Chronic back pain treatment What helps when back pain lasts for months

Back pain that lasts longer than three months is chronic. It often settles into a pattern: stiff in the morning, sore after sitting or standing, flaring with certain tasks (see back pain from sitting). The good news is that most chronic back pain can be treated without surgery once the source is clear. This guide covers the main chronic back pain treatment options and how a back pain doctor chooses between them. For an overview of every back condition we treat, see our lower back pain treatment page.

What keeps back pain going

• Facet joints: small joints at the back of the spine that become arthritic and ache with standing or leaning back
• Discs: a bulging or herniated disc can irritate a nerve and send pain into the leg (sciatica)
• Narrowing: spinal stenosis can cause back and leg pain when standing or walking
• Muscles: weak, guarded or tight muscles that keep the cycle going after an injury has healed

Often more than one is involved, which is why a careful exam comes before treatment.

Chronic back pain treatment options

Physical therapy and exercise

Strength and endurance in the trunk and hips, better movement habits and a gradual return to the activities you have been avoiding are the base of almost every plan. The last video shows the hands-on and exercise side of that work. Our physical therapy team is in Brooklyn and Staten Island, and our post on how to fix lower back pain without surgery covers simple exercises to start with.

Manual therapy

Joint mobilization and soft-tissue work can ease stiffness and guarding so exercise is more comfortable. Learn more about manual therapy.

Spinal decompression

In the third video, a patient lies on a decompression table that gently and repeatedly stretches the lower spine. For some people with disc-related pain it eases pressure and makes movement easier. It works alongside exercise, not instead of it. See traction and spinal decompression and how mechanical traction works.

X-ray-guided injections

The first two videos show procedures done with live X-ray (fluoroscopy), which lets the physician see the spine and guide the needle to the exact level. When a nerve is irritated, an epidural steroid injection places anti-inflammatory medicine next to it; read what an epidural injection can and cannot do. Learn more about fluoroscopy-guided injections, or compare the options in our guide to back pain injections.

Medial branch blocks and radiofrequency ablation

If the facet joints are the suspected source, a test block numbs the small nerves that carry pain from them. If the pain drops a lot, radiofrequency ablation can quiet those nerves for longer. It treats pain, not the joint itself. Our guide to facet joint pain explains the symptoms and the test block.

What you can do at home

• Keep moving. Short walks spread through the day usually help more than bed rest (one of several back pain myths)
• Change position often if you sit or stand for long periods
• Use heat for stiffness, 15 to 20 minutes at a time
• Do your exercises on good days too, not only when it hurts

When to see a back pain doctor

See a physician if back pain lasts more than a few weeks, keeps coming back, wakes you at night, or travels down a leg with numbness, tingling or weakness. Go to an emergency room or call 911 for back pain with loss of bladder or bowel control, numbness in the groin or inner thighs, sudden leg weakness, or fever.

Related care at Precision Care Medical & Sports Performance

Chronic back pain treatment near you

Looking for a back pain doctor near me? Our back pain doctors see patients at all three offices. For back pain treatment in Brooklyn, Ashley Marcus, MD sees patients at our Brooklyn office near Gravesend, Bensonhurst, Brighton Beach and Marine Park, where physical therapists Zoya Reznik, DPT, OCS and Maggie (Yi) Zhang, DPT, with physical therapist assistants Dennis Furman, PTA and Leila Nahmoud, PTA run physical therapy in Brooklyn. For a back pain doctor on Staten Island, Jake Stephen, DO sees patients at our Staten Island office, convenient to Dongan Hills, Todt Hill and New Dorp, with physical therapists Victoria Lynn Kain, DPT and Nicholas “Nick” Ursini, DPT for physical therapy on Staten Island.

For a back pain doctor in Midtown East, Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center in Midtown Manhattan, within easy reach of Washington Heights, Harlem, Midtown and the Financial District. Physical therapy is not offered at the Midtown Manhattan office. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled. Request an appointment or call the office closest to you.

Questions patients ask

Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.

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