Beyond the Scalpel: Exploring Non-Surgical Options for Spine Conditions in India

17 July,2025

Spine issues like herniated discs, vertebral compression fractures, spinal stenosis, and spondylolisthesis affect millions of people in India. These conditions often lead to chronic pain, limited movement, and reduced quality of life. 

While surgery is sometimes necessary, the Indian government now emphasizes a broader spectrum of non-surgical spine treatment in India, along with minimally invasive treatments. It is offered under the flagship schemes. These options aim to ensure safe, effective, and affordable care before resorting to surgical intervention.

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Non-Surgical Options for Spine Conditions in India

Launched in September 2018, Ayushman Bharat–PMJAY covers INR 5 lakh per family per year for hospital treatments at empaneled public and private facilities. While surgical spine care is included, so too are many non-surgical approaches—from rehabilitation therapies to targeted pain relief procedures. 

These interventions are bundled into Health Benefit Packages (HBPs), carefully designed by the National Health Authority to standardize costs and quality.

1. Rehabilitation and Physiotherapy

The first line of defence in spine care is often physical therapy. In public and PMJAY?empaneled hospitals, physiotherapy departments offer:

• Strengthening exercises for the core and back muscles
• Flexibility and movement training to correct posture and for back pain relief in India without surgery
• Pain relief methods like ultrasound and TENS (Transcutaneous Electrical Nerve Stimulation)

These therapies are covered as part of outpatient and inpatient care, often during the pre- and post-hospitalization window provided by PMJAY. For many patients, structured rehabilitation can significantly reduce pain without surgical risk.

2. Pain Management Services

Ayushman Bharat and several state-level programs support pain management clinics in tertiary hospitals. These clinics offer:

• Medication management with NSAIDs, muscle relaxants, and occasionally short-term opioids and neuropathic agents (like gabapentin and pregabalin)
• Precision procedures such as nerve blocks, facet joint injections, epidural steroid injections, and image-guided interventions

These options are covered under PMJAY packages for chronic back and neck pain, emphasizing non-surgical treatment whenever feasible. These are all key parts of interventional pain management in India.

3. Minimally Invasive Procedures

For patients whose pain does not respond to therapy or medication, the government supports several advanced, minimally invasive options:

• Vertebroplasty: This procedure stabilizes fractures in the spine (typically from osteoporosis or cancer). Small amounts of cement are injected into the fractured vertebra to reduce pain and improve mobility. Vertebroplasty is listed under the PMJAY benefit packages and reimbursed per procedure.
• Percutaneous Disc Procedures: Techniques like thermal ablation of disc tissue offer relief for contained discogenic pain. These procedures involve applying localized heat or radiofrequency to reduce inflammation and are included in PMJAY?approved treatments.
• Endoscopic Spine Interventions: For certain conditions, such as herniated discs, spinal stenosis, or spondylolisthesis, endoscopic spine surgery offers symptom relief with minimal tissue damage. These procedures are listed among PMJAY-covered treatments and can be performed in empaneled hospitals, benefiting economically disadvantaged patients.

All these procedures can be followed by physiotherapy for the spine in India.

4. Neuromodulation and Spinal Cord Stimulation

In rare cases of chronic, severe pain not responding to other measures, advanced treatment like spinal cord stimulation or implantable neuromodulation devices is available.

These devices use electrical impulses to block or alter pain signals before they reach the brain.

5. Conservative Care and Lifestyle Education

Standard non-surgical management, including pain relievers, muscle relaxants, physical aids (such as braces and collars), and patient education, remains critical. Public hospitals under PMJAY offer these services, often in addition to outpatient packages. 

Hospitals also advise on lifestyle changes, such as weight loss, regular exercise, proper lifting techniques, and adjustments to posture. Such measures help manage spinal conditions and prevent long-term damage.

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Policy Innovations

Recent updates to HBPs have integrated non-surgical spine care more fully. A standard model encourages conservative care first, followed by escalation to minimally invasive procedures if needed.

The government also promotes AYUSH treatments (Yoga, Ayurveda) for chronic back pain and prevention. Yoga-based rehabilitation programs are being planned in public facilities as adjunct therapy.

Under the Ayushman Bharat Digital Mission, patient records cover physiotherapy, procedures, prescriptions, and follow-ups. This ensures continuity of care and enables remote or telemedicine follow-ups.

Real-World Benefits

A patient diagnosed with a herniated disc can, under PMJAY, receive free sessions of physiotherapy, pain injections, vertebroplasty (if osteoporosis is involved), and follow-up diagnostics. If conservative care proves insufficient, the same policy supports minimally invasive procedures like endoscopic intervention or spinal injections, avoiding open surgery.

For vertebral compression fractures, vertebroplasty can prevent prolonged hospital stays. Patients receive cement injection within days, leading to significant pain relief and quicker mobility.

Here's the graph showing the Pain Relief Timeline after Vertebroplasty, with a clear drop in pain intensity from Day 0 to Day 30.

In remote areas, physiotherapy outreach teams combined with tele-rehab services act as a bridge until the patient can access clinical services. This layered model shows how non-surgical spine care has become a practical reality across India.

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Challenges and the Road Ahead

Despite progress, gaps remain. Public awareness about non-surgical spine treatment in India is still low, and many patients are referred directly for surgery without trying conservative measures. The empanelment of non-surgical spine providers in rural areas is limited, resulting in reduced access to local care.

Capacity limitations at tertiary centers, particularly for specialized procedures such as vertebroplasty or endoscopic techniques, result in some regions being underserved. Digital health expansion is promising, but it requires investment in rural connectivity and the training of personnel.

Final Thoughts

India's healthcare system is undergoing a significant transformation. Spine care is no longer defined solely by surgery. It includes effective, evidence-based non-surgical alternatives. With Ayushman Bharat–PMJAY, services like physiotherapy, pain management, vertebroplasty, spine endoscopy, and neuromodulation have become accessible and affordable for underserved populations.

Non-surgical spine care offers safer, quicker, and sometimes equally effective solutions without the costs and risks of open surgery. Continued efforts to raise public awareness, train providers, expand digital systems, and standardize delivery protocols will further strengthen these options. It ensures that spine care in India remains close to home, is smartly managed, and is truly patient-centered.

FAQs About Non-Surgical Spine Treatment in India

Q1. How can I fix my spine without surgery?

Answer: You can try treatments like acupuncture, massage therapy, laser therapy, or electrical nerve stimulation. These methods help alleviate pain and enhance mobility. They are generally safe for most people and can be used in conjunction with other treatments.

Q2. When should I try non-surgical treatment for my spine?

Answer: If your back pain is mild to moderate and not caused by a serious injury, it's a good idea to start with non-surgical treatments. These methods are less risky and often very effective. However, if the pain doesn't improve, consult a doctor about other treatment options.

Q3. What is the best non-surgical treatment for spinal stenosis?

Answer: Spinal stenosis can be effectively managed through a combination of treatments. Taking warm baths, using a heating pad, sleeping in a better position, or adjusting your workspace can all help. Medicines, physical therapy, and injections may also reduce pain and stiffness.