Take Care of Your Spine Today, or Face Tougher Choices Tomorrow: Why Conservative Chiropractic Care Often Comes Before Invasive Treatments

By Dr. Boris Nektalov, DNM, DC, Chiropractor & Enzyme Nutrition Specialist · Nektalov Chiropractic & Wellness, Forest Hills, Queens NY

Published: November 4, 2026 · Last reviewed: November 4, 2026

Short answer: For many people with uncomplicated mechanical low back pain and no urgent warning signs, clinical guidelines support starting with conservative, non-drug care such as exercise, rehabilitation and spinal manipulation before considering injections, nerve ablation or surgery. Conservative care is not right for everyone. Severe or progressive neurological symptoms need prompt medical evaluation, and necessary procedures should not be delayed. The goal is to choose the least invasive treatment that works for your diagnosis.

What does “food as medicine” have to do with your spine?

There is a well-known saying in conversations about health and nutrition: “If you do not eat food as your medicine, then you will eat medicine as your food.” It is often attributed to Steve Jobs and various historical figures, but its exact origin is uncertain.

Whoever first said it, the message holds: the health choices we make today can shape the treatments we may need tomorrow. Apply that idea to the spine and you get: “If you don’t take care of your spine today, you may be left facing much more difficult treatment decisions tomorrow.”

Think about how many people ignore back pain for months or even years. Some wake up with a stiff neck every morning and tell themselves it’s normal. Some keep taking pain medication while the underlying contributors to their discomfort go unaddressed. Eventually, some of them are discussing injections, nerve ablation or spinal surgery without having fully explored appropriate conservative treatment options.

At Nektalov Chiropractic & Wellness in Forest Hills, Queens, we believe patients deserve to understand their options before they make important decisions about their spinal health. My philosophy is simple: don’t wait until spinal problems become severe before taking them seriously. If you’re looking for a chiropractor in Forest Hills, NY because of back pain, neck pain or a disc problem, understanding the value of early, conservative care can help you make better decisions.

Why shouldn’t you ignore your spine until it hurts?

Most people understand the importance of looking after their teeth. They brush, floss and see a dentist regularly because neglecting oral health can lead to more complicated problems later. The spine gets far less attention.

Your spine supports your body, protects the spinal cord and contributes to nearly every movement you make. You rely on it to walk, sit, bend, lift, exercise, work and sleep. Yet many people pay little attention to spinal health until pain interferes with everyday life.

Consider someone who sits at a desk eight to ten hours a day. At first they notice occasional lower back stiffness. Then the discomfort shows up after long periods of sitting. Eventually the pain comes back in episodes that interfere with exercise and daily activities. They start avoiding movement for fear of making it worse. Their conditioning declines, their muscles weaken, and everyday movements become more uncomfortable.

That does not mean every episode of stiffness will progress to serious spinal disease. Many episodes of back pain improve naturally, and age-related changes are not always painful. However, persistent or recurring symptoms deserve evaluation. The earlier we identify modifiable contributors, such as limited mobility, poor physical conditioning, repetitive mechanical stress or poor movement habits, the more opportunities we may have to address them conservatively.

Is pain the problem, or a warning signal?

Imagine the check-engine light comes on while you’re driving. You wouldn’t cover it with tape and keep driving indefinitely. You’d want to know why it came on.

Back pain can work the same way. Pain tells us something needs attention, but it does not always tell us exactly what is wrong. One patient’s lower back pain may come from muscular irritation, joint dysfunction, disc-related inflammation or nerve-root involvement. Another patient’s persistent pain may be influenced by physical deconditioning, poor sleep, stress and changes in how the nervous system processes pain.

That is why treating pain and understanding its contributors are related but different goals. Pain medication may reduce discomfort and help a person stay active, and in some cases it is entirely appropriate. But medication alone does not necessarily address reduced strength, poor movement tolerance or inadequate rehabilitation. Likewise, a chiropractic adjustment may help relieve certain mechanical symptoms, but it should not be treated as a complete solution for every spinal condition.

At our Forest Hills chiropractic clinic, we evaluate the patient as a whole rather than assuming every painful back needs the same treatment.

Why does conservative chiropractic care deserve consideration first?

Modern healthcare offers many effective treatments for spinal pain, including physical therapy, chiropractic care, exercise rehabilitation, medications, injections and surgery. The important question is not which profession or treatment is universally best. It is:

Which treatment is most appropriate for this patient, with this diagnosis, at this stage of the condition?

For many patients with uncomplicated mechanical low back pain, clinical guidelines support starting with conservative treatment. The American College of Physicians’ guideline on noninvasive treatment of low back pain (Qaseem A et al., Annals of Internal Medicine, 2017; summary via American Family Physician) recommends trying non-drug approaches first. For acute and subacute pain, these include superficial heat, massage, acupuncture and spinal manipulation. For chronic pain, the list includes exercise, multidisciplinary rehabilitation, spinal manipulation and other options, depending on how long symptoms have lasted and what they are like.

Research indicates that spinal manipulation can provide modest improvements in pain and function for appropriately selected patients. It is not a guaranteed cure, and it is not consistently superior to every other conservative treatment. Still, it is a legitimate option to consider before more invasive procedures when there is no urgent medical indication. We believe patients should understand these options and take an active part in their treatment decisions.

What happens when you keep ignoring back pain?

One of the biggest mistakes people make is assuming recurring pain will always go away on its own. Sometimes it does. Sometimes symptoms persist or keep coming back.

Picture a patient who has occasional lower back pain after lifting. Instead of addressing it, they gradually stop exercising, avoid bending and cut back on physical activity. Their strength and endurance decline, and over time even normal activities become harder. This can create a cycle of pain, fear of movement, inactivity and physical deconditioning.

Importantly, this cycle does not mean the spine is necessarily becoming structurally damaged. Chronic pain is complex, and pain intensity does not always match the amount of tissue injury. But reduced physical function can become a significant problem in its own right. For anyone seeking lower back pain relief in Queens, early evaluation and appropriate rehabilitation may help prevent avoidable disability and support a safe return to activity.

What are the risks of relying only on pain medication?

Many patients manage recurring back discomfort with over-the-counter pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) may provide meaningful short-term relief for certain musculoskeletal conditions. However, prolonged or inappropriate use can carry risks. Depending on the medication, these may include gastrointestinal bleeding, kidney injury, cardiovascular complications and interactions with other prescriptions. Opioids carry additional concerns, including dependence, overdose and other adverse effects.

This does not mean patients should refuse medication. Medication should be used thoughtfully, with attention to the patient’s condition, medical history and overall treatment plan. For many musculoskeletal problems, combining symptom management with exercise, rehabilitation and appropriate conservative care may be a more complete strategy. The goal is not only to reduce the sensation of pain but to improve your ability to function.

Are spinal injections a long-term fix?

When back pain persists, some patients are offered spinal injections. Epidural steroid injections, for example, may provide short-term relief for selected patients with nerve-root-related pain. Other procedures target different structures and pain mechanisms.

These treatments can be appropriate, especially when symptoms interfere with function or conservative care has not provided enough relief. However, their effectiveness varies by diagnosis, and benefits may be temporary. Like any procedure, injections carry potential risks, which can include infection, bleeding, nerve injury and, rarely, serious complications. Patients should understand the expected benefits, alternatives and risks before going ahead.

We encourage patients to ask one important question: “Have I explored appropriate conservative treatment options for my condition?” For someone with uncomplicated mechanical back pain, chiropractic care or exercise-based rehabilitation may be reasonable options. For someone with severe neurological symptoms or another serious spinal condition, more urgent medical intervention may be necessary. The key is informed decision-making, not avoiding medical treatment at all costs.

Radiofrequency ablation vs. conservative care: what’s the difference?

Radiofrequency ablation (RFA) is a procedure used for selected chronic pain conditions. In certain patients with appropriately diagnosed facet-mediated spinal pain, it may reduce pain by interrupting signals from specific sensory nerves. In some cases, this provides meaningful relief.

However, RFA does not directly strengthen weak muscles, improve physical conditioning or correct every mechanical contributor to back pain, and it does not treat every cause of spinal pain. The procedure has specific indications, and clinical results vary depending on patient selection and the type of pain being treated.

For patients whose symptoms involve modifiable movement or rehabilitation factors, conservative treatment may help address those issues. But it would be wrong to claim that chiropractic adjustments can always replace RFA, or that RFA is inherently harmful. They are different interventions with different purposes. The best approach depends on the diagnosis and on how the patient responds to appropriate treatment.

When is spinal surgery necessary?

The idea of spinal surgery can be frightening. Patients often worry about recovery time, complications and whether the procedure will actually relieve their symptoms. For certain conditions, though, surgery provides important benefits. For example, selected patients with persistent nerve-root compression and significant symptoms may benefit from surgical decompression.

Warning signs that need urgent medical evaluation

• Progressive neurological deficits
• Symptoms of cauda equina syndrome
• Severe neurological symptoms or other serious spinal conditions

These may require urgent surgical or medical evaluation, not a trial of conservative care.

Does a herniated disc on MRI mean you need surgery?

Not automatically. Many patients with nonspecific lower back pain or uncomplicated disc-related symptoms can be managed without surgery at first, and this is where conservative care can play an important role. A herniated disc does not automatically need an operation just because the MRI shows an abnormality. Many disc herniations can improve over time, and imaging findings must be interpreted alongside the patient’s symptoms and neurological examination.

If you are exploring herniated disc treatment in Queens or seeing a sciatica chiropractor in Forest Hills, a careful evaluation can help determine whether conservative management is appropriate.

We also recognize that delaying necessary surgery can be harmful in some circumstances. The objective is not to avoid surgery at all costs. It is to avoid unnecessary procedures while making sure necessary treatment is not delayed.

What does a holistic approach to spinal health actually mean?

“Holistic” is often misunderstood. It does not mean rejecting conventional medicine. It means considering the many factors that contribute to a patient’s health instead of focusing on one symptom.

When we evaluate someone with chronic lower back pain, we may look at spinal movement, muscle strength, hip mobility, posture, daily activities, sleep, stress and overall conditioning. For example:

• A patient who sits all day may benefit from workstation changes and regular movement breaks.
• Someone with poor trunk endurance may benefit from progressive strengthening.
• A patient with recurrent mechanical neck pain may need rehabilitation of the neck (cervical) and shoulder muscles. See our neck pain care in Forest Hills.
• Someone with disc-related nerve symptoms may need a more specific treatment strategy and neurological monitoring.

Chiropractic care may be part of this approach, but long-term improvement often depends on what the patient does outside the office. That is why we emphasize education, movement and individualized treatment plans.

Is chiropractic care just “cracking your back”?

One of the biggest misconceptions about chiropractic is that every appointment involves the same spinal adjustment. In reality, comprehensive chiropractic care should begin with understanding the patient’s condition.

What to expect at Nektalov Chiropractic & Wellness

Depending on your evaluation, treatment may include spinal adjustments, joint mobilization, soft tissue therapy, rehabilitation exercises, posture correction and ergonomic recommendations. For selected musculoskeletal conditions, our Forest Hills office also offers non-surgical spinal decompression therapy, shockwave therapy and red light therapy.

These therapies are not appropriate for every diagnosis, and the evidence behind them varies:

• Non-surgical spinal decompression has mixed research support for disc-related conditions.
• Shockwave therapy is better established for certain tendon disorders than for routine lower back pain.
• Red light therapy has been studied for selected pain conditions, but it is not a proven way to reverse spinal degeneration.

The value of these services depends on using them appropriately, not on offering more treatments. Our focus is to identify your needs and recommend a reasonable, individualized plan.

Should you see a chiropractor only when you’re in pain?

There is no universal answer. Some patients with recurring musculoskeletal symptoms may benefit from periodic reassessment, movement guidance and appropriate follow-up treatment. Others maintain good spinal health through regular exercise, strength training, healthy habits and occasional visits when problems arise.

Current research does not establish that routine spinal adjustments in people without symptoms prevent disc degeneration, prevent future back injuries or guarantee that someone will never need injections or surgery. However, maintaining strength, mobility, physical activity and healthy movement habits can help support long-term musculoskeletal function. For patients interested in preventive care or posture correction in Queens, our goal is to find useful strategies, not to encourage unnecessary treatment.

Why can waiting until pain is severe limit your options?

When discomfort keeps returning, people often adapt their lives around it. They stop playing sports, avoid lifting their children, give up activities they enjoy and start believing chronic pain is just part of getting older. Yet many musculoskeletal conditions can be evaluated and managed with appropriate conservative care.

Seeking help earlier may create opportunities to improve movement, address deconditioning and build effective self-management habits. That doesn’t guarantee you’ll avoid future spinal disease or invasive treatment, because some conditions progress despite excellent conservative care. But waiting until pain becomes disabling can make recovery harder, especially once significant deconditioning has set in.

If you’re looking for a back pain chiropractor in Forest Hills, the best time for an evaluation is not necessarily when the pain becomes unbearable. Persistent, worsening or recurrent symptoms are reasonable reasons to consult a qualified healthcare professional.

How do nutrition and lifestyle affect spinal health?

The food-as-medicine saying reminds us that health is shaped by daily decisions. As an enzyme nutrition specialist, I believe nutrition deserves attention in any conversation about long-term wellness:

• Adequate protein supports muscle maintenance.
• Calcium and vitamin D contribute to bone health.
• Balanced nutrition supports normal tissue repair and metabolic function.
• Physical activity helps maintain strength and endurance.
• Sleep and stress management can influence pain perception and recovery.

Patients interested in nutrition and chiropractic wellness in Queens often appreciate an approach that considers these factors together. However, no particular food, digestive enzyme supplement or chiropractic adjustment has been proven to prevent all spinal disease. The goal is to support health through evidence-informed habits and appropriate clinical care.

Your spine deserves attention before a crisis

We spend a lot of time and money maintaining our cars, homes and devices. We schedule routine maintenance and fix problems before they become expensive. Yet many people neglect their physical health until daily activities become difficult.

Your spine is involved in nearly everything you do: work, exercise, travel, sleep and time with your family. Caring for it shouldn’t start only when pain becomes severe. That care may involve exercise, rehabilitation, ergonomic changes, appropriate chiropractic treatment and medical evaluation when needed. It should be proactive without being excessive, and conservative without ignoring serious conditions.

Frequently asked questions

Should I try chiropractic care before spinal injections or surgery?

For many people with uncomplicated mechanical low back pain and no urgent warning signs, clinical guidelines support starting with conservative, non-drug treatment such as exercise and spinal manipulation. Severe or progressive neurological symptoms, cauda equina syndrome and other serious conditions need prompt medical or surgical evaluation instead.

Does spinal manipulation work for low back pain?

Research indicates spinal manipulation can provide modest improvements in pain and function for appropriately selected patients. It is not a guaranteed cure and is not consistently better than other conservative treatments, but it is a legitimate option to consider before more invasive procedures when there is no urgent medical indication.

Do I need surgery if my MRI shows a herniated disc?

Not automatically. Many disc herniations improve over time, and MRI findings must be interpreted alongside symptoms and a neurological examination. Selected patients with persistent nerve-root compression and significant symptoms may benefit from surgical decompression, so a careful evaluation is important.

Are spinal injections or radiofrequency ablation a long-term fix?

Epidural steroid injections may give short-term relief for selected patients with nerve-root-related pain, and radiofrequency ablation may reduce appropriately diagnosed facet-mediated pain. Both can be appropriate, but benefits vary by diagnosis and may be temporary. Neither directly strengthens muscles or improves physical conditioning.

Can regular chiropractic adjustments prevent future back problems?

Current research does not establish that routine adjustments in people without symptoms prevent disc degeneration, prevent future back injuries or guarantee that someone will never need injections or surgery. Maintaining strength, mobility, physical activity and healthy movement habits can help support long-term musculoskeletal function.

When should I see someone about back or neck pain?

Persistent, worsening or recurrent symptoms are reasonable reasons to consult a qualified healthcare professional. You do not need to wait until pain becomes unbearable. Earlier evaluation may create more opportunities to improve movement and address deconditioning conservatively.

Don’t wait until your choices become more complicated

The food-as-medicine saying carries a lesson that goes well beyond nutrition: the decisions we make today may shape the health challenges we face tomorrow. For the spine, ignoring recurring pain, avoiding movement and neglecting physical conditioning can contribute to ongoing disability. Appropriate conservative care may help many patients improve pain, mobility and daily function. When it is suitable, it may allow some patients to manage their symptoms without more invasive procedures.

That said, chiropractic care is no guarantee against future injections or surgery, and a medical intervention is not a failure when it is necessary.

Whether you’re dealing with lower back pain, neck pain, sciatica or a herniated disc, we invite you to find out whether individualized conservative care may be appropriate for your condition. At Nektalov Chiropractic & Wellness in Forest Hills, Queens, we focus on identifying contributing factors, explaining your treatment options, improving musculoskeletal function and helping you make informed decisions about your spinal health. Our goal is not just to help you feel better today. It is to help you understand your condition and build habits that support better movement and function over time. Schedule an evaluation.

“Take care of your spine while you still have choices. Don’t wait until pain starts making those choices for you.”

The best healthcare decision is not always the most aggressive treatment. Sometimes it begins with understanding your body, addressing problems early and choosing the least invasive effective treatment for your condition.

About the author

Dr. Boris Nektalov is a chiropractor and enzyme nutrition specialist at Nektalov Chiropractic & Wellness in Forest Hills, Queens, NY. Meet Dr. Nektalov or contact our office.

References

• American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline. Annals of Internal Medicine. 2017;166(7):514-530. Summary via American Family Physician.

This article is for general educational purposes and is not a substitute for individual medical advice. If you have severe or worsening neurological symptoms, seek prompt medical care. Always consult a licensed healthcare provider regarding your specific condition.