Conservative therapy for the spine

The purpose of conservative spinal therapy

Conservative therapy can be used for nonspecific back pain. Also in some cases of specific back pain caused by facet syndrome (vertebral osteoarthritis), disc protrusions, herniated discs, spinal canal stenosis, spondylolisthesis conservative treatment can be performed. Conservative therapy is recommended as a main or adjunct therapy. First of all, it is important to make a clear diagnosis. Depending on the symptoms and the severity of the findings (neurological deficit, MRI findings), the age of the patient, the general health condition, psychosocial circumstances and other factors, we decide whether and how long the conservative therapy can or should be applied.

It is known that conservative therapy usually cannot eliminate the cause - but could relieve the symptoms especially by nonspecific back pain. One has to consider what permanent damage could be caused if one does not treat the cause and only relies on the conservative therapies.

Treatment methods of conservative therapy

Here are some conservative therapies that are surely going to take your attention!

Electro-therapy - TENS

TENS (transcutaneous electrical nerve stimulation) is a method of conservative therapy used in natural medicine. It is the continuation of a method that Egyptians used to reduce pain 4500 years ago - they put fish on troubled body parts. The fish have delivered small power surges and thus interrupted the pain stimulus on the way to the brain. The TENS device also transmits electrical impulses to affected body parts using skin electrodes. The electro discharges the relay station on the spinal cord, so that the painful nerves are no longer able to direct pain impulses towards the brain. Every pain therapist knows this pain therapy - and it is widely used.

Peri-radicular therapy - PRT as conservative therapy

Periradicular therapy (PRT) is a widely used procedure that relieves or substantially reduces back pain in many patients. In the PRT, the patient is lying on his stomach. The specialist inserts a thin hollow needle under fluoroscopy and computed tomography (CT) control. A special local anesthetic (sometimes mixed with cortisone) is injected to the inflamed, painful nerve root to relieve the irritation and swelling. If necessary, this treatment can be repeated several times. Because the puncture needle can be specifically targeted to the nerve roots, the PRT offers a high degree of safety.

Injection therapy

"I'll give you an injection…" is a sentence you have certainly heard. Then he gave you an injection … and surely you felt immediately like “new”, no pain. This treatment is actually very effective, and it has a name: injection therapy. With this treatment, we can interrupt certain pain circuits, suppress or reduce the pain. What happens with this injection therapy? We can specifically introduce a drug where pain origins (root, joint, vertebra) - in inflammation, an anti-inflammatory agent is usually used. In osteoarthritis, which cannot be cured but whose pain can be alleviated, we primarily inject hyaluronic acid.

Drugs prescription as conservative therapy

Painkillers are indispensable in pain therapy and usually work reliably. Whether acute or chronic pain - your specialist will prescribe exactly the right medication for you. An exact medical check is important because drugs have different effects. Some painkillers (such as opioids) act centrally on the nervous system, while others act directly at the site of the pain. Opioids are mainly prescribed for chronic pain (for example, cancer pain); the predominantly peripheral painkillers are used in case of acute pain and inflammation. Even more effective is the administration of the drugs by means of infusions (intravenous). They work faster and an impairment of the gastrointestinal tract is thereby avoided. Alternatives are pain relief plasters.


Acupuncture is part of Traditional Chinese Medicine. The World Health Organization (WHO) has produced a list of complaints that may involve the use of acupuncture. Science does not yet fully know what happens to our body through acupuncture- but scientific research has shown that a well-applied acupuncture has beneficial effects. This includes especially pain therapy. Traditional Chinese medicine has a different body and therapy understanding than the western world. The magic word among the Chinese is called Qi - that is the life energy. When it flows, balanced, man is healthy. When complaints come up, qi is disturbed, obstructing the flow of energy. With acupuncture needles placed on the so-called yin and yang meridians at several acupuncture points (there are a total of 361), blockages can be resolved. Therapy uses sterile needles that stay in the skin for about 20 to 30 minutes. Pregnant women should be careful: While acupuncture needles can alleviate pregnancy-related problems, they can cause premature labor.


Physiotherapy is almost always prescribed by the doctor when it comes to improving the movement and functioning of the body. In most cases, this form of treatment is an additional therapy with which ultimately diseases from almost all medical specialties can be treated. Physiotherapy may only be used by trained physiotherapists. They should perform every movement perfectly in order to help and not further damage the patient. Physiotherapy is very appreciated and successful in strengthening weakened muscles and in relaxation exercises for tense muscles.

Heat and cold therapy

Heat or cold therapies are very impressive and belong to the field of physiotherapy. The main purpose of physiotherapy is to relieve you from pain. They can be used locally or throughout the body. Cold therapy - in the form of cool pads and baths - is one of the most chosen alternative treatments in case of swelling and joint inflammation. Methods of heat therapy are, for example, heat packs filled with bog or mud. They have an intensive effect on the tissue and promote blood circulation, muscle-relaxing and - of course - pain-relieving. Therapists use not only mud and bog, but also special radiators (hot-air), which warms the aching body parts. Certain areas of the body - including back and joints - react very positively to the red light.

Further treatment options of conservative therapy

Conservative spinal therapy also includes: osteopathy, manual therapy, massages, magnetic field therapy, cupping, electrical muscle stimulation, training, chiropractic, prevention (be careful in case of osteoporosis), etc.

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11