What to Do About Back Pain

How to stop back pain and backaches. What to do when your back hurts.

By Elena Rover

Massage topped the list for relieving pain and keeping patients moving in a major review of dozens of studies of massage, acupuncture, and chiropractic spinal manipulation. Kneading the muscles may improve blood flow and reduce tension in the body and the mind, providing enough pain relief to allow people to be more active. Find a practitioner experienced in treating back pain. Massage is generally safe, but women with osteoporosis should talk to their doctors first.

Earlier this year, researchers at the University of Toronto concluded that two herbal supplements are likely to provide relief for back pain when used briefly to treat flare-ups. Devil’s claw extract provides pain relief when taken at a daily dose of 50 milligrams of the effective ingredient, harpagoside. And a 60-milligram dose worked as well as Vioxx (an effective pain-relief drug that was banned because of increased cardiovascular risks). White willow bark — which contains salicin, an ingredient in aspirin — was comparable to Vioxx in reducing pain when taken at a dose of 240 milligrams daily. The only side effects associated with these herbs were mild stomach complaints. Neither should be taken with medications such as anti-inflammatories without consulting a doctor.

CAVEAT: A recent Harvard study showed that patients who used alternative care for acute pain did not recover faster or better than those who used conventional care. Most patients in both groups recovered; however, the sufferers who received alternative treatments were happier with their care. The bottom line: Whatever helps relieve your pain has the bonus effect of keeping you more active and able to prevent future problems.

Step 7: Use Your Head

"Stress can show up as muscle spasms and muscle imbalance," says Brian Hainline, MD, author of Back Pain Understood. This can speed up disc degeneration. Hainline recommends stress-relief exercises to reduce back pain. He also cites depression — another health condition that often strikes women in midlife — as an example of the part the mind plays in recovery from pain. He adds, "It is a virtual certainty that chronic pain cannot be treated successfully in people with major depression until the depression itself is treated successfully." Fear of pain can also bring on more pain. "People who have been in pain for a long time move as if they are braced, which is psychological and physical," Hainline says.

In a recent review of research on the subject, Duke University scientists concluded that counseling, relaxation training, hypnosis, and biofeedback worked better than traditional treatments. So if your pain is unrelenting, mind-body therapies are certainly worth investigating and, according to Gaudet, are safe and once learned can be done on your own. A good place to start is Healing Back Pain: The Mind-Body Connection, by John E. Sarno, MD.

Step 8: What to Do When Nothing Works

When you’ve tried everything else for at least a few months with no results, should you resign yourself to surgery? "Most people with back pain should not have surgery," Frazier says. In fact, it is appropriate in only a small percentage of cases, he says — for people with sciatica or nerve damage.

For the rest, surgery is often ineffective at relieving pain. Even if your doctor advocates it, get a second opinion. If you do decide to go ahead, explore the surgical options. There are vertebrae fusions (a common procedure in back operations, which have been improved but can still cause future problems). And there are artificial disc replacements. (Replacements are a relatively new procedure, and even among surgeons there is controversy about their use. They may hold promise but don’t yet have a track record.)

Originally published in MORE magazine, November 2007.

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