Back To Basics: Ways to care for your back and relieve back pain.

Carol was moving. Being a recently divorced mother of three, Carol's new budget meant leaving her home for an apartment. Coordinating the move, packing belongings, and registering her children in new schools, were just a few of the extracurricular activities she hurdled when she wasn't working full-time as an office manager. After settling in, she began to experience excruciating pain and muscle spasms in her lower back. Thinking it was from lifting one too many boxes, she took some aspirin and rested for a couple of days. Although the pain did partially reside, it kept recurring, so she went to her family doctor for treatment.

Carol's story is not uncommon. Back pain is second only to the common cold as the leading cause of physician visits in the US, and ranks number one as the leading cause of disability in workers under the age of 45. At some point in our lives over 80 percent of us will suffer some form of back pain. Secretaries and truck drivers are susceptible due to inactivity and pressure on their spines; heavy industrial workers who do repetitive tasks, nurses who care for bedridden patients, and the stressed and overworked executive are all equal opportunity targets for back pain. But back pain isn't always job related, women with heavy purses and men with over-loaded briefcases or beer bellies are also prone to back problems.

Common Causes

Back pain is normally divided into two basic categories, acute and chronic. Acute pain comes on quickly, either immediately or over a period of several hours. It is often a result of a sudden motion or injury that may occur from something as simple as lifting a heavy object or falling. Chronic pain comes on slowly and remains for months or, sometimes, even years.

Experts believe most back pain is related to weakness in the lower back, where the bones or vertebrae in the lumbar region bear the brunt of the body's weight. However, back pain can also arise in other spinal vertebrae, such as the ligaments that lash these bones together or the muscles and tendons that hold the spinal column upright. Trouble can even stem from the shock absorbing spinal discs that cushion each vertebrae, the latticework of nerves that branch off from the spinal cord to all parts of the body, or the joints that enable us to bend our backs and twist and turn. The spine affects and is affected by every movement your body makes. The way you stand, sit, move, pick up, and carry objects-all these activities, though natural, have the potential to hurt your back. With so many physical movements and body parts involved, it is little wonder why the precise source of most back pain is tricky to diagnose.

Finding Relief

Back pain treatments are varied and particular to the type of physician you seek for treatment. Because it's your duty (and in your best interest) to be an informed patient, you may want to investigate some alternative therapies currently gaining popularity and credibility: osteopathy, bodywork, yoga, energy and mind/body medicine, acupuncture, and naturopathic medicine.

Research has shown that exercise can also be of benefit in the treatment of low back pain and injury, including aerobic exercises, stretches, and strengthening exercises such as sit-ups. These exercises help to stabilize the pelvis and progressively increase the free range of back movement. Most back pain can be avoided by taking the simple preventive step of staying in good physical condition. The theory that bed rest is the first step to recovery was disproved at several medical centers in Helsinki, Finland. It was found that allowing patients to pursue everyday activities, within the limits permitted by their pain, resulted in quicker results than the bedridden patients.

Due to extensive research and a resurgence of interest in alternative medicines, the National Institute of Health has opened a small center to study these alternative practices. The office will focus on treatments they consider most promising, such as acupuncture, herbal medicine, massage therapy, meditation, and hands-on healing with the same kind of scrutiny that conventional medicine undergoes.

The following are methods and techniques designed for healing an aching back, as well as a variety of approaches designed to prevent future back pain problems.

TREATMENTS

Physical Manipulation Techniques

Physical Manipulation Techniques aim to physically manipulate various parts of the body-muscles, connective tissues, and vertebrae-into proper functional alignment. It can often correct serious problems relating to stress and physical pain. The technique uses thumb pressure on the tissues, sweeping through them in order to break up and release any tissue texture alterations that may be inhibiting muscle movement and contributing to back pain problems.

Chiropractic Care

Chiropractic is the manipulation of joints and vertebrae in the back and neck. The professional practice objective of chiropractic is to correct nerve interference in a safe and effective manner. A misaligned vertebrae can press on a nerve and produce pain not only in the back area but in areas fed by the nerve. This "referred" pain can be felt in other parts of the body, such as the arm or leg, and can even affect the functioning of organs throughout the body.

Chiropractic treatment has been found to be more beneficial to patients with persistent back and neck complaints than other forms of manipulation. The clearing of the subluxation causing the back pain will also correct the nerve flow which restores normal function to all other affected areas of the body. Both insurance companies and medical doctors have acknowledged the effectiveness of chiropractic treatments.

Osteopathy

Osteopathy incorporates methods from both traditional and alternative medicine by combining drug therapy with spinal manipulation, or traction, followed by physical therapy and exercise. The US government has recognized spinal manipulation by osteopaths and chiropractors as being highly effective in treating many back problems. Unique to osteopathy, are electrical stimulation and mechanical therapy that trigger muscle relaxation.

Bodywork

Bodywork includes all the various forms of massage and movement awareness therapies. Massage of the muscles along both sides of the spine helps relieve tension and restore movement, especially in areas that feel tight or hard. Movement awareness therapies, such as the Alexander technique, are useful for corrective whole body positioning to relieve chronic tension and stress. These methods use light touch, as well as visualization and suggestion, in order to reprogram the body's ingrained image of itself. The Alexander technique is an educational process that retrains the way we use our bodies. It helps us recognize habitual movement patterns, and teaches us to use our muscles with minimum effort and maximum efficiency. Shiatsu and reflexology are other hands-on energy healing techniques proven effective in certain back ailments.

Mind/Body Medicine

Mind/Body Medicine is the study of the interaction between emotions, the nervous system, and the immune system. To allow the healing process to succeed, Dr. Bresler, Ph.D., the former Director of the UCLA Pain Center, recommends guided imagery, relaxation, and biofeedback. Patients are encouraged to form an image about what's going on in their back, give the pain a voice, and ask it directly what it wants. Often the body responds with an answer. In this way, we honor the body's inner wisdom and intelligence.

Biofeedback therapy uses carefully monitored low-level electrical impulses. The special equipment translates muscle tension into audible signals. Patients learn to slow the signal and relax the muscle by controlling heartbeat, respiration, muscle tension, and brain waves.

Energy Medicine

Energy medicine techniques, such as ultrasound, help to break up local edema or fibrosis where there's been inflammation. The ultrasound breaks up scar tissue caused by an injury, reduces the nerve conduction velocities (the rate at which a pain impulse is conducted along a nerve pathway to the brain), and slows down the pathway enough to cause a pain-relieving effect. TENS (Transcutaneous Electrical Nerve Stimulator) is used for back pain relief by the patient at home. It applies an electrical current to the affected nerves in the area of the back pain, causing conduction to be blocked, resulting in pain relief. TENS units are also used to stimulate the production of endorphins, the body's own natural painkillers.

Acupuncture

Acupuncture, the ancient Chinese practice, is based on the principle that energy is channeled through the body along specific pathways. Long, thin needles are inserted into the body at specific points along these channels. There are over 1,000 puncture points believed to be responsible for healing and reducing pain. Acupuncture is effective for pain management because it releases painkilling chemicals in the brain and promotes deep muscle relaxation. It is believed that good health depends on the balanced function of the body's motivating energy, or Qi (pronounced chee).

Back pain resulting from nerve-pinching conditions like arthritis and osteoporosis can also be treated by acupuncture, which helps restore the flow of blood and energy that is needed to bring essential healing nutrients, such as calcium, to the injured back. Experts believe 90 percent of herniated disk cases should try acupuncture before resorting to surgery.

Dietary Supplements and Equipment

Vitamin supplements can offer nutritional support. Vitamin C and bio-flavonoids are important for strengthening the connective tissues. Calcium-magnesium supplements may ease muscle spasms and twitching.

Back care equipment such as slant boards, inversion boots, and back swings apply traction to back tissues and are often helpful.

Herbal medicine can only be prescribed after the cause of pain is identified. Typically, herbs may be recommended by naturopaths and doctors who use alternative techniques. Most of the botanicals they prescribe are very safe and virtually free of side effects.

If related to physical strain, drink an infusion of meadowsweet three times a day to reduce inflammation. Valerian, available in capsule form, is recommended as a muscle relaxant and sedative. Take one capsule, as needed, with 150 to 300 mg of standardized valerian root. For general pain relief, use a tincture of white willow. Herbalist, Kathi Keville, recommends one to two droppersful of white willow whenever you feel mild pain symptoms.

Yoga

Yoga breathing and posture exercises help keep the body limber and in shape. Yoga has the potential to reduce the tension and stress that contribute to back pain. A primary focus of yoga is therapeutic relaxation through gentle exercise and meditation. Yoga teachers believe that by focusing the mind inward, one is able to profoundly relax and revitalize the body, and achieve a greater sense of harmony and well-being. "When your attention is directed inward, your body receives messages that you are safe and secure and that it is appropriate to relax," explains Dr. Mary Schatz, M.D. of Nashville, TN. Muscles will relax, blood pressure drops, nerves are calmed, anxiety is decreased, immunity is heightened, and healing is enhanced. All of these efforts can greatly improve your ability to deal with both the symptoms and causes of most back pain.

Yoga provides physical fitness coupled with relaxation exercises to deter potential debilitating back pains as well as aide in the treatment of existing back problems.

Prevention is Your Best Bet

Prevention is the most effective solution for back pain. As most back pain is muscular in origin, the pain usually occurs as a result of the way a person uses or misuses his or her body. Faulty habits push and pull the spine out of alignment and cause weakness, spasms, and strains in tendons, ligaments, and muscles. The end result is pain, which can be felt either in the back or referred through the nervous system to other parts of the body. Through self-awareness, you can learn to use your body more efficiently, and maintain these new habits and postures for a healthier back.

Immediate Care for Back Pain

A standard treatment for back pain is to apply ice for ten minutes, heat for five minutes, then reapply ice, heat, and ice once more for the same amount of time. This can be repeated as needed throughout the day. The ice allows the blood to reabsorb the fluids and chemicals that surround the injured area. If swelling and pain continues, consult a doctor immediately.