Non-surgical treatments
Non-Surgical Treatments
Not all spinal pain or neurological changes require surgery. In many cases, symptoms can be managed with safe and effective non-surgical treatments that respect the body’s natural healing time and each patient’s routine. Dr. André Mendonça, a neurosurgeon trained at Santa Casa de São Paulo, offers modern, personalized approaches focused on pain relief, functional improvement, and quality of life.
When is conservative treatment indicated?
Several conditions can be controlled or initially managed without surgery, including:
Lower back or neck pain
Herniated discs
Spinal osteoarthritis (spondylosis)
Mild spondylolisthesis
Some types of neuropathic pain syndromes
Conservative treatment is also recommended in cases where surgery is not immediately indicated or when clinical contraindications are present.
Multidisciplinary and Personalized Approach
Treatment starts with a detailed evaluation, including:
Patient’s medical history and symptoms
Full neurological exam
Review of imaging (MRI, CT scans, X-rays)
Based on this evaluation, the best therapeutic options are discussed, which may include:
The use of analgesics, anti-inflammatory drugs, muscle relaxants, or neuromodulators can often control pain and restore function.
Prescriptions are personalized based on age, medical history, and possible drug interactions.
Physical therapy supports postural re-education, muscle strengthening, pain control, and improved mobility. It’s indicated for:
Herniated disc (with or without radiculopathy)
Chronic neck or back pain
Recovery after acute episodes
Prevention of recurrence
Minimally invasive procedures performed under local anesthesia and guided by imaging (usually fluoroscopy) to deliver medication directly to the affected area.
They can help with:
Herniated discs
Spinal canal stenosis
Facet joint osteoarthritis
Myofascial pain syndrome
Radiating limb pain
Common types of injections include:
Foraminal or transforaminal blocks
Facet joint blocks
Epidural blocks
Radiofrequency rhizotomy
Many symptoms worsen due to poor posture, mechanical overload, and inactivity.
An essential part of conservative treatment includes guidance on:
Workplace ergonomics
Improving sleep habits
Light, regular exercise
Safe lifting techniques and posture when sitting for long periods
Conditions such as peripheral neuropathy, trigeminal neuralgia, postherpetic pain, and nerve compression syndromes can also be managed without surgery.
The focus is to reduce pain’s impact on sleep, mood, and daily activities using:
Medication
Physical therapy
Image-guided injections or neuromodulation (when needed)
Each treatment plan is individually tailored, respecting the diagnosis, symptoms, and expectations of the patient.
It is essential to work with an experienced neurosurgeon in complex spine and central nervous system conditions to ensure an accurate diagnosis and determine whether conservative treatment is the best option — and when surgery might become necessary.
