Non-Surgical Treatment Options for the Spine

Integrated Care With Excellent Specialists

Spine conditions may impact the life of the patient in numerous ways. For this reason, from a medical point of view, the health of the spine is of major importance, and no spine condition is to be taken lightly.

Trained spine specialists at Cedars-Sinai Marina del Rey Hospital's Marina Spine Center will help patients find a suitable treatment program that responds to the challenges raised by every single specific condition and medical history.

Our spine specialists think of surgical spine treatments as a last resort that should be turned to only when non-surgical treatment options prove to be inefficient, or produce no satisfactory result.

Experience in the treatment of thousands of people with back pain shows that in a significant number of cases, patients are able to return to pre-injury activities, without undergoing any type of surgery.

Non-surgical spine treatment options include:

  • Chiropractic and osteopathic therapy
  • Medications
  • Mobilizations
  • Computerized biofeedback for muscle training
  • Physical therapy
  • Spinal injections
  • Diathermy, laser and ultrasound

According to chiropractic medicine, joint dysfunction in the lower spine causes lower back pain. What chiropractors do is a type of manipulation therapy of the spine for the treatment of functional loss caused by dislocated vertebrae. Chiropractic techniques are usually painless and often offer immediate relief. These include:

  • Motion palpation

    Examination by hand, aimed to assess vertebrae movements and joint dysfunction.

  • Release work

    Fingertip pressure to gently separate the vertebrae.

  • Toggle drop

    Quick and precise thrust that improves joint mobility.

Treatments for lower back pain

Osteopathic specialists may come from different fields of medicine. Osteopathic experts at Marina Spine Center are trained to understand and work together with some of the natural processes of the musculoskeletal system, such as self-regulation and self-healing. Treatments for lower back pain administered by osteopathic specialists depend on the actual condition of the patient, and may include one or more of the following:

  • Counterstrain
  • Massage
  • Myofascial Therapy
  • Muscle Energy
  • Soft Tissue Mobilization

In physical therapy and rehabilitation medicine massage techniques are used to achieve pain relief and health restoration. The many benefits that massage techniques used in spine therapy offer include:

  • Alleviation of muscle cramps
  • Calming of the nervous system
  • Decrease of inflammation
  • Improvement of blood circulation
  • Release of endorphins
  • Release of toxins in the muscles

Chronic back pain can evolve into serious phases where even a simple sleep may seem to be an unrealistic goal. By allowing spine patients to feel relaxed, massage therapy has a significant psychological impact on the overall physical health.

Myofascial therapy is also known as myofascial release therapy or myofascial trigger point therapy. The term covers a low load stretch that aims to release tightness and pain caused by chronic muscles pain with trigger points (otherwise called myofascial pain syndrome).

Administered by spine specialists with extensive training, the procedure is safe and does not pose any health risks. Myofascial therapy sessions are conducted in a similar way with how physical therapy for post-operative rehabilitation is performed. During a first appointment spine specialists at Marina Spine Center will locate the exact areas of the fascia that show restriction, and will measure the level of motion loss and loss symmetry in the body of the patient. Subsequent therapy is later tailored to fit the specific needs of every single patient.

Biofeedback therapy may be viewed as the Western way to incorporate ancient Eastern medicine concepts into the modern medical treatment approach. These ancient concepts emphasize the importance of the power of the mind in controlling physical health.

A popular therapy nowadays in pain rehabilitation, biofeedback is a scientific method that involves the use of electrodes attached to the body. These electrodes then transmit information that allows medical specialists to monitor various factors such as body temperature, heart rate, muscle tension, skin resistance, perspiration rate, etc.

Biofeedback is an efficient instrument that can also be used to help patients learn the effects of stress or relaxation over body functions. Learning to control heart rate and muscle tension for example, leads to better pain management abilities.

Diathermy, a form of physical therapy, is a process through which an electric current is used to produce heat inside targeted tissues, with the aim to release tension and kill pain. Instead of heat being applied directly on the body, the electrical machine used in diathermy makes the targeted tissue generate heat from within.

As a consequence, blood flow and flexibility are immediately improved, which leads to a decrease of inflammation and pain.

Types of diathermy applied by physical and occupational therapists at Marina Spine Center are:

  • Ultrasound

    Ultrasound diathermy is performed with the use of high frequency acoustic vibrations. It is particularly beneficial for alleviating pain in the muscle tissues.

  • Short wave

    Heat is generated by applying high frequency electromagnetic energy over the affected area. It can be effectively used in the treatment of deep muscle and joint injuries.

  • Microwave

    Microwaves employed here are higher in frequency and shorter in length. It is only employed for the treatment of regions which are closer to skin.

Laser therapy is a non-invasive procedure that allows patients to experience pain relief and life-quality restoration, without having to take medication. When administered by experienced spine specialists with thorough training, cold laser therapy does not have serious side.

Medications in spine therapy are used to lessen swelling and reduce pain in the back and neck. Since all medications have side effects and contraindications, it is compulsory to consult with a trained spine specialist before launching any medication plan.

Our medical experts at Marina Spine Center will recommend each patient the type of medication most suited for the type of back pain, the manifested symptoms and the level of pain.

The most commonly used medications include:

  • Acetaminophen (Tylenol)
  • Aspirin for pain relief
  • Narcotic drugs
  • Anti-depressants
  • Muscle relaxants
  • Oral steroids
  • Non-Steroidal Anti-Inflammatory Drugs

Depending on the way they are administered, medications can be classified into:

  • Oral pain medications, in pill or liquid form
  • Topical pain medications, which are applied to the skin and help reduce localized pain
  • Injections, which allow the introduction of the medications directly to the source of the pain

How these medications affect the body, what side effects they may have and what are their specific contradictions, are all questions which need to be answered by medical specialists with extensive knowledge and vast experience in the treatment of spine conditions. Should you experience chronic or acute neck and back pain that alters your quality of life, do not hesitate to consult our spine specialists at Marina Spine Center.

Mobilizations mainly consist of passive movements with the purpose to provide short term pain relief and to restore pain-free, functional movement. Medical specialists at Marina del Rey Hospital trained in the administration of mobilizations are called physiotherapists. This treatment technique can be effective in the management of musculoskeletal dysfunction, since it is capable of improving mobility in the restricted area of the spine.

Mobilizations that involve pressure onto the vertebra are not only used to increase joint range of motion, but also to produce an analgesic effect to treat five symptom groups:

  • Pain
  • Stiffness
  • Pain associated with stiffness
  • Momentary thrusts of pain
  • Diagnosis-specific disorders

Since spine conditions require a delicate approach in each case, and mobilizations as a therapy technique may have numerous contraindications, these procedures may only be performed after in-depth health assessment, and by thoroughly trained and knowledgeable spine specialists.

The key to our physical therapy program is to train muscles to keep the spine in a neutral pain-free position. This entails trunk stabilization exercises for the low back and chest-out posture exercises for the neck and upper back. The basic concept is for the muscles to prevent abnormal motion and to offload pathologic discs and facet joints of the spine.

This is the same program that we use to treat professional athletes from all over the world. We refer our local patients to trusted therapists from Bakersfield to San Diego. The trunk stabilization program is the most effective way to avoid surgery, and to get a good result after surgery.

Regardless of the actual type of physical therapy recommended, it is important to begin the exercise program under the supervision of a trained therapist who can instruct and ensure proper positioning and mechanics. Our entire program can eventually be performed by the patient alone with a few simple weights, pulleys, and exercise ball.

The trunk stabilization program is the best way that you can treat yourself, for the rest of your life! Should you need assistance or detailed information, we are happy to send a copy of our program to physical therapists.

Facet joint, nerve root, and epidural injections can help many patients with spinal pain. The injection is typically a combination of anti-inflammatory steroid and numbing medicine (Marcaine). Injections are usually a quick, low risk, and painless experience.

In our practice, we do not think of injections as changing the inherent pathology (i.e. the injection will not decrease the size of a herniated disc). In some cases, the injections can decrease the pain to allow the patient to tolerate the time it takes for the natural healing process to occur.

In other cases, the injections can decrease the pain to enable the patient to be most effective in physical therapy, which allows the muscles to take pressure off the spine. Either way, injections are an important part of our practice when trying to help a patient avoid surgery. Common types of injections for back pain relief administered at Marina Spine Center include:

  • Epidural
  • Selective nerve root block (SNRB)
  • Facet joint block
  • Sacroiliac joint
  • Vertebroplasty

Epidural injections of cortisone are meant to reduce inflammation or swelling of the nerves in the epidural space. Effects include decreased pain, tingling and numbness. Depending on the condition and level of dysfunction in the body of the patient, one or more injections may be needed to relieve symptoms.

Selective nerve root block (SNRB) injections are destined to deliver medication into the space around spinal nerve roots. The aim of SNRB is to determine the location of a specific spinal nerve root and to provide relief of pain caused by the irritated spinal nerves. Beside this, SNRB injections are often used in the therapeutic treatment of disc herniations.

Facet injections release pain in irritated joints, bone spurs and other conditions that are a result of age or injury. Facet injections act like WD40 on a rusty door hinge, restoring movement in stiff or dysfunctional joints.

Trigger points are painful tissues in and around muscles, which under pressure will cause sharp pain sensation. Trigger point injections are local anesthetics or steroid medications that are administered in the muscles, to relieve spasms and achieve pain relief.

Sacro-Iliac (SI) joint injections are actually long-effect steroids (cortisone) that are injected into the sacro-iliac joint, where they help decrease inflammation or swelling of tissue in the joint space. Effects include reduced pain and inflammation of the joint. As shown by the experience of the spine specialists at Marina Spine Center, symptom relief may require the administration of more than one injection.

Vertebroplasty is a spine treatment procedure performed as an outpatient technique that stabilizes compression fractures in the spine. During vertebroplasty, bone cement is injected into the cracked or broken vertebrae. This injected cement later hardens and by doing so, stabilizes the fractures and supports the spine. Vertebroplasty is an efficient spine treatment procedure that spine specialists at Marina Spine Center perform to reduce pain and allow their patient to return to their normal daily life.

Though the medical procedures listed above are the ones most commonly performed by the medical experts at Marina Spine Center, there are several other types or procedures available to patients with neck and back pains. Some of these include:

  • Acupuncture

    To control the energy flow and restore energy balance, acupuncture specialists make use of thin needles that are inserted at specific points along meridians.

  • Exercise

    Exercise and movement are of great help in improving tissue strength, back support and injury resistance. Exercise and activity may act as a lubricant generator for the back muscles and joints.

  • Regenerative medicine

    Regenerative medicine is a field of medicine that helps restore tissue and joint conditions related to aging, and is also used in accelerating healing processes after injury.

Marina Spine Center is dedicated to offer thorough information to patients about all available spine treatment options, with special emphasis on advanced techniques and up-to-date, relevant data. Our medical experts and knowledgeable medical specialists will gladly help you choose the most appropriate treatment plan to suit your specific condition and group of symptoms.