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What are my treatment options?

Treatment depends on what is causing your pain and if your pain is acute or chronic. Know that you have options! Narcotics and surgery are not the only answers.

WHAT KIND OF PAIN IS IT?

  • Acute pain is pain that hits you suddenly after an accident, a fall or lifting something heavy. Acute pain is the most common type of back pain and lasts no longer than 6 weeks.
  • Chronic pain may come on either quickly or slowly and lasts a long time, generally longer than 3 months. This type of back pain is much less common.
Pain Continuum of Care
Continuum of treatments listed from least invasive and likely less expensive to most invasive and likely more expensive
Home Care and Pain Management
  • Keep moving and stick to your daily activities.
  • Apply heat or ice.
  • Take over-the-counter pain relievers.
  • Apply topical pain relievers.
  • Try stretching exercises.
Massage

DID YOU KNOW?
Studies have shown that massage is an effective treatment for reducing stress, pain and muscle tension.

  • If your pain is caused by tense or overworked muscles, massage may help.
  • Massage therapy is offered at health clubs, spas, clinics and hospitals.
  • Several types of massages are considered part of complementary and integrative medicine (i.e., chiropractic care) along with standard treatment. 

Types of massage:

Swedish massage  A gentle form of massage that uses long strokes, kneading, deep circular movements, vibration and tapping to help relax and energize you.

Deep tissue massage – Slower, more forceful strokes target the deeper layers of muscle and connective tissue, commonly to help with muscle damage from injuries.

Sports massage  Geared toward people involved in sports activities to help prevent or treat injuries.

Trigger point massage – Focuses on areas of tight muscle fibers that can form in your muscles after injuries or overuse.

Physical Therapy
  • May include a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques to reduce pain.
  • Physical therapists can work with you to prevent the loss of mobility by developing a fitness- and wellness-oriented program for a healthier and more active lifestyle.
Chiropractic/Spinal Manipulations

DID YOU KNOW?
Spinal manipulations provided primarily by chiropractors have been shown to provide mild-to-moderate relief from low back pain.

  • Spinal manipulations may help relieve your back pain.
  • Spinal manipulations are performed by a chiropractor using his or her hands, or by using a device to apply controlled force to a joint of the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function and supporting your body's natural ability to heal itself.
  • Chiropractors may combine the use of spinal adjustments and other manual therapies with several other treatments and approaches, such as:
    • Heat and ice
    • Electrical stimulation
    • Rehabilitative and general exercise
    • Relaxation techniques
    • Counseling about diet, weight loss and other lifestyle factors
    • Dietary supplements
  • Many health plans include coverage for chiropractic care. Review your plan documents for what may be included with your plan. 
Acupuncture

DID YOU KNOW?
For patients with chronic low back pain, the American College of Physicians recommends initially selecting from several non-drug therapies that include acupuncture. 

  • Has been reported to help relieve low back pain.
  • An acupuncturist inserts sterilized stainless-steel needles into the skin at specific points on the body.
  • Believed to help clear away blockages in the body’s life force known as Qi (pronounced chee).
  • May also help to release naturally occurring painkilling chemicals such as endorphins, serotonin and acetylcholine.
Traction
  • Uses weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment.
  • May result in pain relief while in traction, but pain typically returns once the traction is released.
  • No evidence that traction provides any long-term benefits for people with low back pain.
Prescription Medications

OPIOID WARNING
Prescription opioids may be used to treat chronic and acute pain and, when used appropriately, can be an important component of treatment. Serious risks are associated with their use, including misuse, addiction, overdose and death.

  • Muscle relaxants. Sometimes prescribed along with over-the-counter pain relievers to relieve the symptoms of back pain or muscle spasms. These medicines may make you dizzy and sleepy.
  • Narcotics. Incudes drugs containing opioids, such as oxycodone or hydrocodone. May be used to relieve pain for a short time with close supervision by your doctor.
  • Antidepressants. Low doses of certain types of antidepressants have been shown to relieve some types of chronic back pain independent of their effect on depression.
Epidural Steroid Injections

DID YOU KNOW?
Epidural steroid injections provide short-term pain relief in at least one-half of the people who receive them. Symptoms may remain better for weeks or months but rarely up to a year.

  • Injection(s) into the space around your spinal cord (epidural space).
  • Steroid is cortisone — an anti-inflammatory medication — or numbing medication.
  • May help decrease inflammation around the nerve roots.
  • Pain relief usually lasts less than a few months.
Surgery

DID YOU KNOW?
In general, surgery is recommended only if there is evidence of worsening nerve damage and when diagnostic tests indicate structural changes for which corrective surgical procedures have been developed.

  • Few people need surgery for back pain.
  • You’ll want to make sure you’ve tried all other options first.
  • It’s recommended to get a second opinion if surgery is suggested.
  • Surgery doesn’t always work and it can take months to recover.
  • Some of the more common surgeries include:
    • Spinal fusion: Permanently connects 2 or more vertebrae in your spine to improve stability, correct a deformity or relieve pain.
    • Spinal laminectomy: Also known as spinal decompression. Opens up your spinal canal to take pressure off your spinal nerves or spinal cord. It may also be done to remove bone spurs in your spine.
    • Discectomy or microdiscectomy: Removes all or part of a disc in cases where it has herniated and presses on a nerve root or the spinal cord, causing pain.
Alternative and Integrative Health Care Approaches*

Some common treatments include:

  • Massage
  • Acupuncture
  • Acupressure
  • Transcutaneous electrical nerve stimulation (TENS)
  • Biofeedback
  • Meditation
  • Yoga
  • Cognitive-behavioral therapy
  • Natural herbs, vitamins and dietary supplements  

Health care approaches
Alternative:
When non-mainstream practices are used in place of conventional medicine, it’s considered alternative.

Complementary: When non-mainstream practices are used together with conventional medicine, it is considered complementary.

Integrative: Emphasizes a holistic, patient-focused approach to health care and wellness. When conventional health care and alternative approaches are brought together in a coordinated way to treat the whole person rather than one health condition.

*Member benefit coverage varies. Please refer to plan-specific information for current coverage information. Some of the recommended alternative medications listed above should be avoided and/or used with extra caution in the elderly population. Alternatives aren’t intended to replace a clinician’s clinical judgment.