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.

Please share this post on social media and follow this blog.

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.

non-drug ways to get well and stay well

In a previous post I introduced you to Mind Over Meds by Dr. Andrew Weil . I reviewed 7 classes of medications he teaches we should use less often. MIND OVER MEDS- book cover

In another previous post I shared 7 drug classes I consider overused, 4 of which he discusses in his book.

In this follow up post I list alternatives to drug therapy. These are also adjuncts to medication- meaning we recommend using them even if you do need medication.

Dr. Weil mentions these in his book, and I’ve pulled from other sources too.

This is a brief overview of several approaches, not a complete list. If you are interested in knowing more, I suggest exploring the reference links. I invite you to send me a message about a topic you would like me to explore in more depth here.

This post uses affiliate links  that support this blog and non-affiliate links that don’t.


I, Dr. Weil and most physicians recommend diet changes to treat and prevent many common medical conditions. Almost any health issue can be improved with better food choices.

bottle of olive oil
Olive oil is an important ingredient in the Mediterranean diet .

The Mediterranean diet, emphasizing fruits and vegetables, whole grains, fish,  and healthy fats like olive oil, seems to protect against heart disease and increase longevity.

The DASH diet is the first choice to lower blood pressure. DASH stands for Dietary Approaches to Stop Hypertension and also emphasizes fresh foods and healthy choices.

The American Diabetes Association offers extensive information on eating to control diabetes.

Food choices are also important in treating high cholesterol, GERD, allergy, heart disease, overweight, gout, kidney stones and other kidney disease, and possibly other conditions.


Herbal medicines are endorsed by Dr. Weil; he points out that early synthetic drugs were derived from plants. Unfortunately most physicians have not had extensive training in their use. They are also not regulated as stringently as prescription drugs so quality may not be uniform.

Herbal medicines are used to treat a wide variety of conditions and symptoms including headaches, gastric distress, hot flushes, depression, insomnia, pain, allergy among others. Scientific confirmation of their effectiveness is lacking for most, but some patients find them helpful and some physicians endorse, or at best tolerate their use.

The unsupervised use of herbs and other dietary supplements can be dangerous, especially if combined with other drugs.


Mind-body therapies can be helpful in managing painful conditions such as IBS (irritable bowel syndrome), migraine, joint pain, and anxiety/depressive disorders. These include

  • Hyposis
  • Biofeedback
  • Meditation
  • Relaxation techniques



Breath work- changing habits of breathing and specific breathing techniques can relieve anxiety, and manage stress. Dr. Weil calls

Breathing: The Master Key to Self Healing and teaches how to do it in this recording. 


Exercise and other forms of physical activity help manage all kinds of musculoskeletal pain, fibromyalgia, lowers blood pressure, aids weight loss,relieves anxiety and depression.  They may even have a role in preventing or delaying the onset of dementia. This includes

woman standing on a rock in a forest
Walking, especially outdoors, can relieve feelings of stress and tension as well as improve physical fitness.  Photo from



Tai chai


Strength training







Manual medicine is used to manage back, neck, and other musculoskeletal pain and headaches.

  • Chiropractic manipulation
  • Osteopathic manipulation
  • Acupuncture
  • TNS-transcutaneous nerve stimulation
  • Massage
  • Support with splints, wraps, slings, braces


CBT (cognitive behavioral therapy) and other forms of psychotherapy should be a part of the treatment of most mental disorders and may be the only treatment needed for mild conditions. The use of therapy animals also fits here.


Lifestyle evaluation and adjustments can improve any medical condition and is also one of the most important factors in prevention of disease.



a sink with colorful wall decorations
Who knew handwashing could be entertaining?

Hand washing is the most effective way to prevent many infections, especially those that can be transmitted by food and water. Proper food preparation and storage and kitchen clean up also contribute to safety.






Habits that create sleep deprivation or poor sleep contribute to depression,musculoskeletal pain, headaches, fatigue, and even make us more prone to infection. Check out this previous post on how to get a good night’s sleep

a bed in a room
One’s sleep environment affects quality of sleep.








Chemicals and pollutants

Avoidance of allergens and toxins should be automatic. For allergy, any known allergens -substances that cause allergy symptoms-can often be eliminated from one’s immediate environment, although I have had patients who insisted on keeping pets that they were allergic to. If the allergens cannot be completely eliminated, you can at least minimize exposure.

At this affiliate link you can find products to help eliminate allergens in your home


It seems we call everything a “toxin” these days, and detox regimens are popular. (although our bodies naturally detox us every day).

Anything in excess can be harmful. But our overall health as a society would improve immensely if more people would avoid the obvious toxins of tobacco, excess alcohol, and illicit drugs.

sign says NO smoking, wilderness area
When walking, wear proper shoes; and don’t smoke.

Review 7 surprising reasons to be smoke free







Stress management 

Many of the techniques I’ve mentioned help with stress management. In turn, managing the stressful events and situations in our lives can help us feel more rested, less tense, more relaxed, calmer, and able to manage our other medical problems better. offers these steps to Managing Daily Stress 



Dr. Weil recommends these resources about  integrative and complementary medical treatments

The National Center for Complementary and Integrative Health

The Office of Dietary Supplements 


Dr. Weil’s books are also available at

Barnes & Noble – Free Shipping of $25+


If you found this post helpful, please share with friends and colleagues. And let me know too. I welcome feedback and use it to plan future posts.

7 more overused drugs – a book review

Learn what meds you should avoid and why #MindOverMeds#DrWeil#IntegrativeMedicine#bookreview

When I wrote the post 7 overused drugs, I knew other doctors would agree with me, but I didn’t know that a well known doctor was publishing a book that agrees with it.

MIND OVER MEDS- book cover

Published this year by Little, Brown and Company, MIND OVER MEDS teaches you to know

“When Drugs Are Necessary,

When Alternatives Are Better-and When to

Let Your Body Heal on Its Own.”

Andrew Weil, M.D. wote MIND OVER MEDS as well as  Spontaneous Happiness, Spontaneous Healing and other books on physical and emotional health and healing, nutrition, and integrative healthcare. He is the director of the University of Arizona Center for Integrative Medicine.

After the introduction, each chapter stands alone if you want to explore a particular class of medication. The book can also be useful as a reference manual. For each chapter Dr. Weil also collaborated with colleagues with expertise in those areas.

Besides 4 of the 7 drugs that I discussed in my post, Dr. Weil discusses 7 other broad categories that I will briefly review.

 general principles about drug use

  • Don’t stop taking a prescription medication suddenly, unless instructed to by a physician.
  • Wean off medications gradually, supervised by a physician.
  • Don’t attempt to stop medication without first initiating other measures to manage the condition the medication was prescribed for. (paraphrased from the introduction)

Dr. Weil reviewed four medication groups that I discussed in this post- 7 overused drugs

  • Antibiotics
  • Sleep aids
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • Opioids and the Treatment of Chronic Pain


Neither of us reject these drugs completely; rather we urge caution,

  • don’t rush to use them without trying non-drug treatments first or concurrently,
  • use only when absolutely necessary, and
  • be aware of potential side effects and harms.

 7 other classes of overused medication

1.Statins- medication used to lower blood cholesterol and prevent heart disease

“Current emphasis on statin therapy should be

balanced by equal emphasis on lifestyle changes.”

diagram of the human heart
Heart diseases affect any and sometimes multiple parts of the heart- the atria, ventricles, the valves, the aorta, the pulmonary artery and veins, the walls and the coronary arteries (not shown in this diagram. )

2. Medication for GERD- gastroesophageal reflux disease, commonly referred to as reflux or heartburn

“Heartburn is a warning sign of disturbed GI function that should prompt us to identify and change the habits responsible for it.”

3. Antihistamines (allergy meds) and Medications for the Common Cold and Flu

These are in two separate chapters but I group them together since the same meds can be used to treat all three conditions.

“People with allergic rhinitis and others…would be wise not to rely on antihistamines, but to try natural remedies and lifestyle change …to control symptoms.”

“Most healthy people recover from both colds and flu on their own with no need for drugs, prescription or OTC (over the counter). “

I included antihistamines on my list of drugs that are underused. I was referring to people with severe uncontrolled allergy. Dr. Weil seems to concur with their use in this case.

4. Steroids- the steroids in the cortisone family, not the anabolic steroids

“Save these powerful drugs for serious conditions and try to slowly wean off them once improvement occurs.”

5. Psychiatric Medications for Adults, Children and Adolescents and for Attention Deficit Hyperactivity Disorder (ADHD)

Dr. Weil’s discussion of these medications takes up three chapters but I’m grouping them together.

These drugs are on my list of underused drugs. I said that because severe mental illness symptoms usually needs  medication for adequate control and those people should stay on medication indefinitely, until a physician recommends stopping. Otherwise, I agree with Dr. Weil that milder illness may not need medication.

“Antidepressant drugs are indicated for major depression, not for routine management of mild to moderate depression, for which more effective and safer treatment options exist.”

“Medication treatment should always be integrated with psychotherapy and other non-pharmacological approaches and should be discontinued as soon as possible” (the chapter on children)

“ADHD is highly overdiagnosed. Children with learning or behavioral difficulties should be carefully evaluated before being labeled with the disorder.”

6. Antihypertensive (hypertension or high blood pressure) Drugs and Medications for Diabetes

I’m grouping these together because these

two conditions frequently occur together, what we in medicine call comorbidity.        complications of high blood pressure

“In treating high blood pressure, it is extremely important to take individual uniqueness into account.”

“Our health care system and our society should encourage better lifestyle choices by making these…more accessible and more affordable…by changing diet, increasing physical activity ..many will be able to keep their use of medications to a minimum..”

7. Medications for Osteopenia (thin bones) and Other Preconditions

“Most people with osteopenia have …low fracture risk. They do not need drug therapy, since the risk outweighs the benefit.”

If you need to check if any of your medications fall into any of these categories, you can check at this link, or ask a question in the comments or here.

MedLine Plus- Drugs, Herbs, and Supplements 

Last words about medication overuse

Dr. Weil offers these last words(among several others) about using meds wisely.

To consumers-

Be informed. Do not take medications (of any kind) unless you know the reason, how they work, and the potential benefits versus the potential risks.

To pharmacists-

Be knowledgeable about the dietary supplements, herbal remedies, and other natural products that consumers are taking.

To physicians, nurses, and allied health care providers-

Be informed about alternatives to medications therapy for the health conditions you see.

To all readers of his book

Contact your elected representatives to end direct-to-consumer advertising of prescription medications.


So what are the alternatives to using drugs for these and other conditions? I’ll tell you what Dr. Weil says, as well as other experts, in my next post. Or, you can get Dr. Weil’s book and find out now.

For your review:

7 overused medications

7 underused medications