Treatment for Back Pain or Backache: Medications, Manual Therapy, Interventional, Surgery

1.  Nonsteroidal Anti-inflammatory Drugs (NSAIDs) – Motrin, naproxen, Daypro and Celebrex.¹
2.  Tramadol – Ultram, Ultracet, Ryzolt and Conzip in USA, Ralivia in Canada.
3.  Opioids:

• Hydrocodone (vicodene, loratab and norco).
• Oxycodone (percocete and oxycontine).
• Morphine (Morphine IR: short acting and long acting).
• Dilaudid.
• Methadone.

4. Muscle Relaxants – Cyclobenzaprine (Flexeril), Soma, Skelaxin and Robaxin.²

5. Antidepressants:

• Tricyclic antidepressants (Elavil)
• Prozac
• Trazodone (Desyrel)
• Duloxetine (Cymbalta)
• Milnacipran (Savella)

6. Anti-anxiety: Benzodiazepine.

7. Antiepileptic:

• Gabapentin: also known as Neurantin.
• Pregabalin: Also known as Lyrica.

• Chiropractic Treatment: Spinal manipulation.³
• Massage Therapy: Massage is manual massaging of superficial and deeper layers of muscles and connective tissue.
• Physical Therapy or Physiotherapy: Physiotherapy is a manual therapy of muscles and joint. The therapy involves application of heat, ice, ultrasound and electrical stimulation, as well as some muscle-release techniques to the back muscles and soft tissues.

• Cortisone Injection: Cortisone is injected in joint or soft tissue, which is a source of pain.
• Trigger point injection is performed when pain is extremely severe and associated with severe muscle spasm.
• Peripheral nerve block with cortisone injection.
• Epidural Injection: Caudal, inter-laminar or transforaminal cortisone injections are performed for back pain localized in neck, mid back or lower back. Radicular pain is treated with epidural injection.
• Sympathetic ganglion block for sympathetic pain.
• Nerve ablation is performed using following method:
  1. Cryo-ablation
  2. Radiofrequency nerve ablation
  3. Chemical neuroablation using phenol
• Spinal Cord Stimulator – Electrode placed in epidural space and generator placed in abdominal wall passes electrical stimulation passing through epidural electrode.
• Intrathecal Pain Medication: Programmable pump delivers opioid pain medication in to cerebrospinal fluid (CSF) through catheter placed in CSF.
• Botox Injection – Botox blocks the nerve stimulations to muscles and prevents muscle spasm.

• Nerve Decompression– Radicular pain caused by pinch nerve is treated by Microdiscectomy, percutaneous disc removal, discectomy and laminectomy.
• Spinal Fusion– If radicular pain associated with back pain is caused by facet joint disease, then pain is treated by spinal fusion surgery or instrumentation of back. The vertebrae are splinted together with metal plates, screws or cages.
• Removal of Tumors– If cancer or tumor mass causes pain by squeezing or pinching nerve, then one of the treatments is surgical removal of tumor.
• Vertebroplasty – Body of vertebrae if fractured because of osteoporosis or trauma and causes severe pain then the symptom is treated by surgery. Surgery is insertion of cement to correct collapse vertebrae. Choices of surgical treatment are kyphoplasy or vertebraplasty.

Several choices of alternative treatments are available. Most of these treatments are not scientifically evaluated. Patient who do not want to take opioids prefer to try alternative treatment. Also patient who had tried all conventional treatment and failed to achieve pain relief, prefer to try the choice of alternative treatments.

• Biofeedback.
• Electroacupuncture.
• TENS (Transcutaneous Electrical Nerve Stimulation).
• Magnet Therapy.
• Homeopathy.
• Ayurveda.
• Aromatherapy.
• Reflex.
• Nutritional Medicine – Herbs, healthy eating, avoid caffeine.
• Spiritual practice is used for chronic pain treatment.
• Good sleep.
• Mind-Body Practices: Pain may be felt less severe if individual can control body with mind.
• Energy Manipulation Therapies: Alternative therapy teaches and enhances energy manipulations, which helps to reduce pain and also modulate endorphin resulting in increased pain tolerance.

References:  

Also Read:

• Lumbar Spinal Stenosis: Causes, Symptoms, Signs, Treatment-Pain Therapy, PT, Surgery
• Disability Benefits For Back Pain
• Minimally Invasive Spine Surgery: Types, Recovery, How is it Done?
• What is Minimally Invasive Spine Surgery & How Effective is it?
• Recovery Time Following ACDF & What to Expect After ACDF Surgery
• What is Dynamic Stabilization & Who is a Candidate For It|Reasons to Prefer Dynamic Stabilization Over Other Fusions & What to Expect in the Recovery Period?

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