When a patient comes to us with back pain, they may worry that surgery will be the only answer to their problem.

However, we prefer to delay surgery as long as possible.

This is because there are many less invasive treatment options that are available that may be a better option.

First, the risk of infection is a specter that looms over all surgeries, and back surgery is no different.

Second, the spine is so complex that the risk of damaging even more nerves can lead to the unfortunate consequence of failed back and neck syndrome. Third, back surgery sometimes just doesn’t take away the pain. Then you are back to the conservative measures.

Fortunately, medicine has found many conservative treatments that can keep a patient from taking the risks of back surgery. These methods are minimally invasive, effective with commitment, and have research that supports their usage.

Many spinal surgeons require that you pursue these methods for at least six months before considering a surgical approach. It is to the patient’s benefit to pursue them for a long as possible because surgery may not be the answer.


Medications are usually the first line of treatment for back pain, and they can be some of the most effective interventions in the physician’s arsenal. Many patients think that medications are limited solely to the narcotic medications, but this is thankfully not so. Medications for back pain can start as simply as over the counter non-steroidal anti-inflammatory drugs, such as Advil.

In addition, certain antidepressants, such as the tricyclic drugs, are very effective against the nerve pain caused by herniated discs. Finally, some anti-seizure drugs, such as gabapentin, effect the transmission of pain. A combination of all of these medications can usually control back pain without the use of a narcotic.

Physical Therapy

Physical therapy is much more than simply exercise, and it is probably the single most important conservative treatment for back pain. Working with a trained therapist, you will be guided through exercises that improve the strength and flexibility of your back. These exercises are targeted and professionally observed for proper form, and they can usually help the back adjust to the problem.

Many patients shy away from physical therapy, and that is a mistake. Some don’t feel that it will be effective because they don’t understand the benefits of strengthening supportive muscles. Part of the reluctance to perform physical therapy is the belief that you should not exercise with back pain or exercise will make it worse.

Exercise when performed with a professional is safe and effective for back pain.

Even simple exercises, such as walking, can benefit the back. Immobilization should be strictly avoided due to the deconditioning of muscles and the risk for blood clots.


In the past, many physicians disparaged the benefits of chiropractic, but recently, chiropractors and spinal medical doctors have learned to work in conjunction to benefit the patients. Chiropractic was generally discredited due to some practitioners insisting that the spinal adjustments could cure any disease of the body, and medical doctors were unnecessary. Not only was this false, it was also dangerous.

Today, chiropractors are used to help relieve the pain due to back and musculoskeletal issues. The simple manipulations of the vertebrae are often enough to decrease pressure on nerve roots, relieve tension, and resolve back pain.

They often work in close conjunction with general practitioners and spinal surgeons to safely and conservatively treat back pain. No longer relegated to the fringe of medical science, chiropractors have become a vital part of the back care team.


Injections may make some patients wary, but they are a great, minimally invasive way to decrease back pain. They generally do not hurt: the site of the injection is numbed and the patient usually only feels slight discomfort. However, they can provide powerful pain relief to a back that may not respond to other conservative measures.

Epidural steroid injections are the most common injection to combat back pain. They are particularly helpful against sciatica and any other pain condition that is rooted in radiculopathy. The injection includes a mixture of a steroid to decrease inflammation and an anesthetic to provide immediate relief.

It is usually guided to the correct placement in the spinal anatomy by fluoroscopy, and this means that the risk for inadvertent placement is less likely.

Stem Cell Therapy

Stem cells have gotten a great deal of bad press, but the recent advances in the field have addressed the ethical question stem cells have raised. Although they were never taken from aborted fetuses, they were harvested in ways that were not considered ethically viable.

Today, however, stem cells are harvested from the umbilical cord blood, placenta, and amniotic fluid of mothers who fully consent to the procedure. This means that the stem cells are not harming any children, and they can still help to combat back pain.

What can stem cells do for your back pain? They can help to regenerate tissue that is less likely to regenerate on its own. Stem cells are basically the foundation cells of all tissue. When they are in an environment with specialized tissue, such as ligaments or discs, they can specialize to create these cells.

In most patients, the ability to regenerate these types of cells is not possible, but stem cells allow the tissue the chance to regrow. Like pain injections, these cells are injected into the problem area using fluoroscopy, and the patient could feel relief within a few weeks as the cells begin to repair the tissue.

Sports and Spine Orthopaedics is the premier spinal practice in Los Angeles, and we emphasize the rigorous usage of conservative measures to treat back pain. We have a full department of physical therapists on our staff to work closely with our patients and board certified surgeons.

In addition, we are also pioneers in the field of stem cell therapy using ethically harvested cells, and we can assist you in pursuing this treatment in addition to other pain injections.

If you have back pain, you need to contact Sports and Spine for a thorough assessment and treatment plan.