It’s challenging to manage chronic back pain, but you’re not alone. About 8% of adults suffer from long-lasting back pain. Luckily, there are some non-surgical treatments for pain relief in the short term.
In fact, if you adopt a healthier lifestyle, including regular stretching and exercises, you might even get rid of back pain without taking medications or going through surgeries.
In this article, we’ll discuss the most common non-surgical treatments for chronic back pain. Read on to learn about your options.
Table of Contents
What is Chronic Back Pain?
Chronic back pain is a prevalent condition that persists for more than three months and can occur anywhere from the neck to the lower spine.
Unlike acute back pain, which is often due to a specific incident and resolves within a few weeks, chronic back pain can develop gradually and is long-lasting, often without a clear, single cause.
While symptoms can vary, you’ll typically experience a persistent dull ache or a sharp pain that may be accompanied by tingling or burning sensations. The pain can worsen with certain activities like bending, lifting, or prolonged sitting, and may radiate down the legs.
Common Causes of Chronic Back Pain
Here’re the factors that contribute to chronic back pain:
- Weak back muscles that fail to properly support the spine.
- Poor posture or repetitive stress that damage spinal structures over time.
- Genetic factors and natural degeneration of spinal structures with age.
- Accidents or injuries.
- Daily activities that stress the back.
12 Nonsurgical Treatments for Chronic Back Pain
1. Physical Therapy
Physical therapy is a highly effective treatment for chronic low back pain (CLBP). It can serve as a conservative treatment option that may help patients avoid or delay the need for surgery.
For pain and inflammation relief, physical therapy uses a combination of active exercises and passive treatments (like massage, heat therapy, ultrasound, and electrical stimulation). The therapies also improve tissue healing, flexibility, and range of motion, which is key to regaining function.
A physical therapist can tailor treatment plans to your needs by focusing on the root causes of back pain, such as muscle weakness, poor posture, or lack of mobility.
Through strengthening exercises, balance and coordination training, and education on proper body mechanics, physical therapy reduces your risk of future injuries or falls.
2. Spinal Manipulation
Spinal manipulation, also known as spinal manipulative therapy or manual therapy, is a therapeutic technique that involves applying controlled, sudden force to the joints of the spine.
This method combines moving and jolting joints, massage, exercise, and physical therapy to relieve pressure on joints, reduce inflammation, and improve nerve function.
Only trained and licensed professionals should do spinal manipulation. This includes:
- Licensed chiropractors
- Physical therapists
- Osteopathic doctors
- Some medical doctors
Spinal manipulation has two main types:
- Spinal manipulation
- Spinal mobilization
The former involves a high-velocity, low-amplitude (HVLA) thrust that often results in an audible “pop,” while the latter uses less forceful thrusts and more stretching, sometimes employing tools like the “activator” for precise application of force.
Despite its widespread use, spinal manipulation is not without risks. Complications, although rare, can include herniated disks, compressed nerves, and even stroke following neck manipulation.
3. Mindfulness and Meditation
Did you know that chronic back pain can affect your mental health? It’s true. People with chronic back pain are more likely to experience problems like stress, depression, anxiety, and sleep issues. But why does this happen?
Chronic back pain can be emotionally exhausting because it never seems to go away. This can lead to feelings of hopelessness and anxiety. Moreover, the tension in your muscles caused by back pain can get worse when you’re stressed, creating a cycle of more pain.
To manage chronic back pain effectively, it’s important to take care of your mental health too. This can prevent your condition from getting worse and stop mental health problems from developing. Here are some simple ways to incorporate mindfulness and meditation into your daily routine:
- Dedicate 10-15 minutes each day to a guided body scan or breath awareness meditation.
- Take short breaks for “mini-meditations” to notice your breath and any bodily sensations.
- Incorporate mindful movement practices such as yoga, tai chi, or simply being aware of your body sensations during everyday activities like walking, sitting, or eating.
- Use mindfulness apps or listen to short guided meditations.
When you develop a more mindful approach to managing chronic back pain, you’ll experience less pain.
4. Adopt an Anti-Inflammatory Diet
You can manage chronic back pain with an anti-inflammatory diet. There’s a focus on reducing inflammation because it’s a big factor in many chronic pain conditions, including back pain. Check out these recommendations:
Foods to include:
- Plant-Based Proteins: Incorporate beans, lentils, and nuts into your diet. These provide essential nutrients without the inflammatory effects associated with some animal proteins.
- Fatty Fish: Opt for fish high in omega-3 fatty acids like salmon, mackerel, and sardines, which are known for their anti-inflammatory properties.
- Fruits and Vegetables: Choose a variety of colorful fruits and vegetables, such as berries, leafy greens, and cruciferous vegetables like broccoli and cauliflower. These are high in antioxidants.
- Whole Grains: Whole grains like quinoa, brown rice, and whole wheat help maintain steady blood sugar levels and reduce inflammation.
- Healthy Fats: Use olive oil for cooking and dressing salads. Avocados and seeds like flaxseeds and chia seeds are also excellent sources of anti-inflammatory fats.
- Herbs and Spices: Turmeric, ginger, and garlic not only add flavor but also possess strong anti-inflammatory properties.
Foods to avoid:
- Processed Foods and Sugars: Limit or avoid processed meats, refined carbohydrates, and sugary snacks and beverages, as these can exacerbate inflammation.
- Red Meat and Dairy: These can be pro-inflammatory for some people. Consider reducing intake or choosing leaner cuts and fermented dairy options.
- Fried Foods and Vegetable Oils: Foods cooked in vegetable oils or that are heavily fried can contribute to inflammation. Opt for cooking methods like baking, steaming, or grilling instead.
Most of all, remember to drink plenty of water throughout the day to help maintain spinal disc hydration and overall health.
5. Losing Weight
Weight loss can help treat chronic back pain for the following reasons:
- Reduced Mechanical Load: Excess body weight, especially around the midsection, increases the load on the spine. This additional weight can lead to structural changes such as increased lumbar lordosis (curvature of the lower back), which puts extra pressure on the intervertebral discs and joints.
- Decreased Inflammation: Adipose tissue, particularly visceral fat, is known to produce inflammatory cytokines that can contribute to systemic inflammation, including in the back. Weight loss reduces the amount of this tissue and therefore the level of inflammatory mediators.
- Improved Mobility and Posture: Excess weight can impair mobility and promote poor posture, both of which can exacerbate back pain. Weight loss can improve mobility and enable better posture.
If you want to design a diet and exercise plan that’s safe and effective for managing your back pain while achieving weight loss, you may consult a registered dietitian or a physical therapist.
6. Improve Posture
Improving your posture can significantly help relieve chronic back pain by addressing the underlying causes like alignment and function of the spine.
Poor posture places uneven pressure on the spine, leading to stress on the vertebrae and discs. This can cause or exacerbate conditions like herniated discs, spinal stenosis, and other degenerative changes. On the other hand, good posture ensures that the spine is correctly aligned, distributing weight evenly and reducing stress on these structures.
Studies have shown that poor posture is a common cause of lower back pain, even in young adults. In one study, people who followed an 8-week exercise program to correct their posture reported feeling much better in their backs and shoulders.
Here are some ways to maintain better posture:
- Core Strengthening Exercises: A strong core is essential for good posture and supporting the spine. Exercises such as planks, single leg extensions, and the “new crunch” or curl-ups target the abdominal and lower back muscles, helping to stabilize your pelvis and spine.
- Stretching and Flexibility: Stretching exercises relieve tension and improve flexibility, which in turn helps you correct your posture. Pilates and yoga are great for strengthening your core and improving your flexibility by focusing on slow, controlled movements.
- Ergonomic Adjustments: You can prevent and relieve back pain by adjusting your workspace and sleeping in the right position. Choose chairs that support the natural curve of your spine, and use a pillow or towel for extra lumbar support. When sleeping, place a pillow between your knees if you’re a side sleeper or under your knees if you sleep on your back to maintain a neutral spine position.
7. Transcutaneous Electrical Nerve Stimulation (TENS)
TENS, or Transcutaneous Electrical Nerve Stimulation, is a method where you stick special electrode patches on your back. Then, you use a battery-powered device to send electric pulses through these patches, which stops pain signals.
Studies have shown that TENS works well. In one study, just 15 minutes of TENS reduced lower back pain a lot. Another big review found that TENS can significantly reduce pain for people with long-term lower back pain.
If you want to try TENS, you can get a device from your doctor or buy one online.
8. CBD Oil
CBD oil is a product made from substances found in the cannabis plant. There are two main substances in cannabis: cannabidiol (CBD) and tetrahydrocannabinol (THC).
THC is what makes marijuana give you a “high.” CBD oil, on the other hand, comes from the hemp plant and doesn’t make you feel high.
People use CBD oil for different health reasons, like dealing with pain. Some studies suggest that cannabinoids, the compounds in CBD oil, might help reduce pain. But we need more research to be sure it’s a good pain reliever.
One important thing to know is that the laws about CBD oil are different in each state. So, before you buy or use it, check your local laws to make sure it’s allowed where you live.
9. Choosing the Right Shoes
The shoes you wear can have a big impact on your spine’s health and how it affects your lower back. Wearing the wrong shoes and not bending correctly can hurt your spine. To keep your spine healthy and reduce back pain, focus on finding shoes that give good arch support and cushioning.
Here are some easy tips to pick the right shoes for a healthier spine:
- Choose Flatter Heels: Go for shoes with flat heels for all-day comfort. These shoes are more stable and put less stress on your lower back.
- Look for Cushion Support: Find shoes with good cushioning support. Cushioning helps your body absorb shock and lessens the impact on your back when you walk or run.
- Try Orthotic Insoles: Consider using orthotic insoles to make your feet more comfortable and mobile while reducing back pain. These special insoles provide extra support and improve your feet’s alignment, which can help your spine too.
10. Injection-based Treatments
If you have chronic back pain, there are injection treatments that can help. These treatments include:
- Trigger point injections
- Epidural steroid injections
- Nerve blocks
- Nerve ablations
Doctors recommend these injections when they know the source of your pain. They can also use them to rule out certain causes if they don’t work.
It’s important to know that injections provide temporary relief, not a long-term fix. They shouldn’t be your only treatment. The main goal of these injections is to help manage pain so you can do gentle activities like physical therapy and home exercises.
11. Acupuncture
Acupuncture is a traditional Chinese medicine practice that uses thin needles inserted into specific points on the body. People use acupuncture to help with various problems, including long-term illnesses and ongoing pain.
Studies suggest that acupuncture can be helpful for chronic low back pain, improving function, and reducing pain. It has also been shown to provide lasting relief for chronic pain when used over a long time.
12. Pharmacologic Treatments
Chronic back pain can be managed using different types of medicines like creams, pills, and injections. These meds range from anti-inflammatories and muscle relaxants to nerve pain relievers and even antidepressants.
However, keep in mind that all drugs can have side effects. You should consult your doctor to find the right medication, use the lowest effective dose to reduce side effects, and stop using them once your pain subsides.
While opioids aren’t usually the first choice for treating chronic back pain, they can be helpful immediately following an injury or surgery. Opioids can temporarily block pain but don’t address the underlying issue, such as inflammation.
After the initial healing period, it’s best to phase out opioids and focus on non-opioid meds for long-term pain control. If you use opioids for a long time, you might get addicted to it.
When to Consider Surgery for Back Pain
You might need back surgery if you have certain warning signs related to your spine issue. These signs include:
- New or worse problems with bowel or bladder control, like accidents or numbness in the groin area.
- Weakness in your arms or legs.
- Trouble with your walking or balance.
- Evidence of increased reflexes (quick reflexes).
Apart from these warning signs, surgery can also be an option if imaging shows a clear cause for your long-lasting back pain, and other treatments haven’t helped.
Keep in mind that surgery is a serious and risky way to treat chronic back pain. It can’t be undone, and it doesn’t guarantee complete relief from your pain. Top spine doctors usually suggest surgery only after trying less invasive treatments first.
Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.
She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.
If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.