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Research IDs 9 Back-Pain Remedies That Really Work

Some treatments out there are likely to bring chronic-back-pain relief—and some are downright rip-offs.



RODALE NEWS, EMMAUS, PA—Did you ever stand in the cereal aisle at the grocery overwhelmed by the dozens and dozens of choices before you? If you're looking for relief from chronic back pain, you're likely to be faced with the same confusing conundrum—too much to choose from. Because back-pain sufferers make up a massive market (85 percent of people report lower-back pain at some point during their lifetime), there is no shortage of gadgets and treatments on the market that claim to ease your aches. The problem is, many of them don't work, says Scott Haldeman, MD, PhD, DC, clinical professor of neurology at University of California–Irvine.


Money spent on direct medical costs for the treatment of lower-back pain are estimated to hit $12 to $90 billion a year in the United States, comparable to the revenue of a Fortune 500 company. Yet 95 percent of people who undergo back surgery for pain are not cured, and could even feel worse after going under the knife, Dr. Haldeman says. "The cost of back pain has gone through the roof, and results of all of our treatments have been very mediocre," he adds. Even though there's no magic cure for chronic back pain, there are strategies that can bring relief. Before you try them, rule out the four conditions that do respond well to surgery: spinal stenosis, vertebrae slipping, a tumor or fracture, or a truly herniated disc that's causing leg pain. These can generally be identified through MRIs or X-rays. Second, keep a positive attitude, but be realistic. If you've had chronic back pain for more than three months, says Dr. Haldeman, it's likely you'll have it off and on for the rest of your life. "It'll move around between no pain, a little pain, and occasional bursts of severe pain," he says. To manage that pain, there are interventions that tend to work much better than others. Of the 200-plus different treatments currently available for back pain, here are nine that seem to be most effective. Everyone is different, so keep trying until you find the ones that work for you.

# 1: EXERCISE

If you're constantly nagged by back pain, it may seem like the last thing you'd want to do is exercise. But Dr. Haldeman says this is the mistake that can leave you feeling the worst. "You can make it worse by going to bed, or by stopping doing things," he says. "Then you get into a negative cycle, gaining weight, becoming mentally depressed, and being scared you're going to hurt your back." Many doctors are more likely to prescribe you painkillers than have you walk for 20 minutes in the park five times a week and lift light weights twice a week.

But emerging research is proving that exercise is a top-notch tool for taming chronic back pain. In June, Canadian researchers presented a study at the American College of Sports Medicine conference showing that men and women with chronic lower-back pain who exercised more frequently had less pain and disability than those who didn't. Pain levels dropped by nearly 30 percent in the group that exercised for four days a week. "Exercise within your capacity," says Dr. Haldeman. "You're not going to do any harm because your back won't let you; it'll hurt too much," he adds.

# 2: NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

NSAIDs are the most commonly prescribed anti-inflammatory meds prescribed in the world, no doubt because they are often used to alleviate lower-back pain. A 2008 review by Dutch researchers of 65 trials that looked at the safety and effectiveness of NSAIDs found they do work for short-term symptomatic relief in patients with acute and chronic lower-back pain without sciatica. The reviewers did not find a particular type of NSAID better than others. Overuse of these over-the-counter medicines can lead to side effects, though, so consult with your physician if you use them often.
# 3: SPINAL MANIPULATION

The American College of Physicians and the American Pain Society conducted a systematic review of studies looking at nonpharmaceutical therapies used to relieve back pain. Spinal adjustments (manipulation) that you'd from chiropractor or osteopathic physician (D.O.) to restore proper alignment of your spine ranked among the best-performing practices, along with exercise and cognitive-behavioral therapy. Northwestern Health Sciences University researchers also reviewed studies looking at spinal manipulation and its effect on lower-back pain. They found spinal manipulation worked better than NSAID medicines. Spinal adjustments aren't recommended for people with osteoporosis, however.
# 4: MOBILIZATION

Mobilization is a hands-on therapy in which a chiropractor or physical therapist guides you through movements that help restore your normal range of motion. Often, this type of therapy can help restore joint function of the spine and ribs due to poor posture or a trauma. Both mobilization and spinal manipulation have been found to be more effective in the short term when compared to general practitioner care, and more beneficial than general physical therapy in the long run, according to a 2004 study published in Spine.
#5: ALEXANDER TECHNIQUE

You probably already know about alternatives therapies for back pain like acupuncture, yoga, and massage, but did you ever hear of the Alexander Technique? Originally developed to help singers improve their voices, the technique, which focuses on proper posture and movement, is slowly creeping onto the radar screens of back-pain sufferers. A study published in the British Medical Journal last year divided chronic- back-pain sufferers into groups that received normal care at the family doctor's office, massage, or six or 24 lessons of Alexander Technique. Half were also prescribed exercise. A year later, the researchers found that the exercise-plus-Alexander-Technique group experienced a statistically significant reduction in the number of days spent in pain, and reported a better quality of life. Six lessons were just as effective as 24. Watch our video to see what to expect at an Alexander Technique session.
# 6: MASSAGE

While the research linking massage to chronic-back-pain relief may not be as strong as it could be, it's still the remedy of choice for many back-pain sufferers. Researchers who compared massage therapy, acupuncture, and self-care in people with persistent back pain found that massage was the most effective intervention, reducing painkiller use by 36 percent. All massage techniques used (Swedish, deep-tissue, pressure-point, and neuromuscular) showed equally positive results. In another important study, researchers from the University of Miami's Touch Research Institute divided lower-back-pain sufferers into two groups: one a muscle relaxation group, and the other a massage-therapy group. The massage group reported less pain, depression, and anxiety, as well as improved sleep and more flexibility, and their levels of "good mood" neurochemicals were even higher.
# 7: ACUPUNCTURE

Getting pricked with acupuncture needles could actually help you banish some back pain, according to mounting research. Researchers from the University of Maryland School of Medicine conducted a review of randomized-controlled trials, considered the gold standard of study design for evaluating medical procedures. They found that although real and sham acupuncture sessions eased pain for participants, those who received the real treatments reported the biggest decreases in pain. According to a study published in the American Journal of Obstetrics & Gynecology, the intervention could be particularly valuable in reducing pregnancy-related lower-back pain. About 10 to 20 percent of women with chronic lower-back pain report that it started during pregnancy; researchers hypothesize that treating back pain during pregnancy could lessen the likelihood of chronic back pain in the future.
# 8: PILATES

A report published in September's IDEA Fitness Journal found that Pilates exercises work well for improving back-pain symptoms. The combination of quality movement focusing on breathing, developing core strength, and correcting joint function helps mitigate pain. "Strengthening exercises are so important. Your abdominal and trunk muscles form the corset that holds your back together," says Dr. Haldeman. Really weak abs and back muscles make you more likely to slump and throw your posture out, leading to more chronic back pain. For an effective one-two punch, try yoga and Pilates during the week. Add a few cardio sessions and watch your pain start to fade.
# 9: YOGA

Is there a downside to yoga? We don't think so. It helps lower blood pressure, stress levels, and fatigue. The ancient practice is also more effective at treating chronic lower-back pain than receiving the usual care at a doctor's office, according to a new study published in the journal Alternative Therapies in Health and Medicine. In the study, those in the group practicing hatha yoga once a week for 12 weeks enjoyed a 2.3-point drop in pain scores compared to a 0.4 drop in the other group. The yoga group also reported using less medication to manage pain. A study with similar results appeared in the September 2009 issue of the journal Spine. Yoga builds strength and flexibility while improving posture, which can alleviate chronic back pain. Try our holiday yoga poses to bounce back from holiday stress and ease pain.

Filed Under: ALTERNATIVE MEDICINE, CHRONIC PAIN, MASSAGE, PAIN MANAGEMENT, YOGA

Published on: December 15, 2009



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Ooh! The thought of back pain is enough to cause me grief. I cannot imagine how difficult it must be when one suffers chronic back pain. I am a fan of the humble massage and I am confident that once you locate a quality therapist you can get some relief and possibly improvement in order to live a quality life free of pain.

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