Nonsurgical Treatment for Back Pain in Adults

If medication doesn’t eliminate your back pain, doctors at NYU Langone's Spine Center may recommend other nonsurgical treatment options before you consider surgery. These may include corticosteroid injections, physical therapy, weight loss, or a combination of these options.

Corticosteroid Injections

If your back pain is caused by a pinched nerve or a herniated disc, a doctor may recommend a corticosteroid injection—usually only after oral corticosteroids have failed to bring you relief. NYU Langone has a dedicated team of pain management specialists who offer steroid injections as a nonsurgical method for pain relief.

Steroids have powerful anti-inflammatory properties and can be injected precisely near the affected nerve in the spine or into the fluid-filled space that surrounds the spinal cord. These injections are performed using local anesthesia, meaning the area is numbed first. Our pain management specialists and radiologists use X-ray guidance to make sure the steroids are injected in the right spot. The procedure typically takes less than 30 minutes.

Pain relief from injected steroids may last anywhere from a week to a year or more. But some people find that injections don’t help them. There is no way to gauge the effectiveness of an injection before the procedure, though for many people, steroids do provide relief. Steroid injections are most effective when used in conjunction with physical therapy, allowing people to build their strength without pain.

Physical Therapy

Physical therapy can be a powerful component of a treatment plan for relieving back pain and preventing further damage to the spine. NYU Langone’s rehabilitation specialists, called physiatrists, and physical therapists at Rusk Rehabilitation work with people who have back injuries. They can create a customized treatment plan based on your daily activities, the location of your pain, and your goals. 

Even if medication is helping to eliminate some of your back pain, core strengthening is an important part of treatment. If muscles in the abdomen, upper thighs, and buttocks are weak, the spine bears more weight. This added pressure can cause instability or make an existing spine problem worse. A physical therapist can provide a series of exercises that can help you to strengthen these core muscle groups and improve posture, all of which can take pressure off of nerves and relieve pain.

A physical therapist can also recommend ways to improve overall spine health, such as stretching, heat and ice therapies, and acupuncture, that make you feel better while you build core muscles.

Weight Loss

Being overweight can cause or worsen spinal conditions. Excess weight, especially in the abdomen, may pull the spine forward and cause a misalignment of the vertebrae, joints, or discs. If you’re overweight and have a herniated disc or degenerative disc disease, this added pressure on the spine may lead to more serious nerve damage and increased pain. 

Our doctors understand that weight loss is not easy, especially if your activity is restricted by a painful condition. NYU Langone’s Weight Management Program offers a variety of services that can help you make positive changes in order to lose weight and improve your overall health.

Smoking Cessation

The nicotine in cigarettes has a direct negative effect on bones and their ability to heal. It can also cause disc degeneration and can make pain medications less effective. Doctors strongly urge smokers to quit smoking if they have had spinal surgery or are pursuing treatment using medications and physical therapy. Our doctors and therapists understand that quitting is not easy and offer ways to help through NYU Langone’s Tobacco Cessation Programs.

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