7/31/2019 7 Ways to Treat Chronic Back Pain Without Surgery | Johns Hopkins Medicine

Health
(/health)

7 Ways to Treat Chronic Back Pain Without

Surgery
 Back and Neck Pain (/health/conditions-and-diseases/back-pain)
 Pain and Palliative Care (/health/wellness-and-prevention/pain-and-palliative-care)
 Chronic Pain (/health/wellness-and-prevention/chronic-pain)
 Pain Management Procedures (/health/treatment-tests-and-therapies/pain-management)

Reviewed By:
Andrew Manuel Nava, M.D. (https://www.hopkinsmedicine.org/profiles/results/directory/profile/10003933/andrew-nava)

B
ack pain is considered chronic if it lasts three months or longer. It can come and go, often bringing temporary
relief, followed by frustration. Dealing with chronic back pain can be especially trying if you don’t know the
cause.

Back pain rehabilitation (http://www.hopkinsmedicine.org/physical_medicine_rehabilitation/services/outpatient/back_neck.html)

specialist Andrew Nava, M.D. (https://www.hopkinsmedicine.org/profiles/results/directory/profile/10003933/andrew-nava) ,
offers insights into common chronic back pain causes and nonsurgical treatment options—and advises not to give up
hope.

Common Causes of Chronic Back Pain

Chronic back pain
(http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/spine_shoulder_and_pelvis_disorders/chronic_pain_85,P01366/) is

usually age-related, but can also result from a prior injury. The most common causes include:

Arthritis of the spine

(http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic_disorders/arthritis_85,p00902/) —the gradual

thinning of the cartilage inside the spine

Spinal stenosis
(http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic_disorders/lumbar_spinal_stenosis_134,18/) —

narrowing of the spinal canal that may lead to nerve pain

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7/31/2019 7 Ways to Treat Chronic Back Pain Without Surgery | Johns Hopkins Medicine

Disc problems, such as a herniated or bulging disc

(http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/nervous_system_disorders/lumbar_disc_disease_herniated_disc_

85,p00783/)

Myofascial pain syndrome—unexplained muscle pain and tenderness

In some cases, it’s difficult to pinpoint the cause of chronic back pain. “If your doctor has exhausted all diagnostic

Physical Therapy
Exercise is the foundation of chronic back pain treatment. It’s one of the first treatments you should try under the
guidance of your physician and spine physical therapist. However, the same set of exercises doesn’t work for
everyone, says Nava. The exercises have to be tailored to your specific symptoms and condition. Maintaining the
exercise routine at home is also a big part of success.

Physical therapy for chronic back pain may include:

Retraining your posture

Testing the limits of pain tolerance

Stretching and flexibility exercises

Aerobic exercises

Core strengthening

Mindfulness and Meditation

Chronic back pain is straining both physically and emotionally. To manage the frustration, irritability, depression and
other psychological aspects of dealing with chronic pain, you may get referred to a

rehabilitation psychologist
(http://www.hopkinsmedicine.org/physical_medicine_rehabilitation/services/outpatient/psychology_neurophsychology.html).

This specialist may recommend meditation yoga tai chi and othercognitive and relaxation strategies to keep your

When is Surgery a Good Idea for Back Pain?

These red flags can be indicators for surgery, if they’re found to be related to your spine condition:

New or progressing bowel/bladder issues

Weakness in limbs

Gait and balance problems

Evidence of increased (brisk) reflexes

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7/31/2019 7 Ways to Treat Chronic Back Pain Without Surgery | Johns Hopkins Medicine

Surgery can also be an option for chronic back pain if there is a known cause confirmed by imaging and if other
treatments didn’t help. “Get opinions from at least two surgeons,” suggests Nava, “as pain can still come back after the
surgery.”

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Maryland

855-695-4872 (tel:855-695-4872)
Outside of Maryland

+1-410-502-7683 (tel:+1-410-502-7683)
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Related
Spinal Stenosis
(/health/conditions-and-diseases/spinal-stenosis)
Sciatica
(/health/conditions-and-diseases/sciatica)
Lumbar Disk Disease (Herniated Disk)
(/health/conditions-and-diseases/lumbar-disc-disease-herniated-disc)

Related Topics
Back and Neck Pain (/health/conditions-and-diseases/back-pain)
Pain and Palliative Care (/health/wellness-and-prevention/pain-and-palliative-care)
Chronic Pain (/health/wellness-and-prevention/chronic-pain)
Pain Management Procedures (/health/treatment-tests-and-therapies/pain-management)
Pain Management (/health/wellness-and-prevention/pain-management)

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