According to the CDC, lower back pain is the most common type of disability globally. In the US, one in four adults reported having back pain in the last three months. Lower back pain is classified based on the type and duration of clinical symptoms: acute (lasting less than 4 weeks), subacute (lasting 4-12 weeks) and chronic (lasting more than 12 weeks). What is alarming is that even with the lack of evidence to support its efficacy, almost 14% of insured patients who sought care for lower back pain were prescribed pharmacological drugs like opioids and/or benzodiazepines. These addictive narcotics and sedatives have severe consequences which can lead to overdose, mis-use and death (nearly 50,000 people died in the US from opioid mis-use in 2019).
So in this blog, I’ll share some evidence-based complementary approaches for back pain that are non-invasive and non-pharmacological treatments.
In this review of 45 clinical trials, participants exhibited significantly lower chronic back pain with exercise intervention. The results found strength/resistance and stabilization/coordination exercise programs to be the most effective forms. For strengthening and stabilizing exercises for back pain, try:
Acupuncture, massage therapy and yoga were three key modalities recommended based on this analysis of randomized, controlled clinical trials conducted on complementary approaches to back pain management.
This ancient practice has been used in Asia for centuries to treat a myriad of conditions and relieve pain. The Chinese form of acupuncture involves inserting fine needles into the skin to work on the trigger points of the body and stimulate endorphins to kill pain. In other variations of this practice, heat or electrical stimulation may be applied to enhance the effects. Check out my earlier blog on how acupuncture works for managing pain.
When looking for an acupuncturist, make sure you verify the credentials and references prior to getting needled as laws vary by state. If unsure, it’s best to find an acupuncturist with certification from the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org). Here’s a useful guide I put together on what to look for: https://community.wholistics.health/making-sense-of-the-alphabet-soup/
There are many forms of massage therapy but make sure your practitioner is licensed in your state and certified by a national organization like the American Massage Therapy Association. Also, here’s a quick guide to finding the right massage for you.
In this systematic review of clinical trials conducted on non-pharmacologic treatments for back pain, the strongest recommendations were given for exercise, acupuncture, tai chi, yoga, motor control exercise, and cognitive behavioral therapy.
Tai Chi is a centuries-old Chinese martial art that utilizes slow, flowing exercises with movement, meditation and rhythmic breathing. Here’s one to try:
For yoga for back pain, here’s a video to check out:
Motor control exercises
These exercises, also called: lumbar stabilization, neuromuscular training, trunk stabilization and segmental stabilizing exercise, utilize a combination of whole-body movements, trunk-focused strengthening exercises, and stretching in order to increase spinal stability. These exercises are well established in the literature to reduce pain and disability. Here’s a good one to try:
Cognitive behavioral therapy
CBT is a type of psychotherapy that enables you to better cope with negative and challenging situations, including chronic pain. If you’re interested in this form of therapy, look for a qualified, certified CBT counselor/therapist in your area:
Bath for muscle pain
How about a nice soak in the tub with Epsom salts and some essential oils? Although Epsom salts (magnesium sulfate) are widely used for alleviating muscle pain, most research done to date on pain management has been on other forms of magnesium (oral, intravenous). So instead of the aspirin or a non-steroidal anti-inflammatory drug habit (like Advil), try an Epsom salts bath to provide soothing relief to your aches and pains without the side effects.
Clinical aromatherapy has been studied for a variety of conditions including pain management. It is understood that the essential oils have a pain-relieving effect on the body combined with a relaxant effect on the nervous system.
Here’s a pain-killing bath recipe to try:
- 2 cups Epsom salts
- 3 drops Rosemary Oil
- 3 drops Lavender Oil
- 3 drops Peppermint Oil
Other essential oils with analgesic and anti-spasmodic effects includer ginger, marjoram, geranium, lemongrass and Roman chamomile – so feel free to mix and match based on preference and what’s readily available. Check out some of these tips and join the Pain forum and let me know what works for you!
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