reduced with lifestyle choices, including smoking cessation, limiting alcohol, maintaining a healthy weight, and keeping bones and muscles strong with adequate exercise and a healthy diet. The risk for disc herniations can be reduced by using proper techniques when lifting heavy loads, smoking cessation, and weight loss to reduce the load placed on the spine. Vertebral fractures may be difficult to prevent since common causes are related to accidents or age-related degeneration associated with osteoporosis. Treating osteoporosis with pharmacotherapy, enrolling in a fall prevention program, strengthening muscles and bones with a weight-bearing exercise program, and adopting a nutritional program that promotes bone health are all options to reduce the risk of vertebral fractures associated with osteoporosis. Treatment Treatment for back injuries depends on the diagnosis, level of pain, and whether there is loss of function or quality of life. Conservative Cold therapy reduces inflammation, edema, pain, and muscle spasms associated with acute back injury. Heat therapy is used to reduce pain and alleviate sore and stiff muscles. Heat therapy is proposed to work by facilitating delivery of nutrients and oxygen to the site of injury to accommodate healing. Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can be taken to reduce mild to moderate pain associated with back injuries. NSAIDs are suggested to be more effective for persistent pain than for acute pain. If pain remains intolerable while taking over the counter medications, a stronger pain medication such as a narcotic or a muscle relaxant can be prescribed at a physician's discretion. Therapy and alternative medicine: an active approach to recovery is recommended over bed rest for most cases of back injury. Activity promotes strength and functional rehabilitation and counters atrophy associated with disuse. Physical therapy can help reduce pain and regain strength and function. The gentle movement of yoga and tai chi are suggested to improve function and to counter the negative psychosocial effects that can be secondary to injury. Spinal manipulation, massage, and acupuncture have been used to treat the pain associated with various back injuries, but there is little consensus on their degree of effectiveness. Injections: Spinal nerve blocks and epidural injections are options available to alleviate pain and neurological symptoms. Injections of anesthetics alleviate pain while steroid injections can be used to reduce the inflammation and swelling surrounding spinal nerves. Non-Conservative Surgery is considered when symptoms persist after attempting conservative treatment. It is estimated 10-20 percent of