Treatments for back pain may include:
Medications. Prescription drugs such as nonsteroidal anti-inflammatory drugs and muscle relaxants may relieve mild to moderate back pain. Your doctor may advise corticosteroid injections to ease more severe back pain.
Heat, cold and massage. When performed by a licensed professional, applications of heat, cold and gentle massage may relieve back pain due to muscle spasms. A word of caution — manipulation of your spine may aggravate a disk problem or cause compression fractures if you have osteoporosis. Ask your primary care doctor if spinal manipulation is safe and helpful for you.
Electrical stimulation. Transcutaneous electronic nerve stimulation (TENS) may help stop pain by blocking nerve signals from reaching your brain. A physical therapist places electrodes on your skin near the area of your pain. TENS may relieve pain in your leg due to inflammation or compression of nerves in your back (sciatica), but it may provide little relief for chronic back pain.
Back schools. These programs, available in many communities, focus on managing back pain and preventing its recurrence. Classroom study generally involves back anatomy and function, followed by practice sessions on how to protect your back at home and work.
Exercise and physical therapy. Once your pain subsides, your doctor or a physical therapist can design an exercise program to improve your flexibility, strengthen your back and abdominal muscles and improve your posture.
You probably won't need surgery for back pain. The pain and disability caused by a herniated disk or spinal stenosis frequently diminish with conservative treatment. If you have unrelenting pain or progressive muscle weakness caused by nerve compression, you may benefit from surgery. Common back surgeries include:
Laminectomy. This procedure may relieve leg pain by removing bone spurs or disk fragments that protrude into your spinal canal or press on nerve roots within your spine.
Fusion. This surgery involves joining two vertebrae to eliminate painful movement. A variety of metal implants also are available to help accomplish the fusion.
Before you decide on back surgery, consider getting a second opinion. Surgery to remove a herniated disk is among the most frequently performed procedures in the United States. This surgery carries little risk, and the results usually are good. But long-term outcomes also are often similar following less-invasive treatments.