Relief for Severe Pain Without Opioids

Patient stretching back on exercise mat while physical therapist helps position their body

Acute or chronic back or neck pain can prevent a patient from doing the activities they enjoy or cause days off from work. Understandably, patients looking for long-term pain relief want to avoid using opioid medications chronically. At Centers for Neurosurgery, Spine & Orthopedics (CNSO), serving patients throughout northern New Jersey, the pain management physicians and physiatrists control pain and reduce or eliminate the cause of it using non-opioid pain control or opioids only for a brief period of acuity.

Here, CNSO highlights some of the available treatment options for severe neck or back pain.

Non-Surgical Treatment Options for Back and Neck Pain

A wide range of spinal injuries, disc disorders, and degenerative spine conditions can cause acute pain that can become chronic pain or a reoccurring pain. Fortunately, these often can be treated effectively without opiates. CNSO’s experienced medical team uses evidence-based pain management treatments, including:

Physical Therapy

Structured physical therapy often is the first line of defense against degenerative spine conditions such as osteoarthritis, spondylolisthesis, spinal stenosis, and herniated discs. A physical therapist will use massage, myofascial release, and other therapies to reduce muscle spasms and improve a patient’s flexibility and range of motion. They also will teach the patient exercises, stretches, and proper posture to prevent future injuries.

Nerve Blocks

Pain management doctors and physiatrists fellowship trained in pain management use nerve blocks to relieve pain and inflammation caused by irritated spinal nerves. These injection treatments include:

  • Epidural steroid injections: In this treatment, corticosteroid medication is injected using X-ray guidance into the epidural space where a nerve root exits the spine.
  • Sacroiliac joint injections: This type of injection can relieve pain in the sacroiliac joints, where the sacrum attaches to the hips.

Transforaminal Injection

Another non-opioid injection treatment is a transforaminal Injection, which can be used to treat lower back pain caused by issues such as spinal stenosis, sciatica, and ruptured discs. In this treatment, a physiatrist can inject a precise dosage of anti-inflammatory medication into the space where the nerve exits the spine.

Trigger Point Injection

A back muscle spasm, while temporary, can be very painful. Spasms can happen in response to a simple muscle strain or from an issue such as a bulging or herniated disc. Trigger point injections are quick, in-office procedures that use anesthetic and steroid medication to relieve pain and swelling.

Radiofrequency Ablation

Radiofrequency ablation (RFA) uses heat to destroy a small amount of nerve tissue to interrupt pain signals. It can be used to treat back pain caused by conditions such as spondylosis and sacroiliitis. RFA can offer long-term pain relief when more conservative treatments have not been effective.

Spine Decompression Surgery

When injection treatments and other conservative interventions are not sufficient to relieve severe back pain, a patient may be a candidate for spine surgery. If back pain is caused by a compressed or irritated spinal nerve, a neurosurgeon or orthopedic spine surgeon is necessary to perform spine surgery including a spine decompression surgical treatment. There are several types of spinal decompression surgery, including:


Nerves exit the spinal cord through small openings known as intervertebral foramen. When conditions such as stenosis make these openings smaller, the nerve roots can be compressed, leading to pain, weakness, or numbness. A foraminotomy is a surgical procedure to remove a small amount of bone tissue, widening the intervertebral foramen so the nerve root can pass through unobstructed.


This procedure typically is used to treat a herniated or slipped disc that requires surgery. During a discectomy, a surgeon will remove a portion of the damaged intervertebral disc material. Discectomy or microdiscectomy may be recommended for patients who have radiating pain that travels into one or both arms or legs. Like a foraminotomy, it typically is performed under general anesthesia.


The lamina is the bony arch on the back of the vertebra that helps protect the spinal cord. In this type of decompression treatment, a portion of the lamina is surgically removed to create more space in the spinal canal. A laminectomy may be used to treat pain caused by bone spurs, arthritis, or acute spinal injuries.

These spine surgeries may be used as standalone procedures, or they may need to be performed within the same surgery day as medically necessary.

Choose CNSO for Pain Management

The dedicated surgical and non-surgical team is dedicated to finding the root cause of a patient’s pain and determining the best course of treatment. CNSO’s providers include interventional pain management physicians, physiatrists, neurosurgeons, orthopedic spine surgeons, and certified physical therapists. Offering personalized care for patients throughout northern New Jersey, CNSO has multiple locations in Bergen, Passaic, Essex, Morris, and Hudson counties, and offers telemedicine appointments. To learn more about non-opioid pain control or schedule an appointment, contact CNSO today.


Centers for Neurosurgery Spine & Orthopedics