Non-surgical therapy

    Last updated date: 03-Mar-2023

    Originally Written in English

    Non-surgical therapy

    Non-surgical therapy

    What is non-surgical therapy?

    When your body is in pain, it might be difficult to concentrate on daily duties. Surgery is not usually required to treat common injuries and ailments. Nonsurgical therapy focuses on the least intrusive and best approaches to get you back to being yourself.

    When someone is impacted by an injury, disease, or handicap, nonsurgical treatment can assist restore mobility and function without the need for surgery. It can also assist to lower your risk of future injury or disease. It adopts a comprehensive approach that directly incorporates the patient in their own treatment.

    When you feel pain in any region of your body, it is only a sign of a larger problem. Sciatica, for example, will produce a tremendous lot of pain, but that discomfort is just a result of the sciatic nerve being compressed or inflamed. Any injury or degenerative disease in your body is the same.

    Physical medicine and rehabilitation physicians (physiatrists) provide comprehensive care to people suffering from musculoskeletal injuries/disorders and sports injuries, with the objective of improving function and quality of life.


    Who are the candidates for non-surgical therapy?

    candidates for non-surgical therapy

    Nobody lives their entire life without experiencing suffering. After all, the goal of this unpleasant sensation is for the body to react and avoid additional tissue damage. Pain is experienced and described differently by various people, making it difficult to diagnose and treat.

    When you have a severe disease in your body, traditional medicine will usually put you on a pain management regimen that involves medication to mask or cover up the discomfort. You may feel better temporarily, but after the drug wears off, the pain returns until another round of medication is taken.

    The primary distinction between pain relief and pain management is that pain relief addresses the underlying source of the pain, whereas pain management addresses the symptom. Only by addressing and treating the underlying source of the pain will you enjoy long-term pain relief.

    Many painful disorders can be relieved with non-surgical treatment, including:


    What are the methods of non-surgical therapy?

    methods of non-surgical therapy

    Pain is the body's way of telling the brain that something is amiss. Either a specific move put too much tension on the afflicted area, or the area is too weak or rigid. Your specialist will assist you in determining the source of your discomfort and the best treatment for it.

    Non-surgical therapy options may include one or more of the following:

    • Activity modification
    • Exercise
    • Relaxation techniques, breathing exercises and mindful meditation
    • Physical therapy
    • Injection therapy
    • Nerve killing procedures such as radiofrequency ablation
    • Pain psychology
    • Acupuncture
    • The use of medications


    How to modify your activity?

    modify your activity

    One type of rest is to remain active while avoiding activities and postures that worsen the discomfort. For example, if lengthy periods of sitting in a car or at a desk aggravate the pain, set a timer for every 20 minutes to get up and move about or gently stretch. If standing causes pain, avoid doing tasks that involve standing, such as washing dishes at the sink. Avoiding or reducing painful activities and postures will assist avoid or lessen painful spasms and provide a healthier healing environment.

    According to studies, rest and inactivity should be confined to no more than two days. Following that, patients should be encouraged to begin moving and exercising in order to strengthen their muscles and enhance their flexibility. And, as part of the rehabilitative process, the patient may be required to work closely with the therapist during the first few weeks to guarantee a good long-term recovery.

    Jogging, deep squatting, kneeling, going up stairs, and slopes are all irritating activities to avoid. Walking on a level surface, motorcycling, and swimming workouts are all low-impact activities that will keep you active without putting strain on your joints. Wearing supportive shoes like tennis shoes rather than sandals and flip flops is also beneficial. Before beginning any fitness program, always speak with your healthcare professional.

    Bed rest was formerly prescribed as a treatment for pain. However, we now know that more than a few days of bed rest following an accident can be detrimental to recuperation. Exercise and movement really assist back tissues grow stronger, more supportive of the back, and more resistant to further damage. Specific exercises can be used to address specific types of pain. Activity works as a lubricant for the muscles and joints, and it is as important to recuperation as oil is to a squeaky door hinge.


    What are the relaxation techniques?

    relaxation techniques

    Relaxation methods are therapeutic activities meant to help people reduce stress and anxiety. Stress can generate physiological responses such as increased heart rate, palpitations, excessive perspiration, shortness of breath, and muscular tightness in addition to its psychological influence.

    There are several relaxation practices that may be provided by a number of health experts or learnt through self-help approaches. Relaxation techniques can help people manage with regular stress as well as stress associated with other health issues, such as heart disease and pain.


    Benefits of relaxation techniques:

    Relaxation techniques can have several advantages, including:

    • Slowing heart rate
    • Lowering blood pressure
    • Slowing your breathing rate
    • Improving digestion
    • Maintaining normal blood sugar levels
    • Reducing activity of stress hormones
    • Increasing blood flow to major muscles
    • Reducing muscle tension and chronic pain
    • Improving concentration and mood
    • Improving sleep quality
    • Lowering fatigue
    • Reducing anger and frustration


    Types of relaxation techniques:

    Relaxation treatments that frequently rely on muscular relaxation or breathing include:

    • Deep breathing/diaphragmatic breathing and Box breathing: Where you bring your attention back to your breathing. Box breathing is a breathing technique that may be used before, during, and/or after stressful encounters to help people manage stress. Box breathing is designed to assist the patient in visualizing a box with four equal sides while performing the exercise. This practice may be done in a number of settings and does not require a quiet place to be successful.
    • Guided Imagery: A relaxation exercise designed to help patients visualize a relaxing atmosphere. Visualization of serene places helps people manage stress by distracting them from intrusive thoughts. Imagery makes use of all five senses to induce a deeper state of relaxation. Guided visualization can be conducted alone or with the assistance of a narrator.
    • Progressive Muscle Relaxation: Tensing and releasing muscles, moving throughout the body, with the concentrate on muscular release during the relaxation phase. Progressive muscular relaxation can be done alone or with the help of a narrator.
    • Meditation: It employs a variety of practices such as contemplation, concentration, the use of different sounds, guided meditation, contemplative movement activities such as yoga and tai-chi, qigong, breathing exercises, and Matra. These strategies act on several levels, including the senses, thinking, intellect, and emotions. The approach that fulfills the objective of connecting the deep inner self satisfies the fundamental purpose of meditation.


    What is physiotherapy?


    Physiotherapy employs physical treatments to enhance mobility, alleviate pain and stiffness, hasten recovery, and improve quality of life. Physiotherapists diagnose and treat a wide range of disorders involving the bones, muscles, cardiovascular system, nerves, and other bodily components and systems. They can assist individuals in managing chronic conditions, provide lifestyle counseling, prescribe activities and devices to assist people in managing better, and provide recommendations.


    Conditions treated by physiotherapy:

    A physiotherapist may help with a variety of conditions, including:


    Activities of physiotherapy:

    Physiotherapists look at the total body rather than just the particular parts of an injury or sickness. Physiotherapists commonly employ the following approaches:

    • Education and advice – Physiotherapists can provide basic advice on issues such as posture and proper lifting or carrying practices to assist prevent injuries.
    • Movement, tailored exercise and physical activity advice – Exercises may be prescribed to improve your overall health and mobility, as well as to strengthen specific body components.
    • Manual therapy – Where the physiotherapist utilizes their hands to reduce pain and stiffness and stimulate greater body mobility.


    What is injection therapy?

    injection therapy

    Injection treatment is only a means to an aim. The objective is to offer adequate pain relief for the patient to transition from inactivity to physical therapy, where pain issues may be effectively managed with particular activities. For many years, spine doctors have relied on cortisone injections, epidural steroid injections, trigger point injections, and nerve blocks to alleviate back pain.


    Epidural injections:

    Cortisone epidural injections may reduce inflammation and/or swelling of the nerves in the epidural space, resulting in less pain, tingling, and numbness. The treatment is injecting a needle with a long-lasting steroid (cortisone) into the epidural space through the skin and deeper tissues. The epidural space is the region that surrounds the spinal cord and the nerves that emerge from it. To alleviate symptoms, one or more injections may be required.


    Facet Injection:

    The facet joints serve as hinges in our back, connecting all of the vertebral bones while enabling us to bend and twist freely. The image above depicts a facet injection in process. These joints can become inflamed or develop bone spurs as a result of injury or aging, making movement unpleasant.

    The spine doctor may inject medicine into the facet joint to reduce discomfort and restore range of motion. In some ways, the drug acts like WD40 on a rusted door hinge, restoring mobility. Injections are typically used to bridge the patient to treatment so that the therapist can assist the patient in maintaining mobility after the effects of the medicine wear off.


    Trigger Point Injections:

    Trigger points are painful tissues that exist within and around muscles. Aching or acute discomfort can be caused by pressure. Trigger point injections are the injection of a local anesthetic and steroid medicine into the muscles that are causing pain. The injection may ease muscular spasms for several weeks to months.


    Sacro-Iliac (SI) Joint Injections:

    To assist reduce inflammation and/or swelling of tissue in the joint area, a long-lasting steroid (cortisone) is injected into the sacroiliac joint. As a result, patients may have less pain and other symptoms associated with joint inflammation. The sacroiliac joint is found in the lower back. A needle is inserted through the epidermis and deeper tissues into the SI joint during the treatment. For symptom alleviation, more than one injection may be required.


    Radiofrequency Ablation:

    Radiofrequency ablation is a pain-reduction method that uses a high-frequency radio wave to burn up a tiny portion of nerve tissue, reducing pain signals from that location. Radiofrequency ablation is an outpatient procedure that includes delivering heat to certain nerve pathways to "switch off" the transmission of pain signals to the brain. It is conducted under local anesthesia and minimal sedation.

    This minimally invasive surgery can give long-term relief to individuals suffering from facet joint discomfort or persistent back and neck pain caused by joint deterioration. The surgery has a high success rate and a low complication risk, and it can relieve pain for up to two years. More than 70% of patients treated with Radiofrequency Ablation get pain alleviation, and the procedure is typically well-tolerated with minimal problems. Radiofrequency ablation is a proven safe method of relieving pain with few to no side effects. The only noticeable adverse effect of Radiofrequency Ablation is pain, which may include swelling and bruising at the treatment site, although this usually resolves within a few days.


    What is Acupuncture?


    Acupuncture is a traditional Chinese treatment that is used to alleviate certain health issues and symptoms, such as pain. At various acupoints, an acupuncturist inserts extremely tiny steel needles into the patient's skin. The needles restore the body's vitality, or qi, and stimulate the release of natural substances to combat the ailment or symptom.

    Acupuncture is a therapy that involves inserting extremely thin steel needles into the skin in order to stimulate certain spots in the body. The objective is to alleviate a medical ailment or symptom, such as pain. The method is based on traditional Chinese medicine. Scientific researches have shown its efficacy in treating certain illnesses.


    Conditions treated by acupuncture:

    Acupuncture can help with a wide range of health problems. It is most commonly used to treat chronic (long-term) pain, such as:

    • Arthritis
    • Back pain, neck pain or muscle pain
    • Headaches and migraines
    • Knee pain
    • Menstrual cramps
    • Sports injuries

    Other conditions acupuncture may help include:

    • Cancer and cancer treatment side effects
    • Face pain and other nerve discomfort
    • Immune system problems
    • Infertility
    • Irritable bowel syndrome
    • Menopause and hot flashes
    • Pregnancy discomforts
    • Repetitive strain disorders and overuse syndrome



    The energy that passes through the body is referred to as qi in Chinese medicine. Chinese medicine practitioners believe that qi interruptions cause energy imbalances in the body, which contribute to sickness. Some kinds of acupuncture use needles to stimulate acupuncture sites (acupoints) throughout the body to rebalance qi. Hundreds of acupoints are located throughout the body along 14 major meridians, which are also known as energy-carrying channels.

    The needles stimulate the body’s existing systems to:

    • React to an illness or symptom.
    • Rebalance the body.
    • Release natural chemicals, such as endorphins, the body’s natural painkillers, and neurotransmitters, chemicals that control nerve impulses.

    The acupuncturist will discuss your issue with you at your initial visit. The therapist will then check your body for places that may respond to acupuncture. The acupuncturist will insert needles into various spots on your skin across your body.

    The needles are disposable, sterile, and as thin as a human hair. Acupuncturists insert needles at varying depths ranging from a fraction of an inch to several inches. The needles can be left in for a few minutes or up to 20 minutes.


    What is pain psychology? 

    pain psychology

    Psychologists are professionals in assisting patients in dealing with the thoughts, feelings, and behaviors that come with chronic pain. They may work with individuals and families in a private practice environment or as part of a health care team in a clinical setting. Other health care practitioners may send patients with persistent pain to psychologists. Psychologists may work with other health care providers to treat both the physical and emotional components of a patient's suffering.

    You can expect to discuss your physical and emotional health when working with a psychologist. The psychologist will inquire about your pain, where and when it occurs, and what factors may influence it. Furthermore, he or she will most likely ask you to discuss any concerns or stresses you are experiencing, including those related to your pain. You also may be asked to complete a questionnaire that allows you to record your own thoughts and feelings about your pain.

    Treatment plans are tailored to the specific needs of patients suffering from chronic pain. The plan often involves teaching relaxation techniques, changing old beliefs about pain, building new coping skills and addressing any anxiety or depression that may accompany your pain.

    One way to accomplish this is to teach you how to challenge any unhelpful thoughts you have about pain. A psychologist can help you develop new ways to think about problems and to find solutions. In certain circumstances, diverting oneself from discomfort is useful. In other cases, a psychologist can help you develop new ways to think about your pain. Studies have discovered that certain psychotherapy can be as helpful as surgery for alleviating chronic pain because psychological therapies for pain can affect how your brain perceives pain feelings.

    Most patients find they can better manage their pain after just a few sessions with a psychologist. Those who are experiencing depression or dealing with a long-term degenerative medical condition may benefit from a longer course of treatment. Together with your psychologist, you will determine how long treatment should last. The goal is to help you develop skills to cope with your pain and live a full life.

    Having a painful condition is stressful. Stress, unfortunately, can contribute to a variety of health issues, including high blood pressure, heart disease, obesity, diabetes, depression, and anxiety. In addition, stress can produce muscular tension or muscle spasms that may aggravate discomfort. Managing your emotions can directly affect the intensity of your pain. Psychologists can help you manage the stresses in your life related to your chronic pain.

    Psychologists can assist you in learning stress-reduction techniques such as meditation or breathing exercises. Some psychologists and other health care providers use an approach called biofeedback, which teaches you how to control certain body functions.



    Physical therapy

    Chronic pain is defined as pain that lasts more than three months. The pain may be there all of the time or may come and go. It can occur in any part of your body. Chronic pain can interfere with daily activities such as working, socializing, and caring for yourself or others. It can lead to depression, anxiety and trouble sleeping, which can make your pain worse. This response creates a cycle that’s difficult to break.

    Some people also have chronic pain that’s not tied to an injury or physical illness. Healthcare practitioners name this response psychogenic pain or psychosomatic pain. Stress, anxiety, and depression are among the psychological factors that contribute to it. 

    Four major lifestyle factors can influence and help reduce chronic pain. Healthcare providers sometimes call them the four pillars of chronic pain. They include:

    • Stress management
    • Exercise
    • Healthy diet
    • Adequate sleep

    Certain therapies may help you manage chronic pain, including:

    • Cognitive-behavioral therapy (CBT): This counseling method helps you think differently about pain and teaches you ways to cope.
    • Counseling: Talk therapy can help you manage chronic pain, especially psychogenic pain.
    • Occupational therapy: Occupational therapy teaches you how to do everyday tasks differently to lessen pain or avoid injury.
    • Physical therapy: Physical therapy involves exercises that stretch and strengthen your body, which can help reduce your pain.

    Alternative treatments that have been shown to relieve chronic pain over time include:

    • Acupuncture, which uses small needs placed in the body
    • Aromatherapy, which uses aromatic plants and essential oils
    • Biofeedback, which teaches you how to tweak the way your body works, influencing such things as heart rate, breathing and muscle tension
    • Mindfulness training, which teaches you how to calm yourself
    • Music, art or pet therapy
    • Relaxation techniques, such as massage, meditation and guided imagery.