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6 Tips to Banish Low Back Pain (and Get On With Your Life)

By Brigid Sweeney | November 1, 2018 | Rally Health

Back pain isn’t just painful — it’s also shockingly common. Most Americans have suffered through at least one bout in their lives and roughly a quarter have experienced back pain for at least one day in the last three months. That translates to about $100 billion annually in medical costs, and lost wages and productivity.

But if you’re turning to painkillers and couch time to relieve the discomfort, it might be time to rethink your approach. The latest guidelines emphasize trying non-drug therapies like exercise, massage, and yoga before turning to medications. Unless you already experience chronic back pain that lasts a few months or longer, an episode of low back pain will likely improve with time. Moreover, opting for pills, MRIs, or the operating table all carry risks.

“People who have back surgery and people who don’t have surgery have extremely similar outcomes,” says Loren Fishman, MD, a back pain specialist in New York City and assistant professor at Columbia Medical School. “Most back pain tends to recede and become much less of a problem. There’s a process by which the body handles the pain and lessens it.”

Some experts liken acute back pain — the type that lasts less than a month and doesn’t radiate down the leg — to a cold: frustrating, sure, even agonizing at times, but rarely the cause of serious problems and often treatable with low-cost or at-home remedies. This type of low back pain tends to improve over time regardless of treatment. So you might not need to call your doctor at all, Dr. Fishman says. Trust your body and rest for a few days until the pain begins to subside, he says. (Of course, a quick call to your doctor is always worthwhile if you’re unsure when to restart physical activity, or you have concerns about your symptoms.)  

Combine strength and cardio

Yep, exercise is a cure-all for many ailments — including backaches, which can be brought on by a sedentary lifestyle. “We have a saying that motion is lotion for the joints and back,” says James Petros, MD, the medical director of Allied Pain & Spine Institute in Los Gatos, Calif. A regimen that combines strength training and walking can improve spinal function and reduce pain in overweight people, according to a recent study in the Journal of Exercise Rehabilitation. (People suffering from acute pain should avoid lifting weights until the pain subsides, Petros says. But strength training may help speed recovery in those who suffer from chronic or subacute pain, which is defined as lasting between four and 12 weeks.)

Those positive results are most likely because the weights help strengthen the back muscles, Petros says, while both lifting and walking boost blood flow, which can speed healing. Activity also counteracts the pressure that prolonged sitting places on spinal disks, says Petros.

Try yoga

“It’s effective and it’s virtually free,” Fishman says. He points to updated guidelines from the American College of Physicians that recommend yoga as one of the preferred first-line treatments of chronic back pain — the kind that lasts more than three months. Newbies with aches should proceed carefully to determine what works: A forward bend, for example, will induce “ahhs” if you suffer from spinal stenosis, which puts pressure on your nerves, Fishman says. But if your pain stems from a herniated disk, backward arching poses are best, he says.

Size up the scale

Doctors know that weight gain is one of the most common causes of back pain, says Harpreet Singh, MD, a pain management specialist in San Jose, Calif., who’s also board-certified in psychiatry and neurology. If you’re overweight, talk to your doctor about whether losing weight and body fat may help to reduce the load on the spinal column and back muscles, he says.

Practice meditation and other cognitive techniques

No one doubts that your pain is real. But dealing with chronic discomfort can cause anxiety, which can exacerbate the problem. “Patients start thinking, ‘This is like a knife stabbing my back’ and the thought becomes repetitive,” says Sarah Church, PhD, a clinical psychologist and CEO of Elevate Psychological Services in New York. “We help them identify those thoughts and break the cycle.”

Gaining a better awareness of this tendency to fixate, and improving your coping skills — whether that’s deep breathing or simply increasing the amount of time spent doing something you love — can help you feel better, she says. Church introduces a combination of meditation and muscle relaxation techniques to calm the nervous system. “When people are calm, they have less pain,” she says. A 2016 study in the Journal of the American Medical Association found that back-pain sufferers noted significant relief from a variety of mindfulness-based practices or cognitive behavioral therapy.

Learn good back habits

Nixing slouching and other bad posture can help keep your spine in alignment. The old charm-school idea of imagining a thread extending through your body and pulling you upward is actually the right way to think about posture, according to Harvard Medical School experts. They also recommend squeezing your shoulder blades together to prevent hunching, while their counterparts at the Cleveland Clinic suggest making sure your chair and workstation are the correct height and adding a pillow under your knees while you sleep.

If you smoke, quit

Smoking has been linked to lower back pain in a variety of studies. Smoking reduces blood flow to the spine, which can contribute to degenerative disk problems. Other researchers point to the idea that the stress of a chronic cough may induce aches, and underscore that smoking increases inflammation, which may trigger your central nervous system to feel more pain. Similarly, researchers at Northwestern University showed that smoking interfered with brain activity in a way that made people more vulnerable to pain. Regardless of the underlying mechanisms, one thing is clear: Smokers are three times more likely than nonsmokers to develop chronic back pain. Talk to your doctor about how to quit.

In some cases, these solutions may not give you enough relief. If that happens, or if your back pain doesn’t improve in several weeks or is associated with fever, chills, or unexpected weight loss, talk to your doctor. (And if you have a history of cancer, vascular or arterial disease, or persistent pain that’s present no matter how you move or adjust your position, talk to your doctor.) Many physicians practice what’s called multidisciplinary care when it comes to back pain. If conservative treatments — i.e., ones that don’t require surgery — don’t work, they can discuss next steps. There are other alternatives, like acupuncture and chiropractors, that might be right for you.  Or your doctor might suggest injections, which can range from epidural steroids to “nerve blocks” that numb the area, according to Petros.

The operating room might be an option in certain cases. Surgery may be used more often than it’s needed, says Fishman, “but that’s not to say it doesn’t have a definite place.”

Brigid Sweeney
Rally Health