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How do you fix lower back pain? Non-surgical options we use
Most lower back pain improves with time, staying active, and exercise or physical therapy. When pain lasts, the fix depends on the source. A physician first works out whether it comes from muscles, a disc pressing on a nerve, or the small facet joints of the spine. Non-surgical options then include physical therapy and lumbar traction, injections such as epidurals or joint injections, and, for confirmed facet joint pain, radiofrequency ablation, which uses heat to interrupt the nerves that carry the pain signal.
"How do you fix lower back pain?" is the title of one of our most-watched videos, with more than 3 million views. The honest answer is that it depends on where the pain comes from. Here are the non-surgical options shown in our videos, and how a physician decides between them.
Start with the basics
Most new lower back pain comes from a strained muscle or ligament and improves within a few weeks. Widely recommended first steps include:
- Staying gently active. Long bed rest usually slows recovery
- Using heat or ice for comfort
- Using over-the-counter pain relievers if they are safe for you
- Doing back and core exercise, ideally guided by a physical therapist
If pain lasts more than a few weeks, keeps coming back, or travels down a leg, it is time for an evaluation.
Find the source of the pain
A physician examines how you move, where it hurts and what makes it worse, and orders imaging when needed. Common sources include:
- Muscle or ligament strain
- A disc bulge or herniation pressing on a nerve, often with pain, numbness or tingling down the leg (sciatica)
- Facet joint arthritis in the small joints at the back of the spine, often worse when bending backward or twisting
- Sacroiliac (SI) joint problems where the spine meets the pelvis
- Spinal stenosis, a narrowing that can cause leg pain with standing or walking
Physical therapy and lumbar traction
Physical therapy is the foundation for most back pain. It includes exercise, hands-on treatment and teaching you how to move. Some patients also use lumbar traction.
In this video, our clinician sets up a traction table. The patient lies in a neutral spine position so the treatment is not too uncomfortable. The table "is going to take her and start to pull her lower half" to take tension off the spine, holding for a set time and then resting. It is "a slow burn, it's not fast, it's actually very subtle." The table gently creates space and then releases it. The force and timing are set for each patient, and traction is used alongside exercise, not instead of it.
Injections that calm inflammation
When a disc is irritating a nerve, an epidural steroid injection can lower inflammation and pain enough for therapy to work. When the pain comes from a joint in the lower back, a physician may inject that joint directly.
In this clip, the physician injects a joint in the lower back on one side and then the other. "That was me popping into the joint," he says, as the patient feels pressure while the medication fills the joint.
Radiofrequency ablation for facet joint pain
For long-lasting pain from the facet joints, radiofrequency ablation (RFA) can give longer relief. In this video, our physician explains the equipment. The needles are hollow, and probes placed inside them connect to a machine that heats the tips. "When you say burning, I'm thinking of heat," the patient says, and the physician agrees: "it technically is heat." That controlled heat interrupts the small nerves that carry pain signals from the joint.
At Precision Care, RFA is considered only after a medial branch block confirms the facet joints are the source. That test temporarily numbs the same nerves. The nerves can regrow over time, so relief is long-lasting but not always permanent.
When to get help right away
Go to an emergency room if back pain comes with new leg weakness, numbness in the groin or inner thighs, or loss of bladder or bowel control. Also go after a major fall or accident, or if you have a fever or unexplained weight loss.
Related care at Precision Care
Where to get care in New York City
Lower back pain is evaluated by a physician at all three Precision Care offices, and injections, procedures and physical therapy are planned by one team. You can request an appointment online or call the office closest to you. An online request is not a confirmed booking until the office contacts you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
How do you fix lower back pain without surgery?
Most lower back pain improves with staying active and exercise or physical therapy. If pain persists, a physician identifies the source and may add lumbar traction, injections such as epidurals or joint injections, or radiofrequency ablation for confirmed facet joint pain.
What is radiofrequency ablation for back pain?
Radiofrequency ablation uses heated needle tips, placed with X-ray guidance, to interrupt the small nerves that carry pain signals from the facet joints of the spine. At Precision Care it is considered only after a medial branch block confirms those joints are the source.
Does lumbar traction help back pain?
Lumbar traction gently pulls and releases the lower spine to take tension off it. Some patients find it helpful as part of a physical therapy plan. Settings are chosen for each patient, and it is used alongside exercise, not instead of it.
When should I see a doctor for lower back pain?
See a doctor if pain lasts more than a few weeks, keeps coming back, or travels down your leg with numbness or tingling. Go to an emergency room for new leg weakness, groin numbness, or loss of bladder or bowel control.
Do back injections fix the problem?
Injections reduce inflammation and pain but do not repair a disc or reverse arthritis. They are used to lower pain so you can do the physical therapy and exercise that address the underlying problem.
Educational only, not medical advice. These videos and this article explain common 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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