Non-Surgical Treatments

At the Spine and Brain Institute of San Diego, we aim to find the least invasive way to relieve your back pain. Many people find relief without surgery. In fact, most back pain resolves with non-operative treatment within six months. Back problems are very individual, so we work with patients to find the optimal blend of approaches to address their particular back problems. Here are the best non-surgical options.

Exercise and Physical Therapy

Our biggest aim is to find the right system of exercise for our patients to build strong back muscles to support their daily activities. Some of the other methods listed below are great for temporary relief or to get you through a tough patch. But ideally, you’ll find lasting relief from pain through an exercise regimen tailored to you. Depending on your condition, this could involve exercises to stretch, strengthen, and/or stabilize certain muscles. A physical therapist might give you a set of very specific exercises to target your problem or develop a more general mix of cardio, core strength, and flexibility exercises that work for you. These could include yoga, Pilates, or aquatic therapy.


Acupuncture is the process of inserting long, fine needles into various trigger points on the body, which then releases natural pain-killing chemicals called endorphins. Acupuncture has become increasingly popular and many insurance companies now cover the treatment.


Many types of massage can help back tension. Trigger point myotherapy is especially good for treating muscle spasms. This technique consists of applying concentrated pressure of alternating levels to the spasming area.


A wide variety of braces can help you address acute pain or temporary flare-ups. While braces can play a valuable short-term role in your back health, prolonged use can lead to dependency and a weakening of muscles. The long-term solution is your exercise program, which will build the muscles surrounding your spine into the world’s greatest back brace. We recommend the strategic use of braces as needed. For example, you might wear a brace while doing yard work or during a long drive.

Oral Medications

Temporary use of oral medications sometimes relieves the pain of back injuries and flare-ups. These range from over-the-counter anti-inflammatories and analgesics to prescription muscle relaxants, narcotics, and antidepressants.

Other Non-Operative Pain Modalities

Heating pads and cold packs are two of the easiest, low-tech ways to treat some back pain. Higher-tech non-invasive treatments include using Transcutaneous Electrical Nerve ( Stimulation (TENS) applied to soft tissue in painful areas. Ultrasound machines can also offer relief by sending waves of soothing vibration into sore tissue and improving blood flow. Traction machines that produce tension across parts of the back or neck are sometimes successful in relieving pain.


As pain specialists, we offer several different types of injections to ease symptoms. All use solutions of steroids and anesthetics. Trigger point injections direct the solution into a muscle that is causing pain. With an epidural steroid injection, the pain specialist injects the solution into the epidural space around the spinal cord and nerve roots. Facet injections target a specific joint where two vertebrae meet.