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6 non-surgical treatments for back pain and sciatica

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Lots of people want to know about the best treatments for sciatica, or the most effective treatments for back pain – or whether a herniated disc needs surgery?

Back pain, sciatica and bulging/slipped/herniated discs are extremely common and only a few people will end up needing surgery. For the right candidates, spinal surgery can have very positive outcomes – but most of the time, surgery isn’t suitable or necessary.

Even for severe and chronic p ain, conservative treatment measures can be immensely effective – and our specialist team is here to help. Here are 6 non-surgical treatments for back pain and sciatica:


1: Physiotherapy

In the long term, keeping fit and active (sensibly!) is often the single most important thing anyone can do in managing back pain and sciatica – and this often starts with a good physio. A specialist physiotherapist will be able to assess a wide range of factors that could be contributing to your pain, including your posture, joints and muscular issues (such as tension, tightness, weaknesses and imbalances) and suggest exercises and stretches specific to your needs that you can incorporate into daily life. Research has shown that patients who engage with physiotherapy for back pain have much better long-term outcomes.


2: Medication

Painkillers are worth trying but are often not very effective and they do not change the underlying problem. Simple floor exercises and stretches are preferable. Medication for back pain is usually used alongside physio and other lifestyle measures. As well as bringing much-needed relief, taking the edge off your pain means you’ll be better able to keep active and do your physio. It’s important to ensure medication is suitable and appropriately managed though. Certain types of pain (for example, if nerve compression is the cause) may require different types of medication only available on prescription, and even over-the-counter drugs like paracetamol and ibuprofen can have side-effects if taken for prolonged periods. So have a chat with your doctor and ask about a referral to a pain management specialist if medications you’ve tried haven’t helped.


3: Injections

A number of injections for back pain and sciatica are available. These include spinal corticosteroid injections, or steroid and anaesthetic injections or ‘nerve root block’ injections. In patients with nerve root compression, treatments are injected into the affected area and are usually effective (painkillers) – in reducing pain. Injections don’t work for everyone but in some cases can be very effective, providing significant relief that lasts weeks or months. They’re usually carried out by a specialist consultant as an out-patient or day case procedure with local anaesthetic and sedation if requested, and you can usually go home a few hours later – but no driving that day.


4: Pilates

Pilates may look gentle but it’s unbeatable when it comes to building a strong core. Pilates doesn’t just focus on those six-pack abs but engage the many stabiliser muscles that support the pelvis and spine and your whole pelvic floor. Strengthening these can be transformative for anyone prone to back pain as it, helps improve balance and posture and, with time, will even improve how you move and hold yourself. It’s important to do any exercise safely though and build up slowly, as rushing straight to the more challenging moves can do more harm than good. Many back pain clinics offer specialist Pilates-based courses, tailored to suit people with pre-existing problems.


5: Sports rehab

If you’re a sports or fitness fan but back pain has been causing issues – or the idea of managing your back pain as much as possible with exercise simply really appeals – then working with a rehab specialist might be worth considering. This is basically like having a personal trainer with specialist knowledge and expertise around problems like sports injuries and back pain conditions. If you’re keen to take your strength and fitness up a notch or want to return to a specific activity (skiing, cycling, running, etc) without risking a back pain or injury relapse, a rehab specialist will be able to tailor a training programme that helps you move towards your goals safely while minimising the risk of further problems. Remember that for many sports, good technique is essential to prevent injury and for many, technical coaching will pay dividends.


6: Lifestyle changes

Lifestyle can play a huge role in managing back pain and sciatica, so it’s a good idea to include this in your pain-management strategy. This may include identifying and managing ‘triggers’ (for example, do you spend long periods of time sitting down?). Being too sedentary is a big factor in back pain and even simple measures like getting up to move around every 20-30 minutes can make a big difference.

Getting the basics right – plenty of sleep, a healthy balanced diet, not smoking and maintaining a healthy weight – can help too. The same goes for looking after your mental health and stress levels, which can have a big impact when it comes to chronic pain. This might mean easing the load at work and making time for relaxation and exercise. Being active is vital, even if it’s just a short daily walk, which works wonders for both body and mind. And if you’re struggling with the impact of chronic pain, cognitive behavioural therapy (CBT) can be very effective.


If you’d like more information on the back pain and sciatica treatments available at Wimbledon Clinic or to book a consultation, get in touch here. Our specialist team is happy to help.