.


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