integrative medicine – watercress words by Dr Aletha

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.

BASIC POINTS

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.

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.

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/Acupressure

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.

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.

EAT TO TREAT

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.

PLANTS THAT TREAT

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.

USING OUR MINDS

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

TAKE A DEEP BREATH

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.

GET MOVING

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 Lightstock.com

Yoga
Tai chai
Aerobics
Strength training
Dance
Sports
Walking
Jogging
Bicycling

Dr Aletha in her bicycle helmet — I’m riding my bicycle while my neighbor is walking with his baby. It all counts.

TOUCH

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

TRAINING THE MIND

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.

CHANGING OUR LIVES

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?

Hygiene

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.

Sleep

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

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.

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.

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.