By Dr. Mercola
It's estimated that, globally, one out of every 10 people suffer from lower back pain. The problem appears to be particularly prevalent in the US. According to earlier estimates, as many as eight out of 10 Americans struggle with back pain.
In the US, it accounts for 10 percent of all primary care doctors visits each year, costing Americans as much as $86 billion annually,1 but according to recent findings, back pain is also the number one cause of job disability worldwide.
Clearly, it's a universal problem of extreme proportions. The study, published in the Annals of Rheumatic Diseases,2 found that out of 291 health conditions included in the Global Burden of Disease 2010 Study, low-back pain ranked at the very top in terms of disability. According to the authors:
"Lower back pain (LBP) causes more global disability than any other condition. With the ageing population, there is an urgent need for further research to better understand LBP across different settings."
Back Pain—A Driving Force Behind A Growing Drug Problem
A related concern, which was not addressed in the featured study, is the fact that lower back pain is also one of the primary reasons why people get hooked on prescription painkillers.
Deaths caused by overdosing on painkillers now surpass murders and fatal car accidents in the US, and over the past five years, heroin deaths have increased by 45 percent3 --an increase that officials blame on the rise of addictive prescription drugs such as Vicodin, OxyContin, Percocet, codeine, and Fentora, all of which are opioids (derivatives of opium). Heroin is simply a cheaper option to these prescription medications.
Still, prescription painkillers claim far more lives than illegal street drugs like heroin. According to Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy,4 prescription painkillers were responsible for 16,600 deaths in 2010—well over five times more than those caused by heroin.
US officials have recently gone on the offensive, stating that narcotic painkillers are a driving force in the rise of substance abuse and lethal overdoses, and that both patients and doctors need to become better informed about their risks.
Back pain, in turn, is a driving force behind opioid drug use, which makes it a central focus not just for decreasing disability claims and improving health and quality of life for millions of people, but also for tackling a rapidly growing problem of legal drug abuse and the associated death toll.
What Commonly Causes Back Pain?
Accidents and sports injuries are the most common causes of chronic back pain, but there are also a number of other factors that can increase your risk, including:
Poor physical conditioning facilitated by inactivity
||Internal disease, such as kidney stones, infections, and blood clots
Obesity - According to a study posted in the Journal of American Epidemiology, overweight and obese people had a higher prevalence of low back pain than non-overweight individuals5
Osteoporosis or bone loss (as measured by the Z-score and not the young adult-based T-score)
Beware: The Worst Treatment Options for Back Pain Are Also the Most Commonly Prescribed
Despite it being so common, few people—including specialists—have a clear understanding of how to treat back pain. Typically, chronic back pain will result in a prescription for a painkiller. Surgery is another overused and largely ineffective strategy that rarely leads to full recovery. On the contrary, it's usually the quickest route to a life of permanent disability.
If you have low back pain and see different specialists, you will get different tests: rheumatologists will order blood tests, neurologists will order nerve impulse tests, and surgeons will order MRIs and CT scans.
But no matter what tests you get, you'll probably end up with a spinal fusion because it's one of the "more lucrative procedures in medicine," according to Shannon Brownlee, author of the book, Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer. This despite the fact that the best success rate for spinal fusions is a mere 25 percent!
According to one 2011 review,6 more than 17 percent of patients told they needed spinal surgery actually showed no abnormal neurological or radiographic findings that would necessitate surgery.
Chiropractic Care May Relieve Pain Better Than Drugs
Seeing a qualified chiropractor or a doctor of osteopathic medicine (DO) is another wise option if you suffer from any type of chronic pain, including back pain. One study published in the Annals of Internal Medicine7 revealed that chiropractic care oftentimes provides greater relief than medication.
After following more than 270 neck-pain patients for 12 weeks, researchers found that those who used a chiropractor or exercised were more than twice as likely to be pain-free compared to those who took medication. Although this study involved neck pain rather than back pain, it's likely the results apply to back pain as well. The results showed:
- 32 percent who received chiropractic care became pain-free
- 30 percent of those who exercised became pain-free
- 13 percent of those treated with medication became pain-free
I am an avid believer in the chiropractic philosophy, which places a strong emphasis on your body's innate healing wisdom and far less reliance on Band-Aid solutions like drugs and surgery. Chiropractic, osteopathic, and naturopathic physicians receive extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which typically lasts anywhere from four to six years.
Due to their comprehensive training in musculoskeletal management, numerous sources of evidence have shown that chiropractic management is much safer and often more effective than allopathic medical treatments, particularly for back and neck pain. In addition, researchers have also found that chiropractic adjustments affect our bodies on a deep cellular level.
This means that chiropractic care may affect basic physiological processes that influence oxidative stress and DNA repair, so in addition to addressing any immediate spinal misalignment that might cause pain, it may also address deeper dysfunction in your body. Acupuncture can be another useful approach, although in my experience requires a bit more time to achieve results.
The Importance of Proper Posture, Both When Sitting and Standing
Addressing your posture is another critical element of self-care that, in many cases, can even help eliminate chronic back pain altogether. Spending most of your day slouched behind a desk or on the couch is a surefire way to develop back pain. Sitting is also an independent risk factor of everything from diabetes to heart disease, and can even take years off your life—even if you exercise regularly!
If you spend the majority of your day sitting like I do, then I could not encourage you more strongly to review last week's article on sitting and intermittent movement, which provides dozens of different mini exercises you can do to interrupt your sitting. Even though I have always been very fit, I believe my chronic sitting caused me back pain, and these intermittent movement exercises have eliminated it.
Proper posture is truly foundational for health and most who live in industrialized cultures have far from ideal posture. By understanding the functional biomechanics of your body, you can learn to optimize the way you move at all times. This in turn effectively prevents aches and pains from developing.
Two effective methods to relearn proper posture are Foundation Training, developed by chiropractor Dr. Eric Goodman to address his own chronic back pain, and the Gokhale Method, created by Esther Gokhale. Her method teaches you to return to what she calls "primal posture," which is the way your body was designed to stand, sit, and move. For a more complete discussion and demonstrations of her techniques, please review my previous article, "The Gokhale Method: Banish Pain by Relearning Proper Posture."
Another important factor is to simply stand up at regular intervals, as this will help counteract the ill effects of sitting. I've found that every 15 minutes seems to be the "sweet spot" for me. I simply set a timer to go off at 15-minute intervals, at which time I stand up and do a few jump squats, one-legged squats, or a wide variety of different hip and chest stretches.
PLEASE Read This Recommendation BEFORE You Ever Consider Back Surgery
Personally, I strongly advise you to AVOID going under the knife until or unless you've exhausted all other treatment options, which include but is not necessarily limited to chiropractic treatments, massage, acupuncture, exercise, yoga, and perhaps most importantly, K-Laser treatment. Truly, I cannot stress this enough; it's one of my most important recommendations: Please avoid surgery until you've tried K-Laser — it's just that good. You have virtually nothing to lose except some time and a relatively minor investment in the treatment, and everything to gain.
K-Laser therapy is typically a tiny fraction of the cost of surgery and has virtually no detrimental side effects, unlike surgery, where just about anything can go wrong. Not to mention the risk of contracting a potentially deadly hospital-acquired infection—a problem that kills more than 205 Americans each and every day. Class 4 laser therapy can also be effectively combined with a number of other treatment modalities, including various soft tissue mobilization techniques. Ideally, your doctor would do the K-Laser treatment before they do those soft tissue techniques.
The Benefits of K-Laser Class 4 Laser Therapy
Several beneficial things happen during K-Laser treatment. First, infrared laser therapy treatment helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones. These benefits are the result of enhanced microcirculation, as the treatment stimulates red blood cell flow in the treatment area. Venous and lymphatic return is also enhanced, as is oxygenation of those tissues.
Finally, the treatment stimulates the cytochrome oxidase enzyme in your cells' mitochondria. This is really one of the key discoveries in the whole science of laser therapy. Specifically, injured cells are targeted because damaged cells are more readily accepting of photons of light, whereas healthy cells don't need this extra energy. As explained by Dr. Phil Harrington, who is an expert on the use of K-Laser therapy:
"By stimulating the cytochrome oxidase enzyme, we are utilizing that oxygen in the respiratory chain inside of the mitochondria, producing more ATP for that cell. So regardless of what kind of cell it is, it's going to function at a higher level."
The three infrared wavelengths of the K-Laser target water, hemoglobin and the enzyme to most efficiently stimulate cellular metabolism. The K-Laser is unique in that it is the only Class 4 therapy laser that utilizes three infrared wavelengths that penetrate deep into the body to reach areas such as your spine and hip. For more information about this groundbreaking technology, and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
Download Interview Transcript
Additional Solutions for Pain Relief
Considering the risks, I strongly recommend exhausting your options before resorting to a narcotic pain reliever or surgery. I believe there are better and much safer alternatives, including intermittent movement, postural training, chiropractic, osteopathic, naturopathic, acupuncture, and K-Laser treatment. Neither drugs nor surgery address the underlying cause of your pain, and both come with the risk of serious side effects. The following options can also provide pain relief. So if you're in pain, try these first, before even thinking about prescription painkillers of any kind.
- Eliminate or radically reduce processed foods, grains, and processed sugars from your diet. Avoiding grains and processed sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
- Start taking high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they manipulate prostaglandins.)
- Optimize your production of vitamin D by getting regular, appropriate sunshine or taking a vitamin D3 supplement, which will work through a variety of different mechanisms to reduce your pain.
- Emotional Freedom Technique (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain.
- Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility.8 A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.9
- Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple, including some of the bromelain-rich stem, may also be helpful.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
- Evening primrose, black currant and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.