There is an immense variety of noninvasive non-drug pain management techniques available for treating back pain and neck pain. A few of the most widely accepted in comprehensive pain management programs are the following:
Exercise – physical exertion with the aim of increasing strength, increasing flexibility, and restoring normal motion.
Manual techniques – manipulation of affected areas by applying force to the joints, muscles, and ligaments.
Behavioral modification – use of behavioral methods to optimize patient responses to back pain and painful stimuli. Cognitive therapy involves teaching the patient to alleviate back pain by means of relaxation techniques, coping techniques and other methods. Biofeedback involves learning to control muscle tension, blood pressure, and heart rate for symptomatic improvement.
Superficial heating or cooling of skin – These pain management methods include cold packs and hot packs, ultrasound, and diathermy and should be used in conjunction with exercise.
Electrotherapy – the most commonly known form of electrotherapy is transcutaneous electrical nerve stimulation (TENS). TENS therapy attempts to reduce back pain by means of a low-voltage electric stimulation that interacts with the sensory nervous system. Randomized controlled trials have yielded either positive or neutral results regarding the efficacy of TENS as a treatment for back pain.
Pharmacologic Pain Management
The most common noninvasive pharmacologic treatments for chronic back pain are:
Analgesics – or pain medications, including acetaminophen. Long-term use may involve risk of kidney or liver damage.
Nonsteroidal anti-inflammatory agents (NSAIDs) – includes aspirin, ibuprofen, naproxen and COX-2 inhibitors. Long-term use may cause gastrointestinal ulcers, and may slightly raise the risk of heart attack.
Muscle relaxants – used to treat muscle spasms due to pain.
Antidepressants and anticonvulsants – used to treat neuropathic (“nerve”) pain.
Neuromodulating medications – used to treat neuropathic and muscular pain.