Trust Your Surgeon

While spine surgery may be the right option for certain patients, many people suffering from back pain have decided that they will do almost anything to avoid surgery. If avoiding surgery is an option for you, it’s worth exploring some of the less common options.

Please note that it is better to first find out if you have a readily correctable anatomic lesion (such as a disc herniation) that would lend itself to minimally invasive surgery, as this may be less expensive and more effective than some of the non-surgical options available.

The following simply highlights several treatment options — this is by no means an exhaustive list. We have selected several treatment options that are relatively new and you may not yet have heard about.

Delivering Electrical Impulses through the Skin

Electricity has been used to treat pain for over 100 years. Early proponents of electricity were labeled as charlatans, but more recent scientific research has shown that electricity can reduce both acute and chronic pain. One type of electrical stimulation available delivers the electricity directly to the deeper tissues (muscles, ligaments, tendons) near the spine through several needle electrodes. The placement of the needle electrodes is designed to reach the specific nerve pathways that may be impacting the pain. The theory is that this type of electrical stimulation helps curtail the central nervous system hypersensitivity that leads to chronic pain. See also Percutaneous Neuromodulation Therapy (PNT).

Reducing Pressure on the Lower Spine with Bracing

Another type of brace may help certain patients to better participate in their daily activities by reducing the pain and symptoms that make it difficult to function. This brace is a pneumatic vest, worn during everyday activities, that uses pneumatic lifters to help take some of the weight off the lower spine and thereby decreasing the pressure on the lower back. Patients most likely to benefit from using this pneumatic vest tend to meet four specific criteria. See Pneumatic Vest – A New Lower Back Pain Treatment Option.

Breaking Down Scar Tissue

There are many treatment options available for back pain caused by soft tissue problems. Two relatively new approaches that are aimed at breaking down scar tissue and fibrous adhesions are:

  • The Graston Technique is a form of soft tissue mobilization that uses specifically designed stainless steel instruments to help identify and break down scar tissue. The majority of practitioners specializing in this technique are chiropractors, athletic trainers, physical therapists and occupational therapists.
  • Manipulation under anesthesia (MUA), is a non-invasive procedure increasingly offered for acute and chronic neck pain and back pain. Manipulation under anesthesia uses a combination of specific short lever manipulations, passive stretches and specific articular and postural kinesthetic maneuvers in order to break up fibrous adhesions and scar tissue around the spine and surrounding tissue.

Interrupting the Pain Signals with a Spinal Cord Stimulator

OK, this option does involve surgery to implant the device, but we wanted to take note there are now newer technologies that eliminate the need for frequent (e.g. annual) additional surgeries to replace the batteries in the stimulator. Spinal cord stimulatorsare small devices implanted under the skin in the low back that use electrical impulses to stop pain signals from reaching the brain. Certain models contain batteries that can last 5 to 9 years before needing to be replaced. While spinal cord stimulation does not work for a lot of patients with chronic pain, for some with nerve pain (e.g., burning, severe shooting pain and/or numbness or tingling) or chronic pain due to radiculopathy (e.g., radiating pain like sciatica) or failed back surgery, spinal cord stimulation may be recommended in an effort to reduce the pain to a more manageable level. This procedure is usually only considered after more traditional non-surgical treatment options have been exhausted. To learn more, see Rechargeable Spinal Cord Stimulators for Chronic Pain.

Finally, Ice and/or Heat Therapy is Almost Always Beneficial

While often used for acute pain due to a back muscle strain, ice and heat packs/wraps/pads can also be used to alleviate ongoing pain and to reduce activity-related discomfort for those with chronic back problems. Among other benefits, ice or cold packs help reduce inflammation and numb sore tissues, acting as an anesthetic for the painful area. Application of heat enlarges the blood vessels, which increases the flow of oxygen and healing nutrients to the injured area.

Importantly, ice and heat can really help you deal with the discomfort and pain of physical therapy and exercise, helping improve your chances of completing this essential aspect of your recovery. Usually, a hot pack is used to warm up the muscles and soft tissues before starting exercise and stretching, and soothing ice packs or cold packs are used to help the muscles and soft tissues calm down after exercise. For more helpful uses of cold and heat packs, see also:

  • Ice Massage for Back Pain Relief
  • Benefits of Heat Therapy for Lower Back Pain

For a myriad of reasons, back surgery may not be the preferred option for your particular pain situation, or you may prefer to try more non-surgical approaches to manage your pain before you’ll really consider surgery. By increasing your understanding of the many non-surgical treatments available for back pain — including ones that your doctor or physical therapist may not have mentioned — you may find one that really makes a difference in your pain level.

Find out more at Scotchtown Chiropractic and Physical Therapy

Topic: Back surgery July 25, 2011 Stephanie Burke


Dr. Tonyes has had extensive postgraduate training in topics such as rehabilitation, x-ray, MRI, diagnosis and treatment. He is a member of the American Chiropractic Association in addition has given many lectures to the community on health, nutrition and ergonomics in the work place. Over the years Dr. Tonyes has established a state of the art facility that provides comprehensive care to his patients that is second to none.

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