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Principles of Health: Pain Management

Other treatments for low back pain and sciatica

by Michael Woods, , MD, FAAP

CATEGORY: Physiotherapy; Procedure; Psychotherapy; Therapy or Technique

Spinal manipulation is a therapy offered by chiropractors, osteopaths, and physical therapists. Physical leverage is combined with a series of exercises to adjust the spine and restore back mobility, while easing pain. Traditional massage is often used with spinal manipulation.

Physical Therapy

Physical therapy includes exercises, teaching back care principles, and using heat, ice, and other methods to relieve pain.

The purpose of physical therapy is to reduce the pain, strengthen the muscles, increase motion and function, and prevent future injury. Physical therapy should include a home exercise program. Treatments may include:

Steroids are injected into the cerebrospinal fluid in the canal surrounding the spine. Nerves branch out from the spine. The nerve roots, which may be compressed, are at the base of the nerves. (BruceBalus via Wikimedia Commons)

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  • Cold packs, which are usually used in the beginning to help reduce pain and muscle spasms

  • Heat, which is used to relieve pain and muscle stiffness

  • Aerobic exercises such as walking or swimming

  • Stretching exercises

  • Percutaneous nerve stimulation (PENS)

  • Braces or other physical supports

Biofeedback

Biofeedback teaches people how to control body functions they normally do not think about. It may help you reduce the severity of the pain. A biofeedback therapist will guide you to relax certain muscles or control breathing. A device shows your body’s response.

Relaxation Techniques

Relaxing the muscles can help prevent and reduce the severity of muscle tension and back pain.

Relaxation techniques may include conscious breathing, visualizing being in a relaxing place, or clearing the mind of any thoughts. A mental health professional can teach you how to perform different relaxation techniques.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is often used to help manage chronic pain and stress. It is a form of talk therapy that may be done individually or in a group. A therapist will help you identify negative thoughts and teach you to unlearn these thought patterns. You will also learn new, helpful habits to manage your pain with minimal disruption to your life.

Epidural Injections and Joint or Soft Tissue Injections

A steroid medication is injected into the epidural space in the spinal canal to decrease inflammation. Injections can be repeated if necessary. Other targets for injection include the facet and sacroiliac joints, as well as muscles and other soft tissues.

Exercise

Consult your physician about what exercises may be helpful for lower back pain. While there is mixed medical evidence about just which exercises will strengthen the back, specialists agree that it’s important to keep moving. Low-impact activities like swimming, bicycling, and walking are especially recommended. Properly performed abdominal crunches and flexibility exercises are also important for strengthening the stomach muscles and relieving tight back muscles.

When to Contact Your Doctor

More serious symptoms associated with back pain that may require immediate medical attention include:

  • Pain that does not subside or worsens with rest

  • Pain that is worse when you are reclined

  • Pain that is severe or that has gotten worse

  • Progressive weakness or numbness in a leg or foot

  • Difficulty walking, standing, or moving

  • Numbness in the genital or rectal area

  • Loss of bowel or bladder control

  • Burning or difficulty with urination

  • Fever, unexplained weight loss, or other signs of illness

References

1 

“2008 Physical Activity Guidelines for Americans.” Health.gov , Office of Disease Prevention and Health Promotion, 2008, health.gov/paguidelines/2008/chapter1.aspx.

2 

“Acupuncture and Related Therapies for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 11 Aug. 2016, www.dynamed.com/management/acupuncture-and-related-therapies-for-chronic-low-back-pain.

3 

“Acute Low Back Pain.” DynaMed, EBSCO Information Services, 25 Oct. 2017, www.dynamed.com/condition/acute-low-back-pain.

4 

Bronfort, Gert, et al. “Spinal Manipulation and Home Exercise With Advice for Subacute and Chronic Back-Related Leg Pain.” Annals of Internal Medicine, vol. 161, no. 6, 16 Sept. 2014, pp. 381–391., doi:10.7326/m14-0006.

5 

“Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 30 June 2017, www.dynamed.com/condition/chronic-low-back-pain.

6 

“Counseling and Education for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 22 Dec. 2017, www.dynamed.com/topics/dmp~AN~T910282/Counseling-and-education-for-chronic-low-back-pain.

7 

Ebadi, Safoora, et al. “Therapeutic Ultrasound for Chronic Low-Back Pain.” Cochrane Database of Systematic Reviews, 14 Mar. 2014, doi:10.1002/14651858.cd009169.pub2.

8 

“Exercise Therapy for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 27 Nov. 2017, www.dynamed.com/management/exercise-therapy-for-chronic-low-back-pain.

9 

Gatti, Roberto, et al. “Efficacy of Trunk Balance Exercises for Individuals With Chronic Low Back Pain: A Randomized Clinical Trial.” Journal of Orthopaedic & Sports Physical Therapy, vol. 41, no. 8, 2011, pp. 542–552., doi:10.2519/jospt.2011.3413.

10 

“Manual Therapies for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 30 June 2015, www.dynamed.com/management/manual-therapies-for-chronic-low-back-pain.

11 

National Guideline Centre. “Low Back Pain and Sciatica in over 16s: Assessment and Management: Guidance.” National Institute for Health and Care Excellence, Nov. 2016, www.nice.org.uk/guidance/ng59.

12 

Natour, Jamil, et al. “Pilates Improves Pain, Function and Quality of Life in Patients with Chronic Low Back Pain: a Randomized Controlled Trial.” Clinical Rehabilitation, vol. 29, no. 1, 25 June 2014, pp. 59–68., doi:10.1177/0269215514538981.

13 

“Physical Supports for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 30 June 2015, www.dynamed.com/management/physical-supports-for-chronic-low-back-pain.

14 

Sahar, Tali, et al. “Insoles for Prevention and Treatment of Back Pain.” Cochrane Database of Systematic Reviews, 2009, doi:10.1002/14651858.cd005275.pub2.

15 

“Sciatica.” DynaMed, EBSCO Information Services, 8 May 2017, www.dynamed.com/condition/sciatica.

16 

“Thermal and Electromagnetic Therapies for Chronic Low Back Pain.” DynaMed, EBSCO Information Services, 23 Mar. 2015, www.dynamed.com/management/thermal-and-electromagnetic-therapies-for-chronic-low-back-pain.

17 

Wegner, Inge, et al. “Traction for Low-Back Pain with or without Sciatica.” Cochrane Database of Systematic Reviews, 19 Aug. 2013, doi:10.1002/14651858.cd003010.pub5.

Citation Types

Type
Format
MLA 9th
Woods, Michael. "Other Treatments For Low Back Pain And Sciatica." Principles of Health: Pain Management, edited by Michael A. Buratovich, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=POHPain_0148.
APA 7th
Woods, M. (2020). Other treatments for low back pain and sciatica. In M. A. Buratovich (Ed.), Principles of Health: Pain Management. Salem Press.
CMOS 17th
Woods, Michael. "Other Treatments For Low Back Pain And Sciatica." Edited by Michael A. Buratovich. Principles of Health: Pain Management. Hackensack: Salem Press, 2020. Accessed September 19, 2025. online.salempress.com.