If you’ve never had back pain, consider yourself lucky – and largely alone. It’s been estimated that eight out of ten Americans will experience low back pain at some point in their life. For some this pain is temporary, clearing up within 24 hours. But for others the issue is a chronic problem that disrupts their quality of life, their work, and their ability to engage with friends and family.
Over the years, there have been tremendous shifts in what physicians thought the best approach to this pain should be. Up until the 1990s, patients were told to stay in bed and rest: years earlier they were put in traction. Surgery was introduced as an option, but the operations were so invasive and laid people up for such a long time that the mere idea scared many people off.
Unfortunately, with people shying away from extreme surgery, powerful medication became one of the most popular alternatives for patients in pain. Not only were the ineffective at providing real relief, but their use has led to frightening dependencies and never-ending costs. Others had adverse side effects, including stomach ulcers and gastrointestinal bleeding from some non-steroidal anti-inflammatory drugs.
Today, physicians and researchers are increasingly turning to alternative approaches, working with patients to find conservative protocols that will provide effective pain relief. Many have proven to be extremely effective, including yoga, exercise, and acupuncture. There are also less invasive surgical procedures that offer patients suffering from specific injuries and degenerative disc issues real help.
In order to provide better guidance for physicians treating patients with low back pain, the American College of Physicians issued a publication specifically addressing noninvasive treatments for low back pain. The first and most important point that the group makes is that opioids and other medications should be avoided if at all possible. The first treatment they suggest for temporary low back pain is heat, and if that doesn’t help some suggest moving on to spinal manipulation or acupuncture (though others question the efficacy of either of these approaches).
For those whose back pain is constant, the group bases its recommendations on several studies showing that movement is integral to muscular health and function. They suggest that after an injury and to prevent future injuries, people should engage in activities such as yoga and tai chi, rehabilitation such as physical therapy, and exercise. Though many patients are hesitant about engaging in any type of workout when they are in pain, studies have shown that when a physician or therapist is involved in creating a fitness plan customized to the patient’s pain, it can provide real results. Those plans should include both strength training and aerobics, as the theory behind the recommendations rests on the common-sense notion that muscles need to stretch, move, and bear weight in order to stay healthy.