Non Surgical Treatment Options for Back and Neck Pain with Dr Robert Feldman

Non Surgical Treatment Options for Back and Neck Pain with Dr  Robert Feldman


– So if a patient is
sent to me for back pain, neck pain, arm pain or leg pain, numbness, tingling, weakness. A question that they often ask is, well, why am I coming
to see you right now, you’re a neurosurgeon. Do I have to have surgery
for this right away? The typical answer actually is no. And there are only a couple of reasons why I would tell a patient that I would recommend surgery right away or before they try other options. And that’s usually if the
patient is in so much pain that they can’t function. Where they’re requiring so much medication that they can’t function, or they have a neurological deficit. A neurological deficit
typically involves weakness in the extremities or bowel and bladder, symptoms of incontinence or retention. And those types of symptoms
you wanna take care of quickly because they can be permanent. So, if the patient doesn’t
have those few symptoms, it’s always a good idea
to try other things first, and the reason for that is
that statistics show 90, 95% of patients will get better and improve without surgical intervention. So it’s really a very
small percentage of people that actually need surgery
to fix the problems that occur because of a
degenerative disc pinches a nerve or causes pain. So what other options does a patient have? Well, I often tell patients,
they’ve really got two options. Two other options. One is to do nothing,
ignore it, put up with it. Go live your life and see if
you could put up with the pain. The other option is called
conservative therapy. And conservative therapy basically means, anything but surgery. And that includes things
like anti-inflammatories, and this could be over the
counter medications like Motrin, Ibuprofen, Advil, Aleve, et cetera. Or prescription nonsteroidal
anti-inflammatories like Celebrex or Naprosyn, or Mobic, types of prescription anti-inflammatories. Other medications include muscle relaxants and pain medications. Those are often used as needed, whereas the anti-inflammatories can often be used prophylactically, which means you would
take it every morning or every evening as opposed
to just when you’re hurting. Other conservative therapies
include physical therapy, heat, ice, massage,
chiropractor, acupuncture, wearing a back brace,
traction inversion therapy, creams, rubs, patches, steroid pills, steroid shots, things like that. And in my view of the
spectrum of treatments, pain management with injections is sort of the last option
of conservative therapy before you would consider
surgical intervention. Pain management with
injections involves needles. And that’s technically invasive. So that would really be at the end of the conservative therapy
spectrum you would want to try. And that would involve steroid injections around the joints of the spine
and the nerves of the spine, which can calm down inflammation, as well as injections
in the joints themselves to numb up or burn the
little nerves and the joints that tell the brain they’re upset, which in turn, the brain will
then tighten up the muscles to try and keep everything still. So injections is a very effective but sort of your last ditch effort
before you would come to see someone like me to
actually operate on the problem. There are also a lot of
alternative therapies out there. The only problem with those is that, there really is no data that
shows they actually work. But I know many patients
that have tried them and felt they worked. So it may not be a bad idea to try them. And we’re talking things
like glucosamine chondroitin, special arthritic ointments
that you can get online, holistic medications or
natural foods and medications to help the body heal. Again, no real scientific
evidence that those things work, but probably very little downside so you can certainly
consider giving them a try.

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