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What is Non-surgical Treatment of the Spine?
Non-surgical treatment of the spine, sometimes referred to as "conservative" treatment is used to describe any treatment or therapy that does not involve surgery. In fact, the vast majority of back or neck problems are successfully resolved with treatments or therapies that do not involve surgical procedures.
For example, treatment may be as simple as reassurance that the problem is not serious and all that is needed is to refrain from certain activity while the body heals. Other non-surgical treatments include preventative measures, such as learning to protect the spine when lifting and doing exercises to strengthen it. The goal of any treatment - conservative or surgical - is to reduce pain, limit further degeneration, and get you back to your activities as soon as possible.
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What Conditions can be Treated Non-surgically?
As mentioned, most back and neck problems can be treated conservatively. In fact, surgery is not considered until nonsurgical or conservative treatments have failed to provide relief. Symptoms such as headaches, sciatica, and pain in the neck, arm, and lower back can often be successfully treated by non-surgical measures. These symptoms are most often caused by conditions such as disc herniation, muscle strains, arthritis, and spinal stenosis.
What are Some of the Types of Non-surgical Treatments?
There are many types of non-surgical treatments available today, and of course, your particular diagnosis will determine which treatments may be recommended. Non-surgical treatments include:
Physical Therapy - Physical therapy can help you stretch, strengthen and exercise your back or neck in ways that can relieve discomfort and help prevent future episodes of pain. Physical therapists can educate you on proper ways to move, how to maintain correct posture, as well as the anatomy of the spine. They also work with your doctor to determine if other treatments such as heat, ultrasound, massage, or spinal manipulation may be helpful.
Epidural Steroid Injections - Epidural steroid injections (ESI) involve an injection of steroid and anesthetic directly into the area of inflamed nerves in the back. This inflammation is usually the result of nerve compression caused by a narrowed spinal canal (spinal stenosis) or a herniated disc. The anesthetic acts to block the pain while the steroid works to reduce inflammation. The injections are generally done on an outpatient basis and take about 15 to 30 minutes to administer. While the injections can offer short or medium term relief, they do not "cure" the underlying problem. They can ease symptoms while you undergo a physical therapy program or considering surgical options.
Facet Joint Injections - Facet joints are the small joints between vertebrae along the back of the spine. There are two primary reasons for injecting these joints. First, because a numbing medicine is injected initially, the amount of immediate pain relief experienced will help confirm or deny the joint as a source of pain. A second injection of long acting steroid reduces inflammation and can often provide long-term relief.
Nucleoplasty - A nucleoplasty is a minimally invasive procedure that is used for alleviating back and leg pain caused by a herniated or bulging disc. Rather than making an incision, the physician uses xray guidance to place a needle-like device inside the problem disc to remove tissue. The device is then heated to shrink the disc, which in turn decompresses the area and reduces the pressure both inside the disc and on the nerve roots.
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