By Dr. Mercola
It has been estimated that 80 percent of Americans will suffer from chronic back pain at some point during their lives.
Nearly 30 percent may be struggling with back pain right now,1 which can cause debilitating symptoms, leading many to resign themselves to a lifetime of taking prescription painkillers, receiving expensive steroid shots or even opting for surgery.
But before trying these conventional options, which have questionable effectiveness and more than their fair share of side effects, why not try a safe alternative treatment that many have not yet heard of: osteopathic manipulation.
Osteopathic Manipulation Helps Relieve Low Back Pain
If you have chronic low back pain, you may want to consult a doctor of osteopathic medicine (DO). As many of you know, I am an osteopathic physician, which I choose to focus on because DOs practice a "whole person" approach to medicine, treating the entire person rather that just symptoms.
As a DO I can tell you that we receive additional training in adjusting the musculoskeletal system -- your body's interconnected system of nerves, muscles and bones that make up two-thirds of your body mass.
This training in osteopathic manipulative medicine (OMM) provides osteopathic physicians with a better understanding of how an injury or illness in one part of your body can affect another.
Osteopathic manipulation, which may involve moving joints back into place, massaging soft tissue and helping you relax stressed muscles, was recently found to reduce chronic low back pain in a study of 455 people.2
Participants received eight weeks of either osteopathic manipulation, a sham treatment, or ultrasound therapy. Sixty-three percent of those who'd had osteopathic manipulation reported a moderate improvement in their pain while half said they had a substantial improvement.
However, in my experience, only a small percentage of DOs are skilled in this area, as they have instead chosen a more conventional allopathic model to follow. So if you choose to see a DO for osteopathic manipulation, make sure they provide this service and have ample experience.
This is just one example of a safe “alternative” treatment that should actually be regarded as a preferable treatment choice to drugs, steroids and surgery. Another is chiropractic care.
Chiropractic Care May Relieve Pain Better Than Drugs
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.3
After following 272 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, specifically, 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 from 4-6 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.
What that means is that chiropractic care may affect the basic physiological processes that influence oxidative stress and DNA repair, so in addition to addressing any immediate spinal misalignment that might cause pain, it can also address deeper dysfunction in your body.
Foundation Training: A Must-Know Technique for Anyone With Back Pain
I recently learned of Dr. Eric Goodman’s work through his TED presentation and was excited about the simplicity and elegance of his approach to exercise — an innovative method called Foundation Training, which he developed while in school to become a chiropractor, to treat his own chronic low back pain. Because exercise often leads to improved posture, range of motion and functionality of your body, it can help treat the underlying source of your pain as well as help prevent chronic back pain from developing in the first place. Exercise helps prevent and relieve pain through a number of mechanisms including strengthening key supportive muscles and restoring flexibility.
Poor posture while sitting, or long hours spent sitting in any position, is one of the key reasons why people develop chronic back pain in the first place. Foundation training exercises are powerful, yet simple, structural movements that help strengthen and realign your body posture by working on your core.
As Dr. Goodman explains, your core is anything that connects to your pelvis, whether above or below it, and this includes your hamstrings, glutes, and adductor muscles. Foundation Training teaches all those muscles to work together through integrated chains of movement, which is how you’re structurally designed to move, as opposed to compartmentalized movements like crunches.
In the video below you can see a demonstration of one of the key exercises, called “The Founder,” which helps reinforce proper movement while strengthening the entire back of your body. The Founder is an excellent exercise that can help reverse the effects of frequent and prolonged sitting (i.e. back pain).
Drugs for Back Pain?
If you visit a conventional physician for back pain, there's a very good chance you'll leave with a prescription for a medication, as non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen (Tylenol) and even opioids (OxyContin, Vicodin, etc.) are the go-to treatment for pain in the modern medical world.
Aside from significantly increasing your heart risks (such as a two to fourfold increase in the risk of heart attacks, stroke or cardiovascular death), NSAIDs are linked to serious gastrointestinal risks like bleeding of the digestive tract, increased blood pressure and kidney problems. Remember, this applies not only to prescription medications like Celebrex but also to over-the-counter drugs like aspirin, Advil and Motrin.
It's very difficult to find a drug-based method of pain relief that is not saddled with severe side effects. The FDA has even recently limited the amount of acetaminophen allowed in prescription products and added a boxed warning due to liver toxicity concerns. Acetaminophen is actually the leading cause of acute liver failure in the United States.
As for the opioid painkillers like OxyContin, they are among the most commonly abused prescription drugs and are a leading contributor to the rising rates of fatal prescription drug overdoses. Many become addicted after using them to treat conditions like back or neck pain.
You Have Many Natural Options for Treating Back Pain
Drugs do nothing to treat the underlying causes of back pain, which is often related to body mechanics, meaning your posture or muscle balance is off kilter. Addressing your posture (or other factors that may be contributing to the strain, such as sleeping in an awkward position) and treating the condition with exercises as described above is often effective at relieving the pain and addressing the underlying cause. If you have chronic pain of any kind, please understand that there are many safe and effective alternatives to prescription and over-the-counter painkillers, though they may require some patience.
For instance, therapeutic massage has been found to offer clinically significant improvement in function and symptoms for those with neck pain,4 while a variety of complementary and alternative medicine (CAM) treatments (including acupuncture, massage, spinal manipulation, and mobilization) were deemed to be significantly more efficacious than no treatment, placebo, physical therapy, or usual care in reducing pain immediately or at short-term after treatment for those with neck or low-back pain.5 There are also lifestyle changes you can make that may have a dramatic impact on your pain.
Among the best are:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have also been found in many animal and clinical studies to have anti-inflammatory properties.
- Eliminate or radically reduce most grains and sugars (including fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain.
- 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.
- Optimize your emotional health with the Emotional Freedom Technique (EFT): Your brain, and consequently your thoughts and emotions, play a large role in your experience of pain. Using mind-body techniques like the EFT is often one of the best pain-relieving solutions there is.
Even More Safe Pain-Relief Options
Methods like osteopathic manipulation may take several sessions to fully relieve your pain. In the meantime, you don't need to suffer unnecessarily. Following are options that provide excellent pain relief without any of the health hazards that pain medications often carry.
- Astaxanthin: One of the most effective oil-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than NSAIDs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb is anti-inflammatory 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: Curcumin is the primary therapeutic compound identified in the spice turmeric. Curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity.
- Boswellia: Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used a topical preparation 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.
- Evening Primrose, Black Currant and Borage Oils: These contain the 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.
- Therapeutic modalities such as yoga, acupuncture, meditation, hot and cold packs, and even holding hands can also result in astonishing pain relief without any drugs.