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Many Back Pain Treatments Are Ineffective and Unnecessary, and Here’s Why...

Back Pain

Story at-a-glance -

  • Most cases of back pain are a result of mechanical problems, such as poor posture or improper movement that are best prevented and managed by regular exercise and strengthening your back and abdominal muscles
  • Well-established guidelines for the treatment of back pain require very conservative management ; in most cases, no more than aspirin or acetaminophen (Tylenol) and physical therapy
  • Recent research shows that many doctors do not follow these guidelines. Over the past decade, use of Tylenol and NSAID’s declined by about 50 percent, while prescriptions for opiates rose by more than 50 percent
  • One of the most effective strategies to prevent or address back pain is posture training like Foundation Training or Esther Gokhale.
  • Other alternatives include chiropractic and osteopathic adjustments, Neuro-structural integration technique (NST), non-exercise activities, and yoga

By Dr. Mercola

An estimated 80 percent of Americans will suffer from chronic back pain at some point in life. Nearly 30 percent may be struggling with persistent or chronic back pain right now,1 leading many to resort to prescription painkillers, expensive steroid shots or even surgery.

This despite the fact that, in most cases, back pain is a result of simple mechanical problems relating to poor posture or improper movement, which are best prevented and managed by regular exercise and strengthening your back and abdominal muscles.

It is estimated that back pain accounts for more than 10 percent of all primary care doctors visits each year, and the cost for treatment stacks up to $86 billion annually.2 According to recent research, much of this treatment is unnecessary, while simultaneously failing to successfully address the problem.

As reported by The New York Times:3

"Well-established guidelines for the treatment of back pain require very conservative management — in most cases, no more than aspirin or acetaminophen (Tylenol) and physical therapy.

Advanced imaging procedures, narcotics and referrals to other physicians are recommended only for the most refractory cases or those with serious other symptoms. But a study published in JAMA Internal Medicine4 suggests that doctors are not following the guidelines."

Back Pain Is Often Over-Treated

The team reviewed more than 23,900 outpatient visits for back pain that was unrelated to more serious conditions (such as cancer) over a 12-year period (1999-2010), and found that during this time:5

  • Use of Tylenol and other NSAIDs declined by just over 50 percent
  • Prescriptions for opiates increased by 51 percent
  • CT and MRI scans also rose by 57 percent
  • Referrals to specialists increased by 106 percent
  • Use of physical therapy remained steady at about 20 percent

Needless to say, the trend shows that back pain is increasingly being treated with addictive drugs and diagnostic exams that expose patients to potentially unnecessary and dangerous levels of radiation. Back pain is actually one of the primary reasons why so many American adults get addicted to pain killers.

Furthermore, the existing treatments do not cure back pain—they only treat the symptoms. Senior author, Dr. Bruce E. Landon, a professor of health care policy at Harvard, told The New York Times6 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."

Opiates are not the only dangerous drugs being pushed for back pain. One of the most egregious examples of Big Pharma disease mongering7 is the emergence of ads suggesting your back pain may be caused by ankylosing spondylitis, a chronic inflammatory disease of the axial skeleton, which includes the spine.

"Do you have back pain? Are you dismissing it as resulting from "lifting too much" at the gym or "bad posture"? one radio ad asks. "You might have ankylosing spondylitis."

The drug advertised is Humira, which has a price tag of about $20,000 a year. It is reprehensible for drug companies to promote this expensive and dangerous drug for an exceedingly rare cause of low back pain, which likely is responsible for less than a tenth of a tenth of one percent of low back pain!

Side effects of the drug8 include tuberculosis, serious infections, increased risk of lymphoma and other cancers, hepatitis B infection in carriers of the virus, allergic reactions, nervous system problems, blood problems, heart failure, certain immune reactions including a lupus-like syndrome, liver problems, new or worsening psoriasis, and many more. Considering the fact that most cases of low back pain are not caused by inflammatory conditions, you probably do not need this drug, although your doctor may very well give it to you should you ask.

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Don't Settle for Band-Aids—Treat the Root Cause of Your Back Pain

With the exception of blunt force injuries, low back pain is commonly caused and exacerbated by:

Poor posture Poor physical conditioning facilitated by inactivity Internal disease, such as kidney stones, infections, blood clots
Obesity Psychological/emotional stress Osteoporosis (bone loss)


Since poor posture and/or improper movement is to blame for most cases of back pain, one of the best things you can do to prevent and manage back pain is to exercise regularly and keep your back and abdominal muscles strong. Foundation Training—an innovative method developed by Dr. Eric Goodman to treat his own chronic low back pain—is an excellent alternative to the Band Aid responses so many are given. The program is inexpensive and can be surprisingly helpful, as these exercises are designed to help you strengthen your entire core and move the way nature intended.

Many people fail to realize that many times back pain actually originates from tension and imbalance at a completely different place than where the pain is felt. For example, the very act of sitting for long periods of time ends up shortening the 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.

The reality is that the imbalance among the anterior and posterior chains of muscles leads to many of the physical pains experienced daily. By rebalancing these muscles, you can remedy many pains and discomforts. Teaching your body to naturally support itself at the deepest level is going to be far more effective than strapping on an external back brace, which over time can lead to even weaker musculature.

Another option is Esther Gokhale who is a posture expert that I interviewed earlier this year. I'll be running that interview shortly. Both of these strategies are far more effective than the typical conventional medical approach for low back pain. Additionally, chiropractic or osteopathic care as discussed below can also frequently be very valuable.

Most Body Pain Can Be Traced to Poor Postural Patterns

Besides having a weak core, another MAJOR cause of neck, back, and other areas of pain is due to the shortening of your suboccipital muscles in the back of your neck. This occurs when you sit and walk around with your head in a forward-tilted position, which is becoming symptomatic of the modern lifestyle where everything you attend to is right in front of you on one screen or another.

According to Dr. Goodman, back pain is just one possible result of this kind of postural imbalance. It can also result in shoulder pain, carpal tunnel syndrome, headaches, jaw pain, knee pain, IT band pain, and more. To address this, Dr. Goodman has expanded Foundation Training into a broader program he now calls "Modern Moveology."

The basic Foundation Training program takes about 20 minutes, and is ideally done daily. You can purchase the Foundation Training DVD from my online store. Once Dr. Goodman releases his Modern Moveology catalog of exercises, I will offer that for sale as well. FoundationTraining.com also offers several free videos, and their thought provoking first book called: Foundation: Redefine Your Core, Conquer Back Pain, and Move with Confidence.

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Chiropractic and Osteopathic Care May Also Be of Benefit

Seeing a qualified chiropractor is certainly a wise consideration if you suffer from back pain. I am an avid believer in the chiropractic philosophy, which places a strong emphasis on your body's innate healing ability and far less reliance on band-aid responses like drugs and surgery.

A recent study published in the Annals of Internal Medicine9 even revealed that chiropractic care is often more effective than medication for treating musculoskeletal pain. 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.

Another option is to consult a doctor of osteopathic medicine (DO). As many of you know, I am an osteopathic physician, which I chose because DOs practice a "whole person" approach to medicine, treating the entire person rather than just symptoms. DOs receive additional training in adjusting the musculoskeletal system, and osteopathic manipulation has also been found to reduce chronic low back pain. In one recent study10 involving 455 people, 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.

That said, it's been my experience that only a small percentage of DOs are truly skilled in this area, as many have instead chosen to follow a more conventional allopathic model. So if you choose to see a DO for osteopathic manipulation, make sure they provide this service and have ample experience.

Two Other Non-Invasive Treatment Options for Back Pain

Neuro-structural integration technique (NST) is yet another non-drug pain relief option. NST is a gentle, non-invasive technique that stimulates your body's reflexes. Simple movements are done across muscles, nerves and connective tissue, which helps your neuromuscular system to reset all related tension levels, promoting natural healing. It is completely safe and appropriate for everyone from highly trained athletes, to newborns, pregnant women, and the elderly and infirm. To find an NST therapist near you, see our NST Therapists Page. You can also purchase a DVD set to learn more about this technique.

Last but not least, yoga, which is particularly useful for promoting flexibility and core muscles, has also been proven beneficial if you suffer with back pain. The Yoga Journal11 has an online page demonstrating specific poses that may be helpful. A recent study in the journal Evidence-Based Complementary and Alternative Medicine12 also found that once-weekly yoga classes appear to produce as much benefit for lower back pain sufferers as taking classes twice a week. According to one of the authors:13

"Given the similar improvement seen in once weekly yoga classes, and that once a week is more convenient and less expensive, we recommend patients suffering from lower back pain who want to pursue yoga attend a weekly therapeutic yoga class."

Even More Tips to Beat Back Pain

Preventing back pain is surely easier than treating it. Besides the recommendations already covered above, which included getting chiropractic adjustments, Foundation Training, Egoscue exercises, and NST, below are several more tips for beating back pain. With this many alternatives available, there are few good reasons to turn to pharmaceutical or surgical band-aids that do nothing to treat the underlying causes of your pain, but might cause additional harm in the process:

  1. 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.
  2. If you spend many hours every day sitting down, pay careful attention to consciously sucking in your belly and rotating your pelvis slightly up. At the same time make sure your head is back with your ears over your shoulders and your shoulder blades pinched. This will help keep your spine in proper alignment. You can hold these muscles tight for several minutes and do this once every hour. The upcoming interview with Esther Gokhale will go into far more details.
  3. Also, to combat the detrimental health ramifications of excessive sitting, make a point to stand up at least once every 10 minutes. In addition to regularly standing up, I also do a few squats while I'm at it. To learn more about the importance of regularly getting out of your chair, please see my interview with Dr. Joan Vernikos, former director of NASA's Life Sciences Division and author of Sitting Kills, Moving Heals.

  4. Optimize your vitamin D and K2 levels to prevent the softening of the bones that can often lead to lower back pain.
  5. Ground yourself. 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.
  6. 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.
  7. Underlying emotional issues and unresolved trauma can have a massive influence on your health, particularly as it relates to physical pain. Dr. John Sarno,14 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).

  8. Get regular massage therapy. Massage releases endorphins, which help induce relaxation and relieve pain.
  9. Keep your weight spread evenly on your feet when standing. Don't slouch when standing or sitting to avoid putting stress on your back muscles.
  10. 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.
  11. Wear comfortable shoes. For the ladies, it would be good to not wear heels most of the time.
  12. Drink plenty of water to enhance the height of your intervertebral disks. And because your body is composed mostly of water, keeping yourself hydrated will keep you fluid and reduce stiffness.
  13. Quit smoking as it reduces blood flow to your lower spine and your spinal disks to degenerate.
  14. Pay attention to how—and how long—you sleep, because studies have linked insufficient sleep with increased back and neck problems. 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.

Addressing the Root of Your Pain Might Save You More Than Dollars

Once you understand that back pain is typically the result of poor posture or improper movement, the remedy becomes clear. Certainly, addictive pain killers and surgery will not address these issues. So if you're among those seeking medical care for persistent back pain, I'd advise you to consider your options before filling that prescription or going under the knife.

As shown in the featured research, the use of potent drugs and back surgeries are now becoming more the trend—not because they're effective, but because many doctors simply do not take the time to educate their patients on the causes of the pain. And in fact, many doctors may still be under-educated on this issue as well.

While drug addiction and surgical interventions can have significant long-term ramifications and may in the long run lead to deteriorating health, most back pain can be prevented and treated by a variety of natural measures, including Foundation Training, osteopathic manipulation, chiropractic care, Earthing, yoga, EFT, and more.

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