Pain in the Back – The Inside Story
“Oh my back!” This can be a real pain, and many of us will experience it at some point in our life, especially those over 45. It’s easy to take our back for granted, until we’re hit by pain. Then we need a solution. There’s a lot of confusion about back pain and the best way to treat it. The pain can be located anywhere from the neck down to the sacrum, but lower back pain (LBP) is the most common. It can be acute and sharp, due to a trauma, or chronic and episodic, due to multiple causes. Some people go for years with chronic pain and usually manage it with medication, if anything. The tragedy is that many people don’t know it’s treatable. Thankfully there is a growing body of evidence that it is and best practices pointing the way forward.
According to the World Health Organization (2003), LBP is the most prevalent musculoskeletal condition in the world. It affects 4 to 33 percent of the world population. The sedentary lifestyle in economically developed countries makes the situation worse. A survey of 46,000 adults in 16 European countries showed that nearly 20 percent suffered from chronic pain, 24 percent had back pain. In a 2002 U.S. survey, 26 percent felt LBP at least one whole day over a three month period. Back pain also costs a lot of money! Americans spend at least $50 billion each year treating it, second only to headaches (National Institute of Health). In 2005 $85.9 billion was spent looking for relief through surgery, doctor’s visits, X-rays, MRI’s and medication. But much of the money spent did not decrease the number of people suffering from pain. The conventional approach sustains a health care system that manages not cures. We should ask ourselves if we want a health care system and economy based on loss, suffering and “sick-care,” or one based on prevention, productivity and wellness. Common sense and empirical evidence easily point to the latter. Preventive care and natural approaches save loads of money and foster wellness.
Most people with back pain go to a biomedical physician who takes a conventional approach prescribing medication, like opiates and anti-inflammatory drugs, steroid injections or if severe enough, surgery. But in many cases, surgery is ineffective and should be considered as a last resort. In some cases the surgery can make the problem worse and afterwards create new problems. Nerve and neurological tissue damage can result from surgery. Surgery works by severing a nerve and/or fusing vertebrae together, which afterwards limits flexibility and movement.
The conventional approach fails since it only treats the symptoms instead of the underlying cause. It views pain in isolation from the rest of the body and misses the true source of the pain. Physicians usually advise plenty of rest. But empirical and anecdotal evidence show that movement, like exercise, is more effective and speeds up recovery. Movement is one of the best activities for back pain and other musculoskeletal conditions. Movement costs much less and has no negative side effects! Both independent research and my professional experience demonstrate that exercise provides an advantage over drugs and surgery. It is natural and helps reduce inflammation as well improve overall health.
Many people come to me for back problems because conventional medicine was not successful. Unfortunately there is a lack of education in conventional medicine as to what the best practices for the back are. Based on empirical data we can see that these natural non-medical approaches are clearly more effective than conventional pain management. The largest study yet (Annals of Internal Medicine, 2005) found that compared to conventional exercise classes, those who attended yoga classes were better able to do daily activities and took fewer pain relievers. A 2011 study by the Institute for Cancer Research found that yoga had greater lasting benefits than other compared methods, including simple stretching.
Most bodyworkers, massage therapists, osteopaths, acupuncturists, yoga and Pilates teachers, will tell you that back pain is one of the most common complaints. The number of people using these modalities is steadily increasing. The quiet revolution is that people are finding relief and healthier backs by using far less dangerous, natural approaches. The side effect is better overall health and for some it started with finding a solution to “Oh my back”!
It’s important to distinguish what kind of pain you have. If your pain is sharp or shooting, be gentle and cautious. First have it checked by a trained, qualified health care professional. After you rule out any gross and internal traumas or neurological conditions, you can decide the course of action for care and restoration.
In the second part of this article we’ll look in more detail at the most effective approaches to back pain treatment and care.
In part 1 wrote about how common back pain is and reviewed and criticized popular treatments. A lot of time and massive amounts of money are wasted because of a lack of reliable knowledge about back pain and which treatments really work. The main points in the previous article were: mainstream biomedical treatments of pain are focused on symptoms, not causes or prevention; common treatments like medication and surgery can sometimes make the problem worse, have negative side-effects and do not address the root causes; studies show that movement, which physicians usual recommend you avoid, is actually beneficial to healing and quickens recuperation. Most physicians misdiagnose back pain, and typically attribute it to a herniated or degenerated discs, or local muscle strain. Except in the case of acute trauma, like a pulled muscle, the real cause usually goes unrecognized, because it’s usually not disc-related. Herniated discs are very common and many people who have them don’t have back pain, so it could not be the real cause of pain. For many, back pain may naturally resolve itself with time and daily movement; however, it usual flares up again or reminds a nagging ach. In this article I’ll discuss the most effective ways to prevent and treat back pain.
What is the best treatment approach? That depends on what the cause of your pain is. First it’s important to understand that every body is different. The same treatment that works for one person may not work for another, even if the pain and location are the same. That’s one reason why some people find relief using one kind of treatment and others do not. One size does not fit all, and each case should be looked at individually.
For acute pain you should have a qualified physician or health practitioner evaluate you. For most people MRI’s and X-ray are costly and really not necessary. If you are not in danger, bodywork and manual manipulation from someone who specializes in back pain is an excellent place to start. There are many types of bodywork, but its best to find someone who specializes in back pain. Poor posture and weak core muscles, a complex group of muscles located in lower back, abdomen, hip and pelvis, create the ideal conditions for back pain and injury.
Yoga is one of the most researched and successful methods for prevention and treatment of back pain. It is proven to be more effective than medication-based treatments. Yoga exercises, called asanas, provide variations on stretching, lengthening, strengthening, balancing and relaxation. It works using contraction and relaxation of muscles and organs. Yoga is very effective because it addresses both the local area in pain and the whole body structure, not just the back, which is key for long-term prevention. It also has many other unintended benefits. In all cases it is good to get an evaluation of your posture. Alexander Technique is a very effective educational approach that helps you correct your posture and learn how to use your body in ways that doesn’t stress your back so you can move more freely. The technique helps you “unlearn” common habits that are harmful to the body. Pilates is another excellent method to strengthen the whole body especially the core muscles. Yoga classes are becoming more and more popular, but if you have back pain it’s better to get a tailored plan to your specific problem from a trained Yoga Therapist.
Research shows that acupuncture can bring moderate to complete back pain relief if the pain is not due to gross structural imbalances. It can also be used as part of a comprehensive treatment plan. It’s my experience that treatments will be more effective when combined with multiple modalities for optimum results. For any long-term prevention and health it’s important to develop your own personalized exercise program.
I have found the best approaches to treating back pain are bodywork, yoga, and targeted exercise (swimming is one of the best for over all body strengthening). In cases that are particularly difficult and chronic with no obvious structural causes or trauma, a special diet will usually be the key. Diet is often and under concerned cause of back pain. You may also need to make life-style changes like standing more and sitting less. Excess weight or obesity increases the load on the spine, leading to bad posture, spinal disc degeneration and systemic chronic inflammation
Besides posture and structural imbalances, the principle cause of back pain is physiologically and chemical changes which produces ph imbalances. Sugar, for example increases ph and causes inflammation. There are certain foods that may not be compatible with your body or immune system, which can cause an immune reaction like inflammation, and eventually pain. This is often the root cause of chronic back pain, which can eventually result in crippling diseases like rheumatoid arthritis. Toxins (substances not eliminated from the body) and metabolites can build up in fat and muscle tissue and also cause pain and/or fatigue. When these substances are eliminated from the body, the symptoms often disappear quickly. Many cases of chronic back pain, considered only manageable by biomedicine using pharmaceuticals, can be cured using key structural interviews. In all cases, strengthening through specific exercises, lengthening and structural balance will need to come into play in order to prevent future occurrences of back pain as well as a healthy diet.
Fun actives like dancing that get your hips moving can also be effective for LBP, prevention and overall health, and its fun. Finding save, effective, natural ways of treating the back is easier than you may think. As Benjamin Franklin wrote: “once of prevention is worth a pound of cure”. The simplest thing to remember when it comes to creating good posture and protecting your back is to raise your chest slightly while tucking your chin in slightly and relaxing the abdomen. The rest of the body will naturally fall into place creating your best posture and making you look good in the process.
© 2017 Keyvan Golestaneh