A Conservative Approach to Spine Care: Treating Patients, Not MRIs

By Amar D. Rajadhyaksha, MD Board Certified Spine Surgeon

As a spine surgeon, my philosophy is simple. Surgery should always be the last resort, not the first option. Most patients who experience spine-related pain, whether in the neck or lower back, can achieve significant relief and return to normal activity through comprehensive, non-operative care.

My goal is to exhaust every conservative measure before considering surgery, focusing on restoring function, reducing pain, and improving overall quality of life.

Every effective treatment plan begins with an accurate diagnosis. Too often, imaging findings such as a herniated disc or degenerative changes are assumed to be the cause of pain.

In reality, many of these findings are also seen in people who have no pain at all. I take the time to understand each patient’s symptoms, activity level, and goals so that I can create a treatment plan that is truly personalized.

Education plays a vital role in recovery. When patients understand their condition and the purpose of conservative care, their outcomes improve significantly, and many can recover without surgery.

In my experience, physical therapy is the cornerstone of conservative spine care. A skilled therapist helps patients strengthen their core, improve posture, enhance flexibility, and correct movement patterns that contribute to pain. Each therapy program I recommend is customized to the patient’s diagnosis, lifestyle, and activity level.

The goal is not only to reduce pain but to build long-term strength and prevent recurrence. Early movement and guided exercise accelerate healing and decrease the risk of chronic pain. For many of my patients, this process also rebuilds confidence and allows them to move freely again without fear or limitation.

Medications can be helpful in managing acute or flare-up pain when used carefully and for a short period. My approach focuses on targeted use of anti-inflammatories, muscle relaxants, and nerve-modulating agents when appropriate.

I avoid long-term opioid use, as it can create additional problems. Instead, I emphasize medications that reduce inflammation and nerve irritation so patients can remain active in therapy and regain function.

In some cases, bracing can provide short-term stability and relief, especially for conditions such as spondylolisthesis or acute muscle strain.

However, bracing should never replace muscle strength. I view it as a temporary support that decreases pain and allows patients to participate in therapy. As strength and stability return, bracing is gradually discontinued.

When used appropriately, image-guided injections can be valuable diagnostic and therapeutic tools. Epidural steroid injections, facet blocks, and nerve ablations can help reduce inflammation, identify pain sources, and support participation in physical therapy.

These procedures are not cures on their own but are part of a broader recovery plan designed to restore movement and function without surgery.

Surgery remains an important part of spine care, but it should be reserved for patients who have truly exhausted all conservative options or who show clear neurological compromise.

My greatest satisfaction as a spine surgeon comes not only from performing successful surgeries but from helping patients avoid them whenever possible.

Through thoughtful, evidence-based, and compassionate care, my goal is to help each patient return to living fully, not simply recovering from surgery.

To schedule a new patient with Dr. Amar please email help@ommktg.com.