If you have never suffered from low back pain, consider yourself one of the fortunate few. Back pain is a common reason for Americans under the age of 45 to limit their activity. It is also a common reason for visits to the doctor and for surgery. There is some good news, though. Most people recover from an acute episode in a few days or weeks without much disruption to daily activities or medical treatment. For others however, low back pain becomes a chronic or recurrent condition, often resulting in considerable social and occupational disability.
The back is a strong column that is made up of of bones, nerves, ligaments, and muscles. This combination of tissue allows for a large range of motion while remaining strong enough to keep you upright and stable. A number of individual bones, called the vertebrae, run from just under the skull through to the tailbone. These bones are separated by cushioned discs and are held in place by strong bands of tissue called ligaments and muscles. The bones create a tunnel that the spinal cord sits in. Nerves leave the spinal cord through several areas in the back to pass to the rest of the body. When all these structures are healthy, the back is in balance and works wells. Chronic pain is caused by strain or injury to one or all of these structures.
Chronic back pain is often due to wear and tear on the back from repetitive stress or strain. It can also develop or worsen because of weaknesses and imbalances in the back. Stress, strain, and imbalances can all place excess stress on supportive tissue like ligaments and muscles. When that tissue is irritated or inflamed it can put strain on nearby nerves. This can lead to a cycle of imbalance and injury that causes chronic pain. The low back is especially susceptible to chronic pain because it is involved in weight bearing of the upper body and lifting.
Common factors that can lead to chronic low back pain include:
Many times, there is no absolutely clear cause of low back pain.
What is the best treatment for chronic low back pain? According to evidence, what seems to matter is not which one, but how many treatments you use. In other words, interventions that address not only the physical aspects of the pain, but also its psychological, social, and occupational influences seem to be the most effective. An effective rehabilitation program may encompass:
Alternative therapies use non-conventional methods to manage or relieve back pain. More often than not, alternative therapies are used in combination with standard medical treatment.
Below are among the most commonly used alternative therapies to treat chronic low back pain:
There is some evidence that, at least in the short-term, each of these therapies may be effective at alleviating discomfort, improving function, and/or enhancing a sense of well-being. However, it is unclear if any one of these therapies is superior to the others or to physical therapy, the standard conventional treatment. Furthermore, it is unclear that any of these approaches provides more than short-term benefit.
This combination of therapies makes a lot of sense. It is well known that an enormously complex range of factors, affecting many aspects of life, contribute to our experience of chronic pain. It is hard to imagine, then, that any single intervention—alternative or conventional—could succeed. An alternative therapy therefore, should be part of a multi-dimensional treatment strategy.
Chronic back pain can affect your ability to keep up with your normal activities. These treatments will help you slowly increase your activity level until over time.
If you suffer from idiopathic chronic pain anywhere in your body consider the following steps:
American Academy of Physical Medicine and Rehabilitation
American Society of Exercise Physiologists
Canadian Society of Exercise Physiology
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Last reviewed March 2017 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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