I have back pain—will relieving my pain take a long time or be expensive?

I can’t bend over to tie my shoes!

I have lower back pain and I can’t straighten up!

My sleep is terrible, I can’t find a comfortable position!

Back pain relieved naturally: Solutions for getting your life back fast

More than ever people are seeking natural solutions for chronic back pain. The Cleveland Clinic reports that 80% of people living in the U.S. have a strong chance of suffering from back pain during their lifetimes. For those who do, 15% – 20% will deal with this pain for a year or more. Adults ages 45-64 are most likely to experience a painful back. ^[1] (1) The medical staff of the Cleveland Clinic. Chronic Back Pain Overview. Cleveland Clinic [website] https://my.clevelandclinic.org/health/diseases/16869-chronic-back-pain (accessed January 29, 2020)

Most back surgery is unnecessary

More than any other common pain condition, back pain diagnosis is surrounded by myth and outdated treatment approaches. For example, if an x-ray or MRI shows arthritis, a bulging disc, or other forms of “spinal degeneration,” then that’s why your back hurts. Right?

Not necessarily. Many studies have shown this is often not true. People who had back scans that exhibit one or more of the conditions listed above but decided not to have back surgery and tried to relieve their back pain naturally ended up with the same if not better results than those who did have back surgery ^[2] (2) Richard Senelick MD. MRI Back Scans Do Not Predict if You Need Surgery. HuffPost [website] January 23, 2014, https://www.huffpost.com/entry/sciatica-_b_4098475guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAHCpNkDqiGKBKqnHCnHLcfY4YHhYcUzYqwyaGnCc9aEaLdEuDtVBce8huebNtpmtzBnzc7UGWScxBYFTwJ-2hwk-yFFtnHUwJCx6m0h58yDPQlqUQDIFYraman51lPnpjcxdx848x6XTRKuSmnWZn89N9CYe2zN5vtH2LhmtrZX (accessed January 29, 2020)

Our spines are not as fragile as we have been led to believe. One major consequence of unnecessary spinal fusion surgeries — a standard and routinely ineffective procedure — is low back pain that persists for years instead of months or weeks. ^[3] (3) Philip Stahel, Todd Vanderheiden, and Fernando Kim. Why do surgeons continue to perform unnecessary surgery? Biomedical Center [website]. January 13, 2017, https://pssjournal.biomedcentral.com/articles/10.1186/s13037-016-0117-6 (accessed February 1, 2020)

Many doctors are not current in their science

The scientific literature does report on more effective solutions for eliminating or significantly reducing back pain. Although many back pain specialists stay current on this topic, this information has been slow to reach the majority of medical care professionals. On average, new scientific research can take up to 17 years before most doctors are aware of it! ^[4] (4) Zoe Morris, Steve Wooding, and Jonathan Grant. The answer is 17 years, what is the question: Understanding time lags in translational research. National Library of Medicine – National Institutes of Health [website]. December 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241518/  (accessed January 29, 2020)

This disturbing fact shows that, in general, treatment for back pain is notoriously out of step with what really works.

I have back pain—will relieving my pain take a long time or be expensive?

The majority of back pain cases can be relieved by following these simple back pain treatment options. Diligent application of these steps gives you an excellent chance of avoiding a prolonged period of discomfort or disability. I recommend that you consider these following tips before you agree to back surgery or even cortisone injections.

1. Self-massage and stretching

If you’re one of the lucky ones, your back pain is caused by ultra-tender points or “trigger points” in your muscles. Pain may also occur in connective tissue that has become ridged; these are known as “adhesions.” ^[5] (5) David Alvarez, Pamela Rockwell. Trigger Points: Diagnosis and Management. American Family Physician [website]. February15,2002. https://www.aafp.org/afp/2002/0215/p653.html (accessed January 29, 2020)

You’d be lucky because this type of back pain is relatively easy to relieve.

Conventional medicine is often ignorant or dismissive of simple solutions for this type of back pain. With a lacrosse ball, a Theracane, a muscle-rolling stick, and a foam roller, and doing some simple stretches, you may be able to relieve your pain quickly at home. ^[6] (6) Sometimes it will only take one of these tools to bring relief. For back pain, the lacrosse ball and Theracane are usually the most effective. More on this in future articles.

2. Acupuncture, chiropractic, therapeutic massage

If you don’t get full relief doing self-massage and stretching, I suggest trying one or more of these above-listed treatments. Choose one approach and try it for 3-5 sessions. Follow any directions if this also includes self-care at home. If you still find no noticeable improvement, then try another of these recommendations. Each of these options has proven to relieve back pain—one of them may be right for you.

3. Practice yoga, Pilates, use a personal trainer or physical therapist

A sedentary lifestyle has shown to be the cause of many contemporary health problems, including back pain. Are you are out of shape and sit or lie down for more hours per day than you are active? If so, one or more of the above-listed approaches may provide long term relief, especially if exercising becomes a permanent lifestyle change for you.

4. Get more quality sleep

An epidemic of sleep problems has occurred in developed nations, including ours. Many scientific studies have linked poor-quality sleep to mental stress issues, low work performance, and chronic pain. Relieving your back pain may be as simple as consistently getting better quality sleep. ^[7] (7) James Gerhart, John Burns, Kristina Post, David Smith, Laura Porter, Helen Burgess, Erik Schuster, Asokumar Buvanendram MD, Anne Fras MD, and Francis Keefe. Sleep and low back pain. National Library of Medicine – National Institutes of Health [website]. June 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846493/ (accessed January 29, 2020)

5. Change your shoes

You may look and feel great wearing your high heel shoes, but they take a toll on your back. High heels cause an unnatural tilt to your pelvis, and, over time, this can cause back pain. Consider wearing them only on special occasions and, even then, try to sit most of the time.

Flip flops may be comfortable and fun to wear during the summer months or around the house. Still, they can cause us to walk unnaturally and be the source of your foot, ankle, and low back pain. Instead, although less easy to slip on, consider wearing a sandal with a strap that anchors your heel. ^[8] (8) Flip-Flops and Back Pain: It’s No Coincidence, Don’t Let Your Choice of Summer Footwear Slow You Down. Advent Health Medical Group [website]. http://www.thespinehealthinstitute.com/news-room/health-blog/flip-flops-and-back-pain-it%E2%80%99s-no-coincidence (accessed January 29, 2020)

6. Move more—and more often

One essential key to overall health, including aches and pains, is to move more often during the day. It’s not enough to work out vigorously at the gym if you also sit for eight or more hours, five days a week. Our bodies need continuous low-intensity movement throughout the day. Activities like walking, cooking, gardening, and even housework are good examples of healthy movement. At work, consider getting a sit-stand desk so you can change positions often during your workday. Also, keep in mind to take stairs rather than the elevator and to park further from the grocery store entrance—all this adds extra movement to your day.

7. Practice mindfulness

Unhealthy levels of stress are often a primary culprit in pain problems. A proven method of coping with stress is called “mindfulness practice.” If you’ve never tried this approach, I recommend the Mindfulness-Based Stress Reduction program (MSBR). This 8-week course is not covered by insurance but often offered on a sliding scale from $350-$600. Classes in this approach are given in many hospitals and private practices throughout the U.S. as well as globally. MSBR is an excellent introduction to a variety of methods that can naturally reduce stress. This course doesn’t include any mystical and spiritual aspects; its nonsecular approach makes the techniques accessible to everyone. ^[9] (9) Mindfulness-Based Stress Reduction (MSBR). Wikipedia Foundation [website].   https://en.wikipedia.org/wiki/Mindfulness-based_stress_reduction  (accessed January 29, 2020)

8. Take magnesium

Magnesium is an essential nutrient for more than 300 biological reactions in the body. Estimates are that 50% – 75% of the U.S. population is deficient in magnesium. Symptoms of magnesium deficiency include fatigue, weakness, numbness, tingling, muscle cramps/spasms, and abnormal heart rhythms. Low magnesium levels can also make it harder for your body to absorb vitamin D, which can cause further muscle trouble. ^[10] (10) Magnesium: Fact Sheet for Health Professionals.National Institute of Health Office of Dietary Supplements [website]. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ (accessed January 29, 2020)

9. Follow an anti-inflammatory diet

The foods we eat can prevent and even reverse a host of health challenges, including some types of back pain. Inflammation is your body’s natural response to injury or threat of harm. Inflammation is also a proven cause of back pain. Studies suggest that an anti-inflammatory diet is as effective at treating back pain as nonsteroidal anti-inflammatory drugs (NSAIDs) that include aspirin or ibuprofen. ^[11] (11) Jennifer Berry, Daniel Bubnis. 11 Ways to Treat Back Pain Without Surgery. Medical News Today [website]. June 28, 2019. https://www.medicalnewstoday.com/articles/325609.php#weight-loss (accessed January 29, 2020)

To begin an anti-inflammatory diet, start by eliminating 100% of the following foods for at least three weeks:

• All processed food—this includes fast food, soda, and anything packaged in the store.
• Sugar
• Gluten—found in wheat, barley, and rye
• Alcohol
• Industrial seed oils—Corn, canola, soy, etc.
• Instead, eat whole foods that are prepared fresh at home or a health-oriented store or restaurant.
• If you want to take a deeper dive, I highly recommend following Chris Kresser‘s 30-day reset diet.

10. Quit Smoking

Smokers are three times as likely to have lower back pain, and smoking may increase pain sensitivity in general. It does this by impairing the delivery of oxygen-rich blood to bones and tissues. Decreased blood and nutrient flow due to smoking can cause degeneration of the body, particularly in discs of the spine, which already have limited blood flow. This condition can often result in an increase in lower back pain and sometimes even osteoporosis. ^[12] (12) Bart Green, Claire Johnson, Jeff Snodgrass, Monica Smith, and Andrew Dunn. Association Between Smoking and Back Pain in a Cross-Section of Adult Americans. National Library of Medicine – National Institutes of Health [website]. September 26, 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081254/ (accessed January 29, 2020)

Each of these options can help you help yourself reduce or abolish your back pain.

I will go into greater detail on each of these subjects (and include tutorials) in future articles.

When is surgery really necessary?

Even though back pain relieved only by cortisone shots and surgery is rare, it is essential to know when you will have to consider these options. Here are some examples of symptoms that likely indicate a need for surgery. ^[13] (13) Roger Chou, MD, Amir Qaseem, MD, Vincenza Snow, MD, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine [website]. October 2, 2007. https://annals.org/aim/fullarticle/736814/diagnosis-treatment-low-back-pain-joint-clinical-practice-guideline-from (accessed January 29, 2020)

• Persistent shooting pain down both legs or both arms that lasts for more than six weeks
• Numbness around the groin, incontinence, difficulty urinating, drop foot (loss of control of ankle muscles that make the foot drag), and significant weakness in the legs. These symptoms can develop gradually, so it’s essential to keep a watchful eye on them.
• Light pressure or tapping on the spine that is unbearable.
• Spinal fracture from a fall, car accident or another traumatic injury

                  “Back surgery may be necessary for people with clear evidence of nerve damage. But without that evidence, surgery is no better than nonoperative methods for people with sciatic-type and so-called degenerative back pain.”

David Hanscom MD. Back in Control: A Surgeon’s Roadmap Out of Chronic Pain, 2^nd Edition. Vertus Press. Kindle Edition.

What if my pain means that I have___________?

(insert a dreaded disease)

As much as I love how easy it is to look up information on Google, there are situations where it causes more trouble than good. Searches can be more upsetting than helpful if you don’t know how to sort the useful from the absurd.

I have lost track of how many clients have come in for their first appointment with a worried look on their faces, saying, “My back hurts really bad. Do you think it’s a tumor?”

The consequence of random web searches is often websites or articles that are upsetting. These sources link your symptoms with cancer, improper lifting techniques, or tell you that it is “all in your mind.” It’s more likely that your anxiety, spiked by alarmist articles, is perpetuating your back pain more than anything else. Also, please keep in mind that the majority of back pain cases are not linked to something exotic and can resolve through lifestyle changes.

If you are intent on researching online about your back pain, start with reputable sources first.  Use these more reliable information sites and refine your search from there. The Mayo Clinic, The Cleveland Clinic and Harvard Medical News all provide health information that presents balanced views and current peer-reviewed scientific research. These institutions also have an open mind concerning viable alternative therapies. If you start with sources such as these, you can avoid a lot of stress and confusion.

Well, why are so many health professionals clueless when it comes to treating chronic back pain?

The primary cause of misguided therapy for chronic back pain is the enduring myth that the pain comes from some structural defect or injury. Damage to the structure may cause the start of the pain. However, often the original cause is long gone or even completely healed although you are still suffering.

What keeps the pain from resolving and disappearing is a pain loop that gets “stuck” in the nervous system. This loop has the same neurological characteristics as daily habits—like when you know it’s time to go to bed or your ability to walk without consciously thinking about it. The longer the chronic pain lasts, the more ingrained it becomes in the nervous system—it’s like a wheel groove made by a car worn into a dirt road. Eventually, these grooves get so deep that it’s almost impossible to drive on the road in any other place. In effect, your nervous system gets very efficient at being in pain and has a hard time stopping this pattern. I call this a “sprained nervous system.”

What is a sprained nervous system?

Just like a sprained muscle, routine activities such as walking are painful or even impossible. People who have a sprained nervous system can’t easily feel safe and calm. They feel continually on guard and often have trouble with sleep, digestion, and cognitive tasks.

Their sprained nervous system becomes hypersensitive to common everyday experiences like background noise at a party or the brightness of fluorescent lights in a store. Imagine if everything in your world got five times louder, brighter, and sensitive to the touch. It would be like listening to all the radio stations in the world at once. Rather than being able to hear any of them, it would sound like a blaring, overwhelming jumble. One of the symptoms of this condition is pain patterns that won’t shut off.

All of these diagnoses describe the same phenomenon of your physical body’s overreaction to sensory input:

Tension myositis syndrome (TMS)

Central sensitization syndrome (CSS)

Psychophysiological disorder (PPD)

Stress illness syndrome

Psychosomatic disorder

Central nervous system—neurophysiologic disorder (NPD)

Mind-body syndrome

Watch this video to understand how these conditions start and perpetuate.

There are effective programs that can help a sprained nervous system to recover.

Here are several that I recommend:

The Safe and Sound Protocol – This is a sound therapy that resets the way the unconscious- automatic brain responds to sounds in the environment. SSP helps people attain states of ease and safety more efficiently. I offer this treatment in my office.

Focus System – This therapeutic program is designed to be used after the use of the Safe and Sound Protocol. In this program, a combination of modified music, core exercises, balance, spatial orientation, and cognitive exercises are engaged to help repair any gaps in your neurological development. These delays can be caused by childhood and adult traumatic stress events as well as brain injuries. This program helps the brain to process stress more effectively as the brain and body functions become more integrated. I offer this treatment in my office.

Dynamic Neuro Retraining System (DNRS) – The Dynamic Neural Retraining System™ is a natural, drug-free, neuroplasticity-based healing program that can aid in recovery from chronic stress conditions.

Each of these programs helps rewire how the nervous system processes stress. They are useful for a wide variety of stress-related and limbic system dysfunction conditions.

These programs help conditions caused by chronic stress, such as:

• Chronic pain
• Chronic fatigue syndrome
• Multiple chemical sensitivity
• Fibromyalgia
• Lyme disease
• Food sensitivities
• Anxiety
• Postural orthostatic tachycardia syndrome
• Type 1 diabetes
• Autoimmune diseases
• PTSD
• Heart disease

Please know I have found that easing or abolishing chronic back pain usually takes more than one approach. In all cases, getting your life back will require a commitment of time and focus and, in many cases, will require significant but doable changes to your lifestyle.

Stay tuned for in-depth articles that explore the origins and solutions to many common acute and chronic pain issues. I will post these regularly, and I look forward to your comments and feedback.

If you would like to know more about a specific pain issue, please send me a request through email, social media, or as a comment after one of my articles.