By Dr. Mercola
The vast majority of Americans will experience back pain at some point during their lives. In most cases (upwards of 90 percent), the pain will go away on its own, allowing you to go about with your normal activities.
Still, if you're in the midst of a back-pain episode, the pain can be severe and debilitating, and this is why back pain is the leading reason why people visit orthopedic surgeons and neurosurgeons, and the second leading reason why people visit primary care physicians.
For a small number of these people, an estimated 5 percent to 10 percent, the pain may become chronic, leading to repeated medical visits. Unfortunately, despite seeking medical treatment, many patients who visit primary care doctors for back pain report they are "often dissatisfied with the care, information, and treatment they receive."1
Among those with chronic back pain, "unmet needs and expectations" are common. In fact, according to one study, "patients repeatedly seek care, not because past care was remembered as having been helpful, but because past care failed to answer fundamental questions about the cause of their pain."2
In other words, many people with back pain are looking to understand the underlying reasons why they're in pain, but, instead, what they're often getting is a lot of superficial (and unnecessary) treatment.
Back Pain Is Often Overtreated
In the video above, Dr. Mike Evans, founder of the Health Design Lab at the Li Ka Shing Knowledge Institute and an Associate Professor of Family Medicine and Public Health at the University of Toronto, gives a clear-cut explanation of the basics of back pain.
As you'll see, in most cases back pain is not a sign of an underlying disease. If you have certain red flags, such as a sudden change in bowel or bladder habits, history of cancer or serious infection, or unexplained weight loss, then you should have your pain checked out by a specialist.
If not, there's a good chance you need nothing more than regular exercise, restorative sleep, stress relief, and, likely, some active supportive therapies (see below).
Instead, back pain is increasingly being treated with addictive drugs and diagnostic exams that expose patients to potentially unnecessary and dangerous levels of radiation, along with often-unnecessary (and ineffective) procedures, like steroid injections and surgery.
Back pain is actually one of the primary reasons why so many American adults get addicted to pain killers. According to one review of more than 23,900 outpatient visits for back pain that were unrelated to more serious conditions (such as cancer) over a 12-year period (1999-2010):3
- Use of Tylenol and NSAIDs declined by just over 50 percent
- Prescriptions for opiates increased by 51 percent
- CT and MRI scans rose by 57 percent
- Referrals to specialists increased by 106 percent
- Use of physical therapy remained steady at about 20 percent
The study's senior author, Dr. Bruce E. Landon, a professor of health care policy at Harvard, even told The New York Times4 that back pain actually tends to improve by itself in most cases, adding:
"It's a long conversation for physicians to educate patients. Often it's easier just to order a test or give a narcotic rather than having a conversation. It's not always easy to do the right thing."
'Movement Is Medicine' for Back Pain
This is one of the central premises of the featured video, and it bears repeating. Your body needs regular activity to remain in balance and pain-free. For example, when you sit for long periods of time, you typically end up shortening your iliacus, psoas, and quadratus lumborum muscles that connect from your lumbar region to the top of your femur and pelvis.
When these muscles are chronically short, it can cause severe pain when you stand up as they will effectively pull your lower back (lumbar) forward. Imbalance among the anterior and posterior chains of muscles leads to many of the physical pains you experience. By rebalancing and strengthening these muscles, you can remedy many pains and discomforts, including low back pain.
One of the best things you can do to prevent and manage back pain is to exercise regularly to keep your back and abdominal muscles strong and flexible. Foundation Training—an innovative method developed by Dr. Eric Goodman to treat his own chronic low back pain—is an excellent alternative to Band Aid options like painkillers and surgery that addresses the cause of the problem. It is one that I have been doing virtually every day for a few years now. Foundation Training exercises are designed to strengthen your posterior chain of muscles that support your back, and teach your body to move naturally, the way it was designed to move.
Another approach is creating and maintaining a balance between stability and mobility as well as your body's ability to move efficiently and resiliently on all planes with Lisa Huck's 3-Dimesional Dynamic Movement Techniques (see the video above). I have found Lisa's recommendations useful and also use these every day.
Both of these strategies are far more effective than the typical conventional medical approach for back pain. Relieving, and preventing, back pain can also be as simple as interrupting your sitting regularly, about every 15 minutes, which I call intermittent movement.
If you have back pain, I could not encourage you more strongly to review this article on sitting and intermittent movement, which provides dozens of different mini exercises you can do to interrupt your sitting. To me, this is absolutely essential for prevention if you sit most of the day like I do. Even though I have always been very fit, I believe my chronic sitting caused me back pain, and those intermittent movement exercises have helped eliminate it.
Yoga Poses for Back Pain Relief
Finding back pain relief often takes a bit of trial and error on your part, and it's wise to try a number of different strategies. One that might work for you is yoga, which is particularly useful for promoting flexibility and core muscle strength. People suffering from low-back pain who took one yoga class a week had greater improvements in function than those receiving medicine or physical therapy.5 The Yoga Journal has an online page demonstrating specific poses that may be helpful,6 and you can also try the five below, which were recently shared by Kristin McGee, a New-York-based yoga and Pilates instructor, in TIME magazine.7
1. Bird Dog
"Start on your hands and knees and imagine you have a glass of water on your lower back and one between your shoulder blades. Without spilling any water, reach your right arm forward and your left leg straight back behind you. Hold here for 30-60 seconds bracing your core. Come back to all fours before switching sides. Repeat 3 to 5 times on each side."
"Sit tall with your knees bent and your feet flat on the floor. Hinge back without rounding in the lower back as you lift your legs out in front of you at a 45-degree angle.
Keep drawing your lower abdominals in and up and lengthen out of your lower back. Hold here for 5 to 8 breaths. Lower down and repeat 2 more times. If this is too challenging with your legs straight, you can bend your knees so the shins are parallel to the floor."
3. Forearm Plank
"If you only have time for one pose, this is the ultimate core move. It really works the entire midsection, deep core muscles and the back, waist, hips, legs, buttocks, arms, and shoulders. Lie on your stomach and place your elbows under your shoulders, tuck under your toes and press firmly through the back of your legs and heels. Engage your lower abs and tighten your core as you lift your body up off the floor coming in to one straight line of energy from head to toe. Don't let your ribs splay open or your butt sag or lift too high. Hold for 45-60 seconds then lower down. Repeat 2 to 3 more times."
4. Cow Face Pose
"Start on all fours and slide your right leg over your left leg high at the upper thigh. Sit back between your heels and adjust your hips so they are even distance from each foot. Lift your left arm overhead and bend the elbow so the hand comes down between your shoulder blades. Reach your right arm behind your back and up towards the left hand try and touch the fingers or clasp the hands. If you can't connect your hands, use a towel or strap. Recline forward over your legs and hold for 5 to 8 breaths. Come up move back on to all fours and repeat on the opposite side. This pose will stretch out tight external rotators, hips, and buttocks as well as shoulders and upper back."
5. Camel Pose
"Tight hip flexors can pull on the lower back and are often the result of sitting for too long of periods. Camel is an excellent counterpose to the slouched forward position we often assume. Camel opens up the entire front body while stretching the shoulders and front of thighs, hip flexors, quads and psoas muscles. Come in to a kneeling position with your toes tucked under. Place your hands on your lower back and try and slide your tailbone down towards the floor to lengthen your lower back. Lift your chest up and drop your head back as you reach for your heels (if this places any strain on the back keep your hands on your lower back).
Hold and breathe for 5 breaths then lift up. If you want to challenge yourself further repeat the pose with the toes flat on the floor. The goal is to open up the chest and stretch the front of the body while lengthening out of the lower back. Use the strong abdominal muscles you found in the first three postures to support the backbend."
Four Factors That Increase Your Risk of Back Pain Becoming Chronic
The featured video highlighted four important factors that signify your back pain may become chronic. The good news is that they are easily avoidable and/or modifiable. First becoming aware of these factors, and then taking steps to remedy them, empowers you to take control of your back pain and recover naturally.
- A belief that back pain is harmful and disabling
- Fear of, and avoidance of, movement and activity
- Low mood and isolation
- Belief in passive rather than active treatment
Changing your mindset may help tremendously in helping you overcome this potentially debilitating problem. Cognitive behavioral therapy may help in this regard. Talking with a therapist, with a focus on changing your thoughts and behavior, helped relieve back pain after just six weeks in one study.
After one year, nearly 60 percent of those who received cognitive-behavioral therapy reported that their pain was gone (compared to 31 percent of those who did not receive therapy).8 Engaging in active treatments is also important, and this means taking control of your health. Following are examples of options that allow you to become an active participant in your back-pain treatment. You can read about them in detail in "15 Natural Remedies for Back Pain."
10 Natural Back Pain Remedies That Work
1. Chiropractic Care
Seeing a qualified chiropractor is a wise option if you suffer from any type of chronic pain, including back pain. One study published in the Annals of Internal Medicine even revealed that chiropractic care is often better than medication for treating musculoskeletal pain.9
2. Stretching, Especially the Egoscue Method
The Egoscue Method is a series of very specific posture stretches and special exercises tailored to each person's specific needs. Egoscue helps to restore muscular balance and skeletal alignment and is often used as a natural method of pain relief. Personally, this method worked well for me in eliminating pain I had when I got out of my chair or car.
3. Strength Training
A regular strength-training routine will help strengthen your back and core muscles, which is essential for both relieving pain and preventing injury.
4. Osteopathic Manipulation
Osteopathic manipulation, which may involve moving joints back into place, massaging soft tissue and helping you relax stressed muscles, was found to reduce chronic low-back pain in a study of 455 people.10
5. Reduce Your Stress
People with persistent negative thoughts and anxiety are more likely to suffer from back pain.11 The Emotional Freedom Technique (EFT) borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system, often helping with pain relief.
Meditation can be a powerful pain reliever. Among volunteers who had never meditated before, those who attended four 20-minute classes to learn a meditation technique called focused attention (a form of mindfulness meditation), experienced significant pain relief – a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness.12
Massage releases endorphins, which help induce relaxation and relieve pain. Massage therapy for 10 weeks offered greater back-pain relief than usual care, according to one study, and the benefits lasted at least six months.13
Acupuncture can be another useful approach, although in my experience requires a bit more time to achieve results. In one analysis published in the Archives of Internal Medicine,14 researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment.
9. K-Laser Therapy
K-Laser treatment helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones. 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.
10. Physical Therapy
People who received physical therapy soon after an episode of back pain are less likely to require subsequent medical care than those who seek it at a later time.15
Got Back Pain? Add These 14 Pain-Fighting Tips to Your Arsenal
Below I list 14 more non-drug alternatives for the treatment of pain. Please try these first, before resorting to prescription painkillers, steroid injections, or surgery of any kind. Often you'll find that these natural alternatives will relieve your pain entirely or at least take the edge off until your body has a chance to heal. Please understand that this list is in no way meant to be exhaustive but merely a list of the ones that I personally have had some favorable experience with.
- Eliminate or radically reduce most grains and sugars from your diet. Avoiding grains and 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.
- Take a high-quality, animal-based omega-3 fat. My personal favorite is krill oil, which contains highly absorbable phospholipid-bound omega-3 fatty acids. 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 sun exposure, which will work through a variety of different mechanisms to reduce your 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 you 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.16 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.17
- 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.
- Medical cannabis has a long history as a natural analgesic.18 At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavanoids. Varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel "stoned"—and high in medicinal CBD. The Journal of Pain has a long list of studies on the pain-relieving effects of cannabis.19
- Hot and cold packs and other mind-body techniques can also result in astonishing pain relief without any drugs.
- Grounding, or walking barefoot on the earth, may also provide a certain measure of pain relief by combating inflammation.