Conservative vs Aggressive Treatment Options for Back Pain
Back pain can be very uncomfortable to live with and affect your ability to do daily activities, sleep, and much more. Depending on the source of the pain, your doctor may elect to try a variety of treatment options. Some treatments are considered more conservative while others are more aggressive. Differences between the two are explained below.
Conservative
Conservative treatment is generally considered nonsurgical and aims to improve a patient’s ability to function. [1] There are numerous options available that your physician may elect to try for your individual circumstances. Some include physical therapy, diet changes, lifestyle modifications, injection-based treatments, alternative treatments and/or medications. [2} Physical therapy involves working with a physical therapist to perform certain exercises that may improve symptoms and reduce pain. Treatment is individualized and often requires constant practice to see results. This means sometimes doing exercises at home if one is able. [3]
Diet and lifestyle play a large role in one’s overall health. Foods leading to inflammation can exacerbate pain while carrying excess weight can increase pressure on the spine. [4] Furthermore, making lifestyle changes – such as quitting smoking – can also improve one’s symptoms and health over time. [5]
In some cases, your physician may recommend injection-based treatments. These include nerve blocks, steroid injections, nerve ablations, and more. [6] While these treatments often only provide temporary relief, they can be quite effective depending on one’s circumstances. [7] It is important to note that these are often not long-term solutions, and your physician may recommend additional treatment to accompany injections. [8]
Lastly, your physician may recommend medications to treat pain. There are a wide variety of medications available for treatment, with the most common being nonsteroidal anti-inflammatory drugs (NSAIDs). [9] However, there are other medications available as well – muscle relaxers, and in some cases of chronic back pain, opiate-based narcotics. [10] While this is not an exhaustive list, your physician will work with you to decide which medications are best for your condition.
With most conservative treatment options, your physician may elect to try several at once. For example, they may simultaneously prescribe muscle relaxers and physical therapy. If these treatments do not work, or you have a more serious condition, your physician may recommend more aggressive treatment options, which are described below.
Aggressive
Some conditions that cause back pain require more aggressive treatments. Most commonly, this involves surgery. There is a broad scope of surgeries that treat back pain, but what type of surgery may be necessary for you depends on your specific condition. A discectomy might be performed to address disc herniation, a laminectomy to address spinal stenosis, or fusion to stabilize parts of the spine. [11] This is by no means an inclusive list of surgical options available, and your physician will work with you to discuss if this is the best option for your individual circumstances.
Sometimes back pain can be caused by the growth of a tumor. When this occurs, your physician may recommend radiation to shrink or destroy the tumor altogether. This can relieve pressure on the spinal cord and lower the risk of nerve damage over time. [12] This treatment option may require one or more hospital visits in which doses of radiation are carefully directed to the part of the spine affected by the tumor. [13] While this treatment may have side effects that may leave one feeling tired or sick, there are medications that may be given in conjunction with this therapy to lessen the symptoms. [14]
In many cases, surgery and radiation treatments are combined to provide the best possible result. For example, spine tumor surgery might be followed by radiation to prevent tumor regrowth. In other cases, radiation may precede spine tumor surgery to shrink the tumor enough for the surgeon to operate more efficiently.
Summary
What might warrant conservative vs aggressive treatment? This depends on your individual diagnosis and a variety of other factors your physician will discuss with you. While back pain can be quite a nuisance, there are a broad scope of treatment options available. The ones described above are but a few of what may be possible based on your circumstances.
