Alternative Approaches To Low Back Pain

Back pain got you backed in to a corner? You might consider alternative therapies to ease your pain. This is Part 4 in a series of four.

Is your back bothering you for several months, or years and both you and your physician have not been capable of determining why. This is not a common problem. According to the National Institutes of Health in the USA, back pain is the number one cause of work-related disability. It costs around $50 billion annually in treatment. Around 80% Americans will suffer from back pain in their lifetimes. However, most back pain cases cannot be attributed to any one cause.

Daniel C. Cherkin is a senior investigator with the Group Health Cooperative's Center for Health Studies, (CHS), in Seattle. "It’s a big problem that both conventional and alternate techniques for treating back pain are available." It's difficult to pinpoint the cause of non-specific backpain, given that there is a large group of patients suffering from it.

Back pain sufferers are often forced to search for alternative treatments, such as massage or acupuncture. Cherkin says that 20% of massage therapists visit back pain, and 14% go to acupuncturists because of it. However, do these methods work?

Many cases are still open to scientific debate. Cherkin led a review that looked at dozens of studies on massage, acupuncture and spine manipulation (chiropractic), as low-back pain treatments. There was some evidence to support the efficacy of spinal manipulation and massage. However, less information is available about acupuncture.

Cherkin states that the studies reviewed showed massage was effective in relieving pain and improving function for people suffering from persistent back problems. Spinal manipulation has little clinical benefit for back pain. It is comparable to conventional medical treatments like over-the-counter pain relief and physical therapy.

Research has shown that acupuncture is not effective. But a recent large-scale study by the Group Health Cooperative, which was launched recently, will attempt to address some of these issues. This study, which will last for four years, is recruiting almost 700 people suffering from back pain.

A Stronger Back The best way to treat chronic back pain is with a strengthening program. There's strong evidence.

Mooney suggests that such programs should be done using calibrated equipment. This allows low-back pain sufferers to increase their strength gradually, so they can measure progress and performance. It's difficult to increase your calisthenic exercise, so make sure you are doing enough to stimulate recovery but not to increase pain.

Florida chiropractor Thomas Hyde DC emphasizes the importance of core stability in all exercise programs that are designed to relieve chronic pain and strengthen the back.

"The Swiss ball is my favorite tool, for instance," he said. In the beginning, a person might just sit down on the ball and learn the basic concepts of "proprioception," which is a sense of balance, joint position, and how to use it. They can then move onto leg lifts, and various other positions on the ball. Then they can use weights or tubes to strengthen their exercises on the ball. The patient will notice a gradual improvement in balance over time.

Cherkin from the GHC says that there are other forms of exercise being investigated for pain relief, including tai chi and Pilates. According to Cherkin, the GHC's preliminary findings of a yoga-for-back pain study "looks promising."

The Mind and the Body. Chronic back pain is not something that can be ignored. However, for certain people the solution to their problem may lie within the body. Andrew Block PhD, clinical assistant professor of psychoiatry at The University of Texas Southwest Medical Center (Dallas) and director of Well-Being Group (Plano, Texas), says that there are many mind-body ways to treat low back pain. The major strategies are what we refer to as'self regulation strategies'. They include hypnosis and biofeedback. Relaxation exercises also play a significant role. They are intended to improve muscle relaxation, pain control and energy efficiency. Patients feel more in control than they do with chronic pain.

Block says that the most common image he uses when helping patients control their pain is of electricity. I saw a patient today, and we discussed the pain signals that travel up their spines like wires. He explains that when they feel pain they will see the wires glow. The glow will decrease as they enter a relaxed and hypnotic state. They'll also see it stop flowing so they can mute their pain.

Sometimes the goal isn't to get rid of pain. It can be about managing the pain through psychological strategies. These fall under the umbrella of "cognitive behavior intervention." Block states that the goal is to help patients change how they see back pain. The main thing that I recommend to people is not to view pain as something to be fixed, but as an ongoing condition that they must adapt to and live with. You must use your strength to conquer what it does to you life.

According to Cherkin of the GHC, each person's choice in back pain treatments is unique. He says that none of the above methods have been proven to cause low-back pain. It really boils down to the individual and which treatment is worth trying. The truth is that no single treatment works for all patients.