Non-Surgical Treatment for Back, Neck and Nerve Pain

Not every spine problem starts with surgery. For many people with neck pain, back pain, sciatica or a pinched nerve, Dr. Grunch begins with treatments that calm pain and help the body heal, such as therapy, medicine and targeted injections. She works closely with trusted physical therapists, hand therapists and pain management specialists, and she follows your progress along the way.

When these treatments do not bring enough relief, or when there are warning signs such as weakness, surgery can often correct the problem. This guide explains each non-surgical option, how it works and what to expect.

• Physical therapy: strengthens and loosens the spine and core, and is often the most important first step
• Occupational and hand therapy: splints, exercises and daily-life skills for carpal tunnel, nerve injuries and recovery after surgery

• Medications for back, neck and nerve pain: anti-inflammatories, nerve pain medicines, muscle relaxants and how to use them safely

Pain management specialists use image-guided injections to calm inflamed nerves and joints, and to pinpoint where pain is coming from.

• Epidural steroid injections: calm pinched-nerve pain that travels into the arm or leg
• Selective nerve root blocks: target one specific nerve to relieve pain and confirm the source
• Facet joint injections: treat arthritis pain in the small joints of the spine
• Medial branch blocks: a test to see whether facet joints are causing your pain
• Radiofrequency ablation (facet ablation): quiets the nerves to painful joints for months of relief
• SI joint injections: treat and diagnose buttock and low back pain from the sacroiliac joint
• Trigger point injections: relax painful muscle knots in the neck, shoulders and back
• Occipital nerve blocks: treat headaches and pain at the back of the head
• Basivertebral nerve ablation (Intracept): for chronic low back pain from the vertebral endplates

For long-lasting pain that has not responded to these treatments, a spinal cord stimulator may help. See our guide to chronic pain and spinal cord stimulation.

Call us or seek care promptly if you have:

• New or worsening weakness in an arm or leg, or foot drop
• Clumsy hands, trouble with balance or walking
• Pain that keeps you from working or sleeping despite treatment
• Pain that keeps returning after injections wear off

Call 911 for new loss of bladder or bowel control, numbness in the groin or inner thighs, or sudden severe weakness. These can be emergencies.

When a nerve or the spinal cord stays compressed, surgery can often correct the problem. Learn more about the procedures Dr. Grunch performs and choosing a spine surgeon.

Do I have to try physical therapy before spine surgery?

Many patients start with physical therapy, and many insurance plans require a trial of conservative care before surgery. But if you have significant weakness, spinal cord compression or an emergency such as cauda equina syndrome, surgery may be recommended sooner.

Who performs spine injections?

Injections are usually performed by pain management or interventional specialists. Dr. Grunch works closely with trusted specialists and refers patients when an injection is a good next step.

Do injections fix the problem?

Injections calm inflammation and pain and can help confirm where pain comes from, but they do not remove a herniated disc or bone spur. For some people, the relief allows healing and therapy to work. If a nerve stays pinched, surgery can often correct the problem.

How many steroid injections can I have?

Most doctors limit steroid injections to a few per year because of the cumulative effects of steroids on the body.

If you have neck pain, back pain or nerve pain and want to know which treatments make sense for you, call 470-293-9800 or contact us to schedule a visit with Dr. Grunch or one of her physician assistants. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All non-surgical treatment options · Imaging and diagnostic tests

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and treatment options.