Complementary and alternative medicine for back pain

Besides treatment provided by a doctor and self-care steps taken at home, some people have turned to complementary and alternative therapies for relief of back pain.

  • Chiropractic care. Back pain is one of the most common reasons that people see a chiropractor. If you’re considering chiropractic care, talk to your doctor about the most appropriate specialist for your type of problem. In addition to chiropractors, many osteopathic doctors and some physical therapists have training in spinal manipulation.
  • Acupuncture. Some people with low pack pain report that acupuncture helps relieve their symptoms. The National Institutes of Health has found that acupuncture can be an effective treatment for some types of chronic pain. In acupuncture, the practitioner inserts sterilized stainless steel needles into the skin at specific points on the body. Acupuncture is thought to stimulate your central nervous system to release the body’s natural pain-relieving endorphins. Acupuncture may also alter how your blood pressure, blood flow and body temperature are regulated and respond to pain.
  • Music therapy is a low-cost natural therapy that has been found to reduce the disability, anxiety, and depression associated with chronic pain. A study evaluated the influence of music therapy in hospitalized patients with chronic back pain. Researchers randomized 65 patients to receive, on alternate months, physical therapy plus 4 music therapy sessions or physical therapy alone. Music therapy significantly reduced disability, anxiety, and depression. Music had an immediate effect on reducing pain, although the results were not statistically significant.
  • Vitamin D Chronic muscle pain can be a symptom of vitamin D deficiency. Vitamin D is found in fish with small bones, fortified milk and cereal, and exposure to sunlight.

Risk factors for vitamin D deficiency are:

  • darker pigmented skin (e.g. Hispanic, African American, Asian) does not convert UV rays efficiently to vitamin D
  • digestive disorders, such as celiac disease
  • use of glucocorticoid medications for conditions such as lung diseases and allergies
  • minimal sun exposure (elderly, institutionalized, homebound, veiled or heavily-clothed individuals)
  • latitude and season – for example, people in Boston do not produce vitamin D from sun exposure between November and February

A study by the University of Minnesota looked at the prevalence of vitamin D deficiency in 150 people with chronic musculoskeletal pain. Researchers found that 93% of patients had vitamin D deficiency. All people with darker pigmented skin (African American, East African, Hispanic, and Native American origin) had vitamin D deficiency.

Another interesting finding was that the majority of people with severe vitamin D deficiency were under 30 years of age. Season was not a significant factor.

The researchers concluded that all people with persistent, non-specific musculoskeletal pain should be screened for vitamin D deficiency.

Prolotherapy

Multiple studies of prolotherapy have reported conflicting evidence regarding its effectiveness in treating chronic pain. Some studies have shown a benefit, others have showed none.

Prolotherapy involves injecting painful ligaments and tendons with sugar solutions that are intended to stimulate production of connective tissue. A typical course of treatment is six to 10 sessions, sometimes with multiple injections at each session.

Proponents believe that these treatments restore strength and stability to ligaments and joints, which may relieve pain. Prolotherapy has been used to treat a number of painful musculoskeletal conditions, such as osteoarthritis and chronic back pain.

Prolotherapy is known to cause some pain at the injection site, but this is typically mild and temporary. As with any injection, there is a risk of infection, bruising, bleeding or tissue damage.

A 2007 review of five well-designed studies involving 366 participants concluded that prolotherapy alone was ineffective in treating chronic low back pain. However, when combined with other treatments – such as spinal manipulation and exercise – prolotherapy may improve chronic low back pain.

Chiropractor

Low back pain may have many causes. In most cases of injury or strain, there’s no magic cure. It simply takes time for your back to heal. Back pain lasts just as long if you go to a chiropractor, if you go to a physical therapist or if you seek no treatment at all. But treatment of some type – either chiropractic or conventional – might make you more comfortable as you wait for your back to heal.

Researchers say chiropractic manipulation and conventional medical care are about equally effective for relieving acute low back pain. In one study, chiropractic manipulation was found to relieve back pain better than a sham therapy in which therapists only imitated chiropractic manipulation.

Treatment

Chiropractic treatment is based on the concept that restricted movement in the spine may lead to pain and reduced function. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease back pain.

During an adjustment, chiropractors use their hands to apply a controlled, sudden force to a joint. This maneuver often results in a cracking sound made by separation of the joint surfaces – not, as many people think, by “cracking joints.” Although this sound is common, it doesn’t have to occur for the treatment to be successful.

Chiropractors may also use massage and stretching to relax muscles that are shortened or in spasm. Many use additional treatments as well, such as ultrasound, electrical muscle stimulation and exercises.

Chiropractic care is generally considered safe, but it’s not appropriate for everyone.

  • Don’t seek chiropractic adjustment if you have osteoporosis or symptoms of nerve damage, such as numbness, tingling or loss of strength in a limb, hand or foot.
  • If you have a history of spinal surgery, check with your surgeon before consulting a chiropractor.
  • Manipulation of the neck may be hazardous if you’ve had a stroke or you have a history of vascular disease.
  • If you have back pain accompanied by fever, chills, sweats or unintentional weight loss, see a medical doctor to rule out the possibility of an infection or tumor.

If you’d like to try chiropractic care to treat your low back pain, a little preparation can help you get the most from your treatment.

  • Consult your doctor. Talk to your doctor about the type of specialist best able to treat your back pain. In addition to chiropractors, many osteopathic physicians and some physical therapists have training in spinal manipulation.
  • Make it a team approach. As with any medical specialist, select a chiropractor who’s willing to work with the other members of your health care team.
  • Arrange a consultation. Before you make a treatment appointment, arrange a consultation with the practitioner – either in person or by phone – to find out how he or she might address your back pain. Make sure you’re comfortable with the recommendations, including how many sessions you’ll need. For acute low back pain, four to six sessions are typically enough.
  • Understand the risks. When limited to the low back, chiropractic adjustment has few risks. However, manipulation of the neck has been associated with injury to the blood vessels supplying the brain. Rarely, neck manipulation may cause a stroke.

A little care and attention can help you keep back pain at bay. Maintain a healthy weight. Exercise regularly. Sit up straight. When you lift something heavy, let your legs do the work. If you smoke, ask your doctor to help you develop a plan to quit. Smoking reduces blood flow to the lower spine, which can hinder the healing process.

Some exercise to practice

Stretching For Relief Of Back Pain

Stretching is more important for the relief of back pain than strengthening exercises. The key is to find what muscles or muscle groups are asymmetrically tight or imbalanced, causing postural problems and strain leading to back pain. One of the most common muscles associated with this kind of back pain problem is the rectus femoris. This muscle runs from above the hip down through the kneecap into the front of the tibia (the inner, longer bone of the leg between the knee and ankle). If the muscles in both legs are tight, it can produce, what doctors call, an anterior pelvic tilt, where the whole pelvis leans forward. This often results in a lordosis in the back or an excess amount of lumbar curve. This condition is commonly referred to as sway back.

Chair exercise

Sit in chair and lean forward until pain is felt; breathe out and slowly lean farther, stretching muscles further.

Stand and put the knee of the leg you want to stretch on the seat of a chair. Hold on to the back of the chair with the opposite hand for balance. Pull the heel of the leg you want to stretch to the buttocks, and push forward with the pubic bone. This will push the pelvis backward, and you’ll feel the stretch all the way from the knee, up the leg to the front of the thigh.

Knee pulls

Sit in a straight-backed chair. Lift your right knee and clasp it in both hands and pull it as close to your chest as possible. Exhale deeply as you feel tension or mild pain in your back. Do the same with your left leg. Do several repetitions.

Do the same exercise while lying on mat placed on the floor. While lying on the mat, pull both knees toward your chest. Breathe out as you pull your knees toward your chest and as you feel the tension.

Pelvic Jack

The Pelvic Jack is another easy stretch to help with low back pain. You can do this while sitting in a chair. Simply sit up straight, back against the chair back so that you have the normal low back curve. Then just allow your pelvis to roll back as if you were going to slouch into the chair. Hold that for a few seconds and then come back up into the straight position with the normal lumbar curve.

Press-ups

Press-ups are something like half of a push-up. It is a great exercise to strengthen your lower back. Lie on the floor on your stomach. Keep your pelvis flat on the floor and push up with your hands, arching your back as you lift your shoulders off the floor. Do press-ups once in the morning and once in the afternoon.

Crunch sit-up

Lie flat with both feet on the floor and your knees bent. Cross your arms and rest your hands on your shoulders. Raise your head and shoulders off the floor as high as you can while keeping your lower back on the floor. Hold for 1 second, then repeat.

Swim on dry land

This is great for extending and strengthening your lower back. Lie on your stomach and raise your left arm and your right leg. Hold for 1 second, then alternate with your left leg and right arm as if you were swimming.

Swimming

Swimming is great exercise for the back. A good exercise for acute low back pain is to get into a warm pool and swim.

Make sure that before you stretch any muscles it must absolutely be relaxed. It must be relaxed in order for it to stretch at all. Do the stretch, hold it for five to ten seconds, then release and relax for five to ten, then go back into the stretch and hold it for five to ten seconds.

Sources: Mayo Clinic, Altmedicine

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