Back pain is one of the most common health issues affecting the population. It can be caused by a variety of injuries and conditions ranging from pinched nerves to herniated discs to pulled muscles and more. Fortunately, there are numerous ways to treat the condition depending upon what the underlying cause is diagnosed to be.
As a general rule, in medicine, conservative treatments like physical therapy or exercise are preferred over heavy-hitting invasive treatments like surgery. The following list of treatments for back pain available in Anchorage, Alaska, including chiropractic care and others, are roughly divided into groups based on degree of invasiveness.
Conservative Treatments
A. Chiropractic Spinal Manipulation
Chiropractic spinal manipulation is the go to for acute and subacute (pain lasting up to 12 weeks) mechanical back pain. Chiropractors are trained in manipulating the bones of the spine with application of pressure from their hands. This allows them to realign improperly aligned spines. This can serve to reverse certain injuries, improve posture, and benefit overall health.
One study, Paige et al., JAMA (2017) found that SMT modestly improves pain and function short term.3
Chiropractic spinal manipulation is available in Anchorage at:
B. Exercise Therapy
The first type of treatment for back pain is simple exercise. Not any exercise, of course, but directed exercise that targets the muscles around the problem area. It is best used in cases of chronic low back pain and mechanical back pain (pain resulting from problems in the muscles, bones, or ligaments of the back). Typical exercises used include core stabilization, aerobic conditioning, and yoga.
Multiple studies have found positive effects of exercise on back pain. One study, for example, The Cochrane Review (2016) found that exercise improves pain and function in chronic low back pain.1
In Anchorage, Alaska exercise therapy is offered at the following locations:
- Integrative Physical Therapy and Spine Treatment Center
- Alaska Fracture & Orthopedic Clinic – Physical Therapy
- Empower Physical Therapy
C. Physical Therapy
Next on the list is physical therapy, a modality that best suits acute or chronic non-specific back pain with a special emphasis on postural or mechanical pain. It, too, incorporates specific exercises and stretches that target specific muscles and muscle groups.
Physical therapy is available at:
- Better Health Alaska
- Alaska Physical Therapy Specialists
- Integrative Physical Therapy and Spine Treatment Center
D. Cognitive Behavioral Therapy (CBT)
Another back therapy that may easily be overlooked is Cognitive Behavioral Therapy or CBT. It is useful in addressing those cases of back pain (particularly chronic low back pain) that incorporate one or more psychological factors. For example, a person suffering from depression might have back pain from poor posture and lack the motivation to do exercises or PT stretches. By helping with the depression, CBT can help the back pain as well.
A study, Williams et al., Cochrane Review (2012) found evidence for improvement in pain, disability, and distress.2
- Alaska Behavioral Health
- Thriveworks
- Orthopedic Physicians Alaska
E. Acupuncture
Acupuncture can be used in cases of chronic nonspecific low back pain (i.e. persistent back pain with an indeterminate cause). It’s a process involving the insertion of needles into nerves throughout the body. It serves to interrupt neural signals in order to provide pain relief.
Acupuncture is available at the following locations in Anchorage:
- Snow Blossom Acupuncture LLC
- Relaxupuncture
- Natural Health Center LLC
F. Pharmacologic Treatments
1. NSAIDs
Non-steroidal anti-inflammatory drugs – these are best for acute low back pain and mechanical strains but they do have certain long-term risks.
2. Muscle Relaxants
These are best for acute back pain with muscle spasms.
3. Antidepressants (e.g., Duloxetine)
These can be used in cases of chronic low back pain, and they are especially useful in cases where the patient is simultaneously suffering from depression.
4. Opioids (use with caution)
In cases of severe acute pain that is not responding well to other treatments, a doctor might prescribe heavy-duty opioids. Although typically effective at stopping pain there is an addiction risk.
Interventional and Minimally Invasive Treatments
A. Epidural Steroid Injections (ESIs)
In this treatment, the steroid is injected into the precise location of the injury or nerve (herniated discs often extrude material that irritates nearby nerves causing sciatica or radicular pain). It serves to reduce inflammation and alleviate back pain.
It is offered by:-
- Advanced Pain Center-Alaska
- Alpenglow Pain & Wellness
- AA Spine & Pain Clinic
B. Facet Joint Injections & Radiofrequency Ablation (RFA)
Facet joint injections are similar to ESIs, but in their case the steroid involved is injected into the facet joint (joints in the spine that connect vertebrae). RFA, on the other hand, is a process that directs radiofrequency energy to deactivate the nerve that is the source of the problem. Both techniques are best used for chronic mechanical low back pain emanating from a problem in the facet joints.
It is offered by:
- Alpenglow Pain & Wellness
- Orthopedic Physicians Alaska
- Algone Interventional Pain Clinic
C. Percutaneous Discectomy
Percutaneous discectomy is a procedure that removes material from within a herniated disc. Removing such material should reduce the amount of contact between the disc and the nerve it’s irritating, as well as the amount of pain caused by that same nerve. It is best used to relieve discogenic pain or to deal with a small contained disc herniation.
It is provided by:
- Alaska Surgical Group
- Alaska Spine Center
- Algone Anchorage Interventional Pain Clinic
IV. Surgical Options
A. Microdiscectomy
A microdiscectomy is a form of surgery used to remove the material that is actually extruding from a herniated disc and touching a nerve. Its use is usually limited to cases where the herniated disc is causing radiculopathy and has not responded well to conservative forms of treatment for the prior 6-12 weeks.
It is available at:
- Alaska Medical Center – Providence
- Anchorage Neurosurgical Associates
- Algone Anchorage Interventional Pain Clinic
B. Spinal Fusion
Spinal fusion is a surgical procedure that mechanically fixes two or more vertebrae together. It is usually done in cases of spondylolisthesis or spinal instability. It is done in order to provide the lacking stability and to retain and allow some degree of movement. It is not recommended for nonspecific chronic pain.
A systemic review in the journal Spine found that spinal fusion is “a viable treatment option for reducing pain and improving function in patients with chronic LBP refractory to nonsurgical care when a diagnosis of disc degeneration can be made.”4
Spinal fusion is a technique available at:
- Providence Alaska Medical Center
- Alaska Spine Center
- Anchorage Neurological Associates
Conclusion:
Clearly, patients in Anchorage, AK who suffer from back pain do have options available to them. Many medical professions are available to serve them. Better Health Alaska is a medical office headed by chiropractor Dr. Brent Wells that has on staff chiropractors, physical therapists, massage therapists, and more.
So, if you are dealing with back pain and have had enough, stop by our office and make an appointment. We can often get you in and seen that very same day.
Scholarly Articles, Studies, and Other Sources:
- The Cochrane Review (2016) (https://www.cochrane.org/CD009790/BACK_exercise-treatment-chronic-low-back-pain)
- Williams et al., Cochrane Review (2012): (https://pubmed.ncbi.nlm.nih.gov/32794606/),
- Paige et al., JAMA (2017) (https://chiro.org/LINKS/ABSTRACTS/The_Role_of_Spinal_Manipulation.shtml?utm_source=chatgpt.com)
- Phillips, Frank M. MD, et al,, Spine (2013) (https://journals.lww.com/spinejournal/abstract/2013/04010/lumbar_spine_fusion_for_chronic_low_back_pain_due.18.aspx)
