Conservative Care for Back Pain

For most people back pain tends to get better within two weeks to three months. During this time period that an episode of back pain is resolving, or if the back pain is chronic, it is important to consider the appropriate course of conservative (non-surgical) treatment in order to:

• Reduce pain and spasm

• Provide conditioning for the back

• Assist in managing issues frequently associated with back pain, such as sleeplessness or depression.

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Treatment options are considered "conservative" when they are non-invasive (such as medication) or markedly less invasive (such as injections or chiropractic) than surgery. In general, surgery for lower back pain is considered if conservative back care fails and the lower back pain (or leg pain) persists for an extended period of time.

For those patients who have back pain or neck pain, but an anatomical reason cannot be found, surgery is not advisable and conservative treatments are the only recommended course of action.

Contraindications for Conservative Back Care

Conservative treatments like chiropractic care are not the first option of choice is if the patient loses bowel or bladder control, or develops progressive weakness in the legs — these symptoms constitute a medical emergency and require immediate surgery. However, surgical emergencies for back pain are extremely rare and most episodes of lower back pain can be treated conservatively.

The length of time that conservative treatment should continue varies widely. In general, the more pain and dysfunction a patient experiences, the earlier surgical treatments will be considered. The morbidity (e.g. incidence of post-operative discomfort) or extent of the surgery must also be considered, and therefore a microsurgery (small surgery using microscopes) will be considered much earlier than a much more extensive fusion operation.

At the onset of lower back pain it is generally advisable to try one or two days of bed rest to decrease muscle spasm and allow the back to rest. More extensive bed rest seems to be counterproductive because it leads to further deconditioning (weakening) of the muscles that provide critical support for the spine.

In addition to initial bed rest, either one or a combination of several conservative treatment options (possibly including seeing a chiropractor) is often recommended in order to alleviate pain and rehabilitate the lower back.