Non-Surgical Treatments & Physiotherapy
Many spinal conditions affecting the lumbar spine can be managed successfully without surgery. A wide range of non-surgical treatments is available for lower back pain, leg pain and sciatica, and these options are often recommended before surgical intervention is considered.
Non-surgical management is tailored to the individual and may include medication, injections, physiotherapy and other supportive treatments aimed at reducing pain, improving function and preventing recurrence.
Pain Medication
Pain medication may be used to help manage symptoms of lower back pain and leg pain. Commonly used medications include paracetamol, non-steroidal anti-inflammatory drugs, oral steroids, opioid medications, muscle relaxants and certain antidepressants.
Each type of medication has specific benefits, limitations and potential side effects. The choice of medication depends on the underlying spinal condition, symptom severity and the patient’s general health.
Injections
Epidural steroid injections are a commonly used non-surgical treatment for lower back pain and sciatica. They have been used for spinal conditions for many decades and remain an important part of non-operative care.
The aim of an injection is to reduce inflammation and relieve pain. In some cases, an injection alone may provide sufficient symptom relief. More commonly, injections are used alongside a structured rehabilitation programme to improve overall outcomes.
Injections may provide relief for some patients but not all. They can also be helpful in identifying the source of pain within the spine.
Heat and Ice Therapy
The application of heat or ice can help reduce lower back pain and muscle discomfort. Some patients find benefit from cold packs, while others prefer heat. Alternating between heat and ice may be effective for symptom relief.
Manual Manipulation
Manual manipulation may be provided by a chiropractor, osteopath or other suitably trained healthcare professional. This approach aims to reduce pressure on sensitive spinal structures, improve flexibility, increase blood flow and reduce muscle tension.
Physiotherapy
Physiotherapy is often recommended when lower back pain persists for more than two to six weeks or when symptoms recur frequently. Physiotherapy focuses on reducing pain, improving movement and restoring function.
A key component of physiotherapy is patient education, including advice on posture, activity modification and exercises designed to reduce the risk of future episodes.
Components of a Physiotherapy Programme
Physiotherapy for back pain usually consists of both passive and active components.
Passive Physiotherapy
In the early stages, physiotherapy may focus on reducing pain using passive treatments. These are treatments applied to the patient and may include:
- Heat or ice packs
- Transcutaneous electrical nerve stimulation (TENS)
- Iontophoresis
- Ultrasound therapy
Active Physiotherapy and Exercises
Active rehabilitation is essential for long-term recovery and spinal health. Exercise programmes are tailored to the individual and typically include a combination of strengthening, stretching and low-impact aerobic exercise.
Stretching Exercises
Stretching plays an important role in managing lower back pain. Regular stretching of the hamstring muscles is commonly recommended and is most effective when incorporated into a daily routine. Additional stretches may be prescribed depending on individual needs.
Therapeutic Massage
Massage therapy may be used as part of a physiotherapy programme to improve circulation, reduce muscle stiffness and relieve tension within the lower back.
Exercise and Conditioning
Structured exercise programmes often include core strengthening, flexibility exercises and low-impact aerobic activities. These exercises aim to support the spine, improve endurance and promote long-term spinal health.
Assessment by a Spine Surgeon in Nottingham can help determine the most appropriate non-surgical treatment plan and identify when surgical intervention may be necessary.