Specialist treatments for back pain

Exercise classes

One of the team may suggest attending an NHS group exercise programme if they think it might help reduce your pain.

These programmes involve classes led by a qualified instructor, where you’re taught a mix of exercises to strengthen your muscles and improve your posture, as well as aerobic and stretching exercises.

Manual therapy

Manual therapy is the name for a group of treatments where a therapist uses their hands to move, massage and apply careful force to the muscles, bones and joints in and around your spine.

It’s usually carried out by chiropractors, osteopaths or physiotherapists, although chiropractic and osteopathy aren’t widely available on the NHS.

Manual therapy can help reduce back pain, but it should only be used alongside other measures such as exercise.

There’s also some evidence that a therapy called the Alexander technique may help with long-term back pain, although the National Institute for Health and Care Excellence (NICE) doesn’t currently recommend this treatment specifically.

Behavioural or psychological therapies

Your GP or one of the Camden MSK team may suggest psychological therapy, in addition to other treatments such as exercise.

Therapies such as cognitive behavioural therapy (CBT) can help you manage back pain better by shifting how you think about your condition.

While the pain in your back is very real, how you think and feel about your condition can make it worse.

If you’ve been in pain for a long time, a specialist treatment programme that involves a combination of group therapy, exercises, relaxation, and education about pain and the psychology of pain may be offered.

Surgery and procedures

Surgery for back pain is usually only recommended if there’s a specific medical reason for your pain, such as sciatica or a slipped (prolapsed) disc, and other treatments haven’t helped.

But a procedure called radiofrequency denervation may sometimes be used if:

• you’ve had back pain for a long time
• your pain is moderate or severe
• your pain is thought to originate from the joints in your spine

Your doctor will talk to you about what this procedure involves before going ahead.

Treatments not recommended

A number of other treatments have sometimes been used for non-specific back pain (back pain with no identified cause), but aren’t recommended by the National Institute for Health and Care Excellence (NICE) because of a lack of evidence.

These include:

• belts, corsets, foot orthotics and shoes with “rocker” soles
• traction – the use of weights, ropes and pulleys to apply force to tissues around the spine
• acupuncture – a treatment where fine needles are inserted at different points in the body
• therapeutic ultrasound – where sound waves are directed at your back to accelerate healing and encourage tissue repair
• transcutaneous electrical nerve stimulation (TENS) – where a machine is used to deliver small electrical pulses to your back through electrodes (small sticky patches) attached to your skin
• percutaneous electrical nerve stimulation (PENS) – electrical pulses are passed along needles inserted near the nerves in the back
• interferential therapy (IFT) – where a device is used to pass an electrical current through your back to try to accelerate healing
• painkilling spinal injections (although these can help if you have sciatica)
• spinal fusion or disc replacement surgery