By Dr. Mercola
If you have back pain or sciatic nerve pain, you're not alone. Globally, one out of 10 people suffers from lower back pain, and back pain is also the number one cause of job disability worldwide.
The problem appears to be particularly prevalent in the US. According to estimates, as many as eight out of 10 Americans struggle with back pain, and this affliction has now become a primary cause of pain killer addiction.
I was one of its victims because I failed to appreciate the dangers of excessive sitting and suffered with low back pain for many years. Now I firmly believe back pain can be successfully treated using a combination of posture-correcting exercises and strictly limiting sitting.
Sadly, opioid drugs are typically prescribed as a first line of treatment for back pain,1 not exercise, and these drugs have now surpassed both heroin and cocaine as the leading cause of fatal drug overdoses in the US.
If you have back pain and suffer depression or anxiety you're at even greater risk for opioid abuse and addiction, according to recent research.
Depression Combined with Back Pain Raises Risk of Drug Abuse
As reported by Medical News Today,2 55 chronic lower back patients with symptoms of depression or anxiety participated in the study. During a six month period, they were given either morphine, oxycodone, or a placebo to take as needed for the pain.
Those who rated high in terms of anxiety or depression not only experienced greater side effects; they also got less relief from the drugs, and were more likely to abuse them.
Compared to those with low levels of depression or anxiety, these patients experienced:
- 50 percent less improvement of their back pain
- 75 percent more opioid abuse
According to the authors, this highlights the importance of identifying symptoms of depression prior to prescribing opioid painkillers for back pain, as the risks are so much greater in such instances, and the benefits more limited.
Common Back Pain Triggers
Understanding what may have triggered your back pain can help you avoid another episode, but many back pain sufferers tend to misidentify their triggers. According to recent research,3,4 about two-thirds of the patients blamed a specific incident on the day their pain began — most typically the lifting of a heavy load.
But lower back pain can actually be triggered days or weeks before any discomfort sets in, and rarely suspected triggers include alcohol consumption, sex, being distracted while performing physical tasks, and fatigue.
Accidents and sports injuries tend to be among the most common causes of chronic back pain. Poor posture, obesity,5 inactivity (especially chronic sitting), and stress can also increase your risk.
That said, while it can help you avoid a recurrence, it's not essential to determine what triggered your pain in order to successfully address it.
What to Do When Back Pain Strikes
As reported by the Epoch Times,6 75 to 80 percent of back pain cases will resolve on its own within two to four weeks, even without treatment. But you can certainly speed up your recovery.
As an initial step, when pain suddenly strikes, try to relax both your back and your mind. Applying ice can be helpful, as can getting acupuncture or chiropractic care.
In lieu of prescription painkillers, try some anti-inflammatory herbs instead: boswellia, curcumin, and ginger are a few examples. For a more complete list, please see my previous article "15 Natural Remedies for Back Pain."
And, while many fail to consider this, addressing your emotions is another important component. Depression and anxiety tends to reduce or slow down your body's innate capacity for self healing, so when pain strikes, it may be a sign that you've let emotional difficulties and stress go unaddressed for too long.
Your brain, and consequently your thoughts and emotions, actually play a large role in your experience of pain. Your central nervous system "remembers" any pain that lasts more than a few minutes at the neuronal level.
These memories can become so vivid that the pain persists even after the injury has healed, or re-occurs when it shouldn't, such as from a gentle touch. Retraining your brain using mind-body techniques like the Emotional Freedom Technique (EFT) can be very helpful in such instances.
In the following video, EFT practitioner Julie Schiffman shows how you can use EFT to relieve your pain, be it acute or chronic.
Addressing Sciatic Nerve Pain
Sciatic nerve pain is another common problem, and it can be quite excruciating. Sciatica results when your sciatic nerve gets pinched in your lower back. The pain is typically felt as originating in your buttock, radiating down your thigh.
Stretching exercises can help reduce sciatic pain. Your sciatic nerve runs through your piriformis, a muscle located deep in your glutes. If the piriformis gets too tight, it can impinge the sciatic nerve, causing pain, tingling, and numbness in your leg. Sometimes, stretching your piriformis may be enough to reduce the pain. Four exercises to try include the following. For illustrations demonstrating each stretch, please see the featured article in Mind Body Green:7
- Piriformis stretch
- Seated hip stretch
- Pigeon pose
- Self-trigger point therapy using a tennis ball or foam roller
The video below also illustrates a simple one-minute daily stretching routine8 that can help reduce sciatic pain stemming from an overly tight piriformis muscle in your buttocks.
Other Treatment Options for Sciatica
A related article in Prevention Magazine9 lists a number of other treatment alternatives for sciatica, including the following:
||In one 2010 study,10 60 percent of people with sciatica who received chiropractic care three times a week for four weeks experienced the same degree of relief as those who ended up getting surgery
||Research11 published in the Journal of Traditional Chinese Medicine found that 17 out of 30 patients with sciatica experienced complete relief with acupuncture. You may need about a dozen treatment sessions to see improvement
||As reported in the featured article:12 "A study in the journal Pain reported that people with chronic back pain who practiced Iyengar yoga for 16 weeks saw pain reduced by 64 percent and disability by 77 percent. Although yoga's effects on sciatica are less clear, gentle forms may be beneficial."
||A recent Spanish study13,14 found that older women with back pain can reduce their pain, improve balance, and reduce risk of falling by adding Pilates to their physiotherapy routine. All of the 100 women in the study received 40 minutes of nerve stimulation and 20 minutes of massage and stretching twice a week. Half of them also did one hour of Pilates twice a week. At the end of the six-week long study, those taking Pilates reported greater improvements.
|Trigger point massage
||Trigger point therapy, where the therapist applies firm pressure to points on your piriformis, lower back muscles, and glutes, can help release the pressure and impingement on the sciatic nerve
||Anti-inflammatory oils and liniments can also be helpful. Examples include St. John's wort oil and cayenne pepper cream. Apply to the painful area two to three times a day
Avoiding Sitting May Be Part of the Long-Term Solution for Back Pain
While maintaining proper posture when sitting can be helpful for avoiding pain in a variety of different areas, including your back, neck, and shoulders, an even better solution may be to avoid sitting altogether. I struggled with persistent back pain for many years despite seeing many chiropractors, stretches and strengthening exercises, laser treatments, grounding, massage, and using an inversion table. It wasn't until I decided to experiment with standing as much as possible that I noticed significant improvement.
Paradoxically, standing initially would cause pain and it was difficult for me to stand in an hour lecture without pretty severe back pain. But by reducing my 12 to 14 hours of daily sitting to under one hour, my back pain vanished. Now I typically sit for less than 30 minutes a day and have been free of low back pain for many months.
I stand most of the day on a 2 foot by 4 foot cushioned grounding pad that I designed. If you have a desk job, I highly recommend investing in a stand-up desk. I'm so convinced of the benefits of standing up rather than sitting down that I'm in the process of providing employees at my office with stand-up desks, and cushioned grounding pads once we have them available. Below is the video I shot for our 18th anniversary showing my home office stand up desk.
This is part and parcel of the evidence that the human body was built for more or less continuous movement — not consistent strenuous activity, but gentle non-exercise activity, and this includes simply standing. In other words, your body ceases to function properly when it is too still for too long. The evidence suggests sitting for just one consecutive hour is too long. Ideally, sitting should break up your movement, not the other way around.
Other Strategies for Preventing Back Pain
Preventing back pain is surely easier than treating it, and there are many alternatives available, in addition to what I've already mentioned above. Here are a dozen more tips that can help you lead a pain-free life:
||Exercise and physical activity will help strengthen the muscles of your spine. Make your exercise time count by including high-intensity sessions. You probably only need this once or twice a week at the most. You'll also want to include exercises that really challenge your body intensely along with those that promote muscle strength, balance, and flexibility.
Yoga, which is particularly useful for promoting flexibility and core muscles, has also been proven beneficial if you suffer with back pain. The Yoga Journal15 has an online page demonstrating specific poses that may be helpful.
|Mind your posture
||If you spend many hours every day sitting down, pay careful attention to minding your posture.
When standing, keep your weight spread evenly on your feet, and don't slouch when standing or sitting to avoid putting stress on your back muscles. Always support your back, and avoid bending over awkwardly. Protect your back while lifting – this activity, along with carrying, puts the most stress on your back.
Foundation Training exercises are also excellent, as they work to gradually pull your body out of the movement patterns that are hurting you. The focus is on strengthening your core, which helps stabilize your spine, vertebrae, discs, and pelvis.
|Vitamin D and K2
||Optimize your vitamin D and K2 levels to prevent the softening of the bones that can often lead to lower back pain.
||Grounding yourself to the earth, also known as Earthing, decreases inflammation in your body, which can help quiet down back pain and other types of pain. Your immune system functions optimally when your body has an adequate supply of electrons, which are easily and naturally obtained by barefoot/bare skin contact with the earth.
Research indicates the earth's electrons are the ultimate antioxidants, acting as powerful anti-inflammatories. Whenever possible, take a moment to venture outside and plant your bare feet on the wet grass or sand. Walking barefoot is also an excellent way to strengthen your feet and arches.
|Address psychological factors
||Few people want to be told that their pain is psychological or emotional in origin, but there's quite a bit of evidence that backs this up. Dr. John Sarno,16 for example, used mind-body techniques to treat patients with severe low back pain and has authored a number of books on this topic.
His specialty was those who have already had surgery for low back pain and did not get any relief. This is one tough group of patients, yet he had a greater than 80 percent success rate using techniques like the Emotional Freedom Technique (he has now retired from practice).
||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.
The infrared wavelengths used in the K-Laser allow for targeting specific areas of your body. The K-Laser is unique in that it is the only Class 4 therapy laser that utilizes the appropriate infrared wavelengths that allow for deep penetration 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.
||Drink plenty of water to enhance the height of your intervertebral disks. Because your body is composed mostly of water, keeping yourself hydrated will also keep you fluid and reduce stiffness.
||Smoking reduces blood flow to your lower spine and promotes degeneration of your spinal disks.
|Pay attention to how — and how long — you sleep
||Studies have linked insufficient sleep with increased back and neck problems. Also pay attention to your sleep position. Sleep on your side to reduce curving of your spine, and stretch before getting out of bed. A firm bed is recommended.