Surprising effective ways to relieve back pain

What is the most common disability world wide? What most commonly causes workplace absence?

Would you be surprised that it is low back pain?

What is the most common disability world wide? What most commonly causes workplace absence?

Would you be surprised that it is low back pain?

Pain in the spine, including the neck and back, affects 85% of people at some time. I’ve had it, my husband has had it, and likely you have too. Low back pain causes $7.4 billion in lost revenue from lost or decreased workplace productivity. Add to that the health care costs and it exceeds $100 billion.

Let’s explore  what causes back pain, and what we can do about it, focusing on non-drug non-surgical methods.





This post will explain some of the treatments which are backed by medical studies and recommended by medical experts.

We should use medication and surgery when appropriate, but when these can’t be used or are not helpful, we can consider alternative methods, or what I and other doctors prefer to call complementary or integrative treatment.

This post focuses on symptom relief, not necessarily curative treatment.

Herbals and supplements are drugs and can be effective for certain conditions, but this post will discuss non-drug treatments only.

Many cases of back pain improve spontaneously with no specific treatment.

Almost everything works sometimes.

There are few if any down side to any of these treatments. Used under supervision they are unlikely to have adverse side effects or result in long term complications.

The most important ingredient in managing a chronic or persistent condition is having a therapeutic relationship with your physician and other healthcare professionals- physical therapist , mental health counselor, nutritionist.

doctor holding a patient's hand

I do not recommend you pursue any of the treatments mentioned in this post without first consulting a qualified health professional about your condition.

What causes back and neck pain

Pain in the spine results from many medical conditions, ranging from minor to life threatening. Most cases are due to routine or excessive physical activity or a minor injury causing strain of the muscles, tendons, and ligaments, and will go away with no or minimal intervention in less than 12 weeks.

a human skeleton
The spine connects the head to the rest of the body. It extends from the skull to the pelvis and legs, and along the way attaches to the shoulders and rib cage.

Some cases are due to serious but treatable conditions like

  • Infection
  • Major injury, causing broken bones (fractures) or more severe injury to the muscles and nerves.
  • Cancer of the spine, which may have started somewhere else in the body and spread to the bones, called metastasis.
  • Various forms of arthritis- degenerative, rheumatoid, psoriatic
  • Disorders of the intervertebral discs, the soft jelly like cushions between the bones of the spine, the vertebrae
  • Fibromyalgia– a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.


Managing pain in the neck or spine

The first step in treating back pain is to identify the underlying cause and treat that appropriately, which might involve anti-inflammatory medication, antibiotics, surgery, chemotherapy, radiation, and/or injections.

But sometimes pain persists after these treatments, or none of those treatments are appropriate or effective.

Medications for back pain

Patients often expect, and doctors have traditionally turned to pain relieving medications starting with the non prescription drugs like acetaminophen (Tylenol) and the anti-inflammatories called NSAIDS. A muscle relaxer might be added if muscle spasm is present. If those are not sufficient, the next step was often narcotics or opioids.

But we know that the benefit and effectiveness of these drugs do not always outweigh the side effects and risks so we look harder at non-drug methods to relieve pain. And studies comparing them indicate they can be as effective if not more so than drugs.

More about this at my related post

7 overused drugs



Integrative medical treatments for back pain


Lifestyle changes

Back pain sufferers should start by avoiding or modifying activities that cause or aggravate back or neck pain .

  • In  the workplace- more frequent breaks, limits on lifting, a different chair, adjusting the height of a desk or computer monitor or keyboard.
  • At home- changes in performing chores like vacuuming, mopping, gardening, laundry.
  • Smoking may not cause back pain, but use of tobacco seems to increase the risk of developing back pain. Another good reason to not start or to stop if you already start.     7 surprising reasons to be smoke free
  • Excess weight also contributes to back problems,maybe by putting more stress on the spine, or by limiting physical activity. Losing those extra pounds or kilograms may decrease pain. Obesity and pain- you can lose both this year


sign says NO smoking, wilderness area
When walking, wear proper shoes; and NO smoking.



Physical activity/Exercise for spine pain

All guidelines for back pain treatment encourage continued physical activity rather than bedrest, and agree than any activity is better than nothing.

a bed in a room
Rest in bed only for severe pain and for short intervals.

Some of the frequently recommended activities include

Meditative movement therapies are exercises that include body movement or positioning and focus on breathing and relaxation. Examples include Tai chi and yoga.

Other types of exercises which involve a combination of stretching and strengthening, as well as aerobic conditioning. This includes Pilates and other exercise, walking, jogging, dancing, swimming, and many sports.

jogging trail sign
Get up and move more.

When using any exercise to treat back pain you should consider working with a certified instructor who is aware of your condition. Don’t do any positions or movements that cause or aggravate the pain.






Topical therapies

    • Heat and/or ice applications
    • Hydrotherapy or aquatics – the use of water or an aquatic environment (includes exercise in water)



 Manual therapy

  • Massage
  • Spinal manipulation, osteopathic or chiropractic




Acupuncture, a staple of traditional Chinese medicine, which is becoming more popular in the Western world, uses very fine needles to stimulate various pressure points around the body and re-shift the body’s balance of energy. The practice is also thought to improve blood flow and increase levels of the body’s natural pain-relieving chemicals. Acupressure uses the same principle with pressure instead of needles.



An acupressure mat (affiliate link)



Dr. Michelle Ramirez explains more about  acupuncture and its uses at this link.

A look at acupuncture




Mindfulness based stress reduction/CBT(cognitive behavioral therapy)

Does the way you think affect pain? Apparently so. Studies show that “mind-body” approaches that reduce stress and enhance relaxation can reduce functional limitations and distress from back pain.

WebMD explains how this works-

“Cognitive behavioral therapy (CBT) is a form of talk therapy that helps people identify and develop skills to change negative thoughts and behaviors.

CBT says that individuals — not outside situations and events — create their own experiences, pain included.

And by changing their negative thoughts and behaviors, people can change their awareness of pain and develop better coping skills, even if the actual level of pain stays the same.”

Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach






The North American Spine Society offers

10 Tips for a Healthy Back

feet in sports shoes
Don’t let back pain keep you from  being active and enjoying life.









The product links in this post are for illustration only, and do not imply endorsement.

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In a future post I will talk about how to manage other types of pain, and use of non-drug treatments for other conditions.

exploring the HEART of health with you.

    Dr. Aletha  




I’m pleased to share this post at

Encouraging Hearts and Home
a link up of family friendly blog posts every Thursday



This affiliate link can help you get fit at home on your own terms. I am enjoying working out with the Aaptiv trainers. Give it a try.

Why are we obsessed with OCD?

It seems that everyone is obsessive compulsive these days and sports a tee shirt or posts a social media message to prove it.

We are obsessed with a variety of things most of them generally benign or even good- cooking, reading, sewing, running, dancing, decluttering, work- you name it and there seems to be an obsession for it. But do these make it a disorder?

Probably not. And that is why I’m concerned that people throw around the term OCD, acronym for obsessive-compulsive disorder, minimizing the seriousness of the disorder for the people who do suffer from it.

an MRI image of the human brain ; there is still much we do not understand about how the brain works and why problems develop (photo from Pixabay)



Maybe I’m sensitive about this because as a physician I deal with people who have all kinds of disorders which are disabling and disturbing and because I deal with neuropsychiatric disorders in my family.

My late mother suffered from severe dementia for several years; early on the main symptom was poor memory; some people thought it was no big deal, not considering that forgetting important things like where you live has serious consequences.

Many years after a tour of duty in Vietnam, my veteran husband still works on managing  depression and PTSD (post-traumatic stress disorder).

And my grandson is on the autism spectrum, affecting his social and verbal development.


disorder causes distress and affects functioning; these conditions as well as OCD fit that criteria.

Obsessive compulsive disorder , OCD, is a distinct neuropsychiatric disorder

with characteristic and diagnostic features. These are

  • Recurrent distressing thoughts such as contamination, aggression, superstition, exactness, doubt

  • Repetitive behaviors or mental rituals such as handwashing, checking, counting, ordering,


These behaviors are

  • performed to relieve anxiety

  • consume an unreasonable amount of time, and

  • impair  social interaction and work.

Those affected may feel shame and secrecy.

The exact criteria for a diagnosis of obsessive-compulsive disorder are outlined in the recently updated Diagnostic and Statistical Manual of Mental Disorders, aka DSM-5.



OCD can be mistaken for other disorders including

  • ADHD- attention-deficit hyperactivity disorder,
  • anxiety,
  • autism,
  • depression,
  • psychosis
  • Tourette syndrome

(Read information about these and other neuropsychiatric conditions at this link. )




I think some people who claim OCD may  have obsessive compulsive personality disorder. Their behavior emphasizes organization, perfectionism and a sense of control but they are not disabled  by it.

Most people who like things to be neat, orderly, organized and perfect do not have OCD.



OCD can be difficult to diagnose,because patients  do not seek help, or are too embarrassed to report their symptoms in detail.

But with treatment much of the distress can be eliminated or at least minimized so no one needs to hesitate to seek help.

So, if you think you or someone you love may have OCD, see your physician. Many primary care physicians can and do diagnose and treat this disorder, or will  refer patients to a psychiatrist (M.D.or D.O.) or other mental health professional.




Available treatments include

CBT, cognitive behavior therapy, using exposure to anxiety producing stimuli and  and learning response prevention( not performing the compulsive behaviors),  administered by a trained health care professional in an individual or group format.

Some patients choose medication; Several medications are effective and should be continued for at least 1-2 years, if not indefinitely, as there is a fairly high rate of recurrence.

If either treatment alone lacks effective relief, they can be used together.

Deep brain stimulation is approved by the FDA as a last resort only for severe cases which don’t respond to the approved medications and CBT. So far it has been used in only a few patients.


Follow this link to a printable article about OCD from .

Find more information at this link from the American Psychiatric Association .


The Mighty,a website that reports on disability, mental illness and chronic disease, posted a story about OCD; they asked “people with OCD” to share their symptoms. I don’t know whether  these people had professionally diagnosed  OCD, the descriptions shared in this article sound compatible with true disabling obsessions and compulsions.

And please review a previous watercress words post on mental illness.


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