Understanding Back Pain

According to the American Chiropractic Association, back pain affects half of Americans, is the most common reason for missed work, and is the second most common reason a person visits the doctor.  This condition is most likely caused by something that is non-organic (organic being cancer, rheumatoid arthritis) and is mechanical in nature. 

Many patients are concerned with the cause of the back pain but also with answers as to why anti-inflammatory medications and muscle relaxers do not alleviate completely their condition.    Back pain can be multifaceted with many sources being the cause of the pain and often it is not one pain generator but multiple that need to be addressed.  To understand why a pain medication may not be enough, we must briefly discuss the anatomy of this condition.  Your spine is composed of ligaments (structures that connect bones), tendons (structures that connect muscles to bones), joints (areas were bones move with one another), and lastly muscles (structures that generate movement in bones).  These four anatomical components have the potential to generate pain and discomfort in different ways. 

Let’s take a back sprain (injury of a ligament) or strain (injury to a muscle) for example.  If a person lifts something heavy without the appropriate strength and core stability, they may sprain/strain the back ligaments or muscles.  When the muscle strength is not adequate, the back relies on the ligaments to help stabilize joint segments.  Rarely does one occur without the other.  If the ligament is sprained, it typically coincides with an injury of the muscles which spasm or contract in protection.  To add to what appears to be a complex situation, the joint can also become injured in this situation resulting in joint inflammation.  If a muscle relaxer is prescribed, it may relieve the muscle pain but what about the injured ligament and/or joint pain?  Lastly, muscles often do not fire properly after a serious injury, so is the pain reduction a complete assessment of a person’s function or should we also care whether a person’s movement is appropriate after such an injury?

While the last paragraph was quite technical in it’s delivery, the message is important.  There is not a single therapy in most situations that alleviate all the levels of back pain (especially when chronic), but rather a combination of therapies that will deliver complete relief. Treatment plans for every condition, including back pain, must be specific and targeting the areas of deficient in the person’s body.  It is necessary to have a comprehensive evaluation to derive such a treatment plan.  Patients often want to know how long it should take to experience relief.  Any precise treatment plan should deliver relief in a reasonable time frame with 8 weeks being the absolute longest and 3 weeks potentially being all you need.  If the treatment targets the right anatomical issues, back pain and all other mechanical issues should experience a percentage of relief with every visit. 

We would not be a holistic practitioner without recognizing that back pain is not just mechanical but could be as a result of other issues.  We recognize pain related to the meridian system (think acupuncture) and it’s imbalance and internal medicine complaints (for example, constipation) that refer pain to the spine.  These conditions require a different therapeutic approach which we can discuss in another post.

Are you wondering what you can do to make your back pain better?  Here is a list of changes you can make to reduce the pain you experience and potentially remedy it all together.

·    If you are overweight or obese, reduce your weight which will reduce the stress on the spine and aid in strengthening the core.

·    Wear shoes that support the arch and have no more than a 1-inch heel

·    Stretch your legs after sitting for extended periods – if you work at a desk, stand all day, or stand/sit in any position for too long, your body develops tight muscles that need to be stretched.

·    Strengthen your abdominal muscles

·    Sleep on a supportive surface with a pillow beneath your knees if you sleep on your back or between your knees if you sleep on your side.

·    Hydrate and nourish your body with water and nutrient rich foods.

If these changes are not effective, you should consider being evaluated for holistic care.