Cure My Low Back Pain

posted by editor on Aug 24

During WWII when one of the U.S. Army hospital anesthesiologists ran critically short or morphine, his nurse initiated injections of saline (salt water); it worked.  If saline injection was effective, so would sucrose (sugar) pills work as a panacea for pain.

Dr. Beecher, the anesthesiologist, returned to his position at Harvard after his military tour of duty and in 1955 published “The Powerful Placebo” in the AMA Journal. Multiple prospective trials noted the curative effectiveness of placebos. Moreover, Beecher found that the effects of many current drugs were no better than placebo. However, the pharmaceutical products wee all associated with risk of side effects whereas the placebos were not.

By 1962 even the FDA was willing to acknowledge “placebo effect”. As such, new pharmaceutical products have to outperform placebos in at least two authenticated trials. We are not yet out of the woods. Pharmaceutical companies market physicians and now directly to patients via television and other media, grossly downplaying costs, adverse effects, and effectiveness compared to alternatives.

If your doctor offered you pill #1 that is effective in 5/10 cases and perfectly safe always versus pill #2 that is effective in 9/10 cases but may cause ulcers, dizziness, blindness, and in rare cases death, which would you choose? Just listen to the disclaimer statements in direct to consumer pharmaceutical related television advertising, then tell your doctor that it would probably safer (and maybe just as effective) to prescribe so sugar pills for my pain.

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posted by editor on Mar 6

Chinese Medicine, classical and traditional involves a range practices originating in eastern Asia. Although well accepted throughout China and many other parts of the world, it is considered an alternative medicine in the West. Practices include use of herbs, dietary adjustments, movement therapies, massage therapies, moxibustion and acupuncture.

While western medicine is based upon theories related to anatomical function and physiology, Chinese medicine is based upon at least five major theories relating the human body and its life energy to nature, the universe, and a higher being. Its practices have roots that are thousands of years old.

One aspect of Chinese medicine, acupuncture, is the procedure of inserting and manipulating very fine needles into points on the body to treat and cure medical disorders, including pain. Acupuncture points, stimulus placement sites, are situated along body meridians through which our theorized life energy flows. Modern acupuncture texts present meridians as conceptual targets. While there is no physical evidence to support their existence, consider that the only evidence of gravity is the fact that bodies attract each other in predictable manners (e.g., objects stay on the ground). Similarly, people respond to acupuncture stimulation along meridians in predictable manners. Moreover, acupuncture does not cause undesired side effects like most regularly prescribed medications.

The earliest recognized written record of acupuncture is from the second century BC. Different variations of acupuncture are practiced throughout the world. Acupuncture has been difficult to study by western medical researchers due to the invasive nature of the practice (having to place needles). Scholarly reviews are often biased by origin of the researchers. However, there is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles, and further research is ongoing. Alternative treatment approaches are available to the untrained and general public via electroacupuncture and acupressure. These are applied at the same points, along the same meridians, without the risks related to needle use by the novice, in case I wish to cure my own low back pain.

One extraordinary source of information on acupuncture is A Manual of Acupuncture, published by the Journal of Chinese Medicine Publications. Following research of many years, Peter Deadman, editor-in-chief of The Journal of Chinese Medicine, and colleagues created the primary reference for the study and practical application of acupuncture points and meridians. With subtle use of color to illustrate the acupuncture points and anatomical features in approximately five-hundred illustrations, it is a very comprehensive, attractive and user-friendly tool for the novice and professional. The index identifies every part of the body reached by each meridian, and there are separate indexes to direct readers to address health issues via Chinese medicine categorization and western medicine symptom approaches.

posted by editor on Feb 28

Whether you want to reduce back stress or fatigue or stimulate your blood circulation, an inversion table makes a great household accessory. An inversion table contributes to your body’s overall health via lumbar traction, relieving pressure on your vertebral discs and nearby structures, stretching muscles in your torso and promoting circulation. Additionally, when your back starts to relax, the rest of your body follows. For frequent and relentless symptoms, even reduced pain is a relative cure for your or my low back pain.  A table can also help with flexibility for improved athletic performance, reducing the apparent aging effects of gravity, relieving pain related to prolonged sitting or standing. Spine inversion is better than manual adjustments and it pays for itself within a few sessions.

Quality products boast durable tubular steel frames that are light, yet strong. More importantly, inversion systems are a breeze to use. You rest your body against comfortable foam backboards, slipping your feet into the ergonomically molded ankle cushions, simply reaching your arms overhead to initiate your treatment. As your arms go up, your body gradually inverts, as far as 90 degrees as desired. All that is needed is you, your inversion table and gravity.

Quality tables have non-skid floor stabilizers, keeping the table stable, and extra-long safety handles to provide an easy return to upright. Tables weighing less than ninety pounds that can support frames up to 6 feet 6 inches, weights up to 350 pounds, with easily adjusted ratchet ankle locking systems are ideal for the consumer market. With chronic pain, even intermittent markedly reduced pain is a relative cure for your or my low back pain.  Spine inversion has been around for more than two thousand years.  Spine inversion is better than manual adjustments because it is effective and pays for itself within a few sessions.

posted by editor on Feb 16

A patient presented asking “Do you have an alternative approach by which I might cure my low back pain?” A few minutes into discussion I determined his low (lumbar) back pain symptoms to be relatively minor and not radiating into his legs or feet. However, he had substantial anxiety about a concurrent illness with which he had been suffering for years. Not curable by present western medicine and somewhat stigmatizing, he lived with recurrent anxiety, depression and insomnia. We completed the evaluation and determined that his primary concern was not the physical pain, rather the psychological issues that complemented his pain. He tried and disliked prescription medications, and formal medical counseling. He did not like disease associated support groups, feeling them to magnify the stigmata. He said his spiritual peers, atheists, had nothing to offer him.

After discussing numerous options, he was willing to try acupuncture and herbs. He had not grown up with traditional Chinese medicine or other herbal intervention. He did not have any prior scientific understanding or reference by which to accept the underlying mechanisms by which these alternative treatments might work. However, he stated “With hope and faith, I am willing to explore these approaches.” “Hope and faith”, maybe he should consider an alternative spiritual perspective as well.

posted by editor on Feb 9

Do you think hanging upside down to relieve back pain is unusual, or a new-age approach? Reconsider your perceptions. Spinal inversion probably goes back to the dawn of documented human medical care.

We know that inversion has been used at least since 400 B.C., when Hippocrates, the father of western medicine, first observed a patient have his knees and ankles tied to a ladder to be hoisted upside down for a dose of what has come to be known as inversion therapy.

The Greek theories on inversion are still valid, but today there is a much easier way to relieve the back pain than having your family and friends hoist you with ropes. The process is called spinal inversion therapy, and it can be the natural way to a better back and a better body.

Inversion-traction and Tissue Movement Studies

The journal – Spine: 1 May 1998 – Volume 23 – Issue 9 – pp 1061-1063

Study Design. Experimental study of 30 patients diagnosed with low back pain resulting from lumbar disc herniation, disc degeneration, and segmental instability. Patients underwent gravitational traction, and widening of the intervertebral space and posterior facets was measured on x-rays. This same procedure was performed with a group of 30 healthy individuals.

Objectives. To determine the effect of gravitational traction on the widening of the intervertebral space and the other vertebral structures in patients with low back pain and in healthy individuals.

Summary of Background Data. Gravitational traction is performed by suspending the patient in a hanging, upright position for an extended period of time. (inversion)

Methods. A specially designed apparatus was used to apply gravitational traction. Before and after inversion x-rays were obtained to study the changes in the L2-L3, L3-L4, L4-L5, and L5-S1 intervertebral spaces. Other data was also collected.

Results. Inversion-Distraction/traction created more than 3 mm of increased intervertebral disc space in subjects.

Conclusion. Spinal gravitational traction (inversion) had a very measurable effect on intervertebral space and was found to be an effective method to distract lumbar vertebrae.

Other studies

1) Kane, M, et al: Effects of Gravity-facilitated Traction on Intravertebral Dimensions of the Lumbar Spine. Journal of Orthopedic and Sports Physical Therapy. 281-288, Mar 85. Study found gravity-facilitated traction (inversion), produces significant intravertebral separation in lumbar spine.

2) Gianakopoulos, G, et al: Inversion Devices: Their Role in Producing Lumbar Distraction. Arch Physical Med Rehabil 66: 100-102, Feb 85. Study found all subjects experienced intervertebral separation in the lower lumbar vertebrae.

3) Nosse, L.: Inverted Spinal Traction. Arch Physical Med Rehabil 59: 367-370, Aug 78. Study found EMG activity (an indicator of muscle activity, which tends to be greater with pain) declined 35 percent within the first 10 seconds of inversion

4) Nachemson, Alf, et al: Intravertebral Dynamic Pressure Measurements in Lumbar Discs. 1970. The study measured internal disc pressure (in the 3rd lumbar disc) during a range of activities, including standing, sitting, bending and vertical and traction. The study results identified that a traction load equal to sixty percent of body weight was sufficient to reduce the internal disc pressure to zero. This suggests that pain related to intradiscal pressure can be relieved by inversion.

5) Sheffield, F.: Adaptation of Tilt Table for Lumbar Traction. Arch Physical Med Rehabil 45: 469-472, 1964. One-hundred, seventy-five patients who were unable to work due to back pain were treated. After eight inversion treatments, 155 patients were able to return to their jobs full time. Study concluded that the main basis for improvement was the stretching of paraspinal vertebral muscles and ligaments and possibly the widening of intravertebral discs. The study found significant improvements in patients with a variety of diagnoses including spondylolisthesis, herniated discs, lumbar osteoarthritis with sciatica, and coccydynia.

6) Dimberg, L, et al: Effects of gravity-facilitated [spinal inverson] traction of the lumbar spine in persons with chronic low back pain at the workplace. One-hundred sixteen people were enrolled in a randomized controlled trial that lasted for 12 months. The study compared inversion trained subjects to a control group who did not perform inversion to asses the effect of gravity inversion on pain level and absenteeism due to low back pain. After 12 months of training program, the employees performing inversion 1 or 2 times per day decreased sick days due to back pain by 33 percent. Moreover, the average number of sick days used due to back pain fell by eight days per individual in the inversion group.

If you have some disc bulging or herniation, and you are not a surgical candidate or do not wish to proceed with surgery, many of you will markedly decrease your pain with inversion-traction.

Over half of people who perform spinal inversion regularly do so to relieve back pain. But, to discount inversion as simply a back pain remedy would be to ignore a wide range of benefits that can be easily achieved by a passive, or more active, inversion session.

Inversion represents the quiet side of fitness, helping your body to recover from the compressive effects of gravity and daily activities. Doctors, physical therapists and sports trainers recognize spinal inversion as a safe and effective form of therapy for the spine and weight-bearing joints. In fact, the US Army is evaluating including spinal inversion into its worldwide physical training.

Whatever your reason for inverting, inversion equipment provides a comfortable and easy method to turn your painful world upside down.

posted by editor on Feb 1

While causes of back pain may not be all in the mind, experiencing the symptoms is all in the mind. That is to say, in the absence of a neural connection between that which you are experiencing in your back and signals transmitted to your brain, there would be no pain (i.e., if a tree fell in the woods all alone, did it make noise?). As such, when considering back pain alternative treatment, consider working on your mind.

For many, the mental aspects of pain management are another significant tool in their armory. These back pain alternative care approaches are referred to by some as “self-regulation strategies” including biofeedback, distraction, hypnosis, relaxation techniques and spiritual healing. These approaches are reduce the perception of pain signals by a variety of methods.

With biofeedback your train yourself to focus upon relaxation and well-being when you recognize a precursor signal that precedes cycles of increased pain. Via distraction you singly or with a partner engage in a healthy activity that is very pleasant or pleasurable, or induces laughter, pleasant thoughts or otherwise distracts one mentally without impairing function. Hypnosis is essentially induced biofeedback, relaxation programmed into your behavior by a skilled practitioner of hypnotism. A variety of relaxation techniques may be applied at any time, with or without the willful efforts of biofeedback or subconscious actions of hypnotism. Lastly, there are spiritual approaches to pain management. These are beyond the scope of this post, and may range from simple relaxation via meditation and altered states of consciousness, to permanently altered brain perceptions of stimulus and changes in underlying pathology depending upon the belief systems and faith in beliefs.

Often, pain management is about determining where you and the professionals with whom you wish to work can meet in the middle. Care of low back pain is a team effort. There is no single treatment that is right or effective for everyone. Cognitive behavioral therapies, care via mind-body experience, play a significant role in back pain alternative intervention.

posted by editor on Oct 4

When might you need surgery on your back:
1. Tumor.
2. Significant stenosis.
3. Marked foraminal stenosis.
4. Marked spondylolisthesis.
5. Spinal instability (all causes).
6. Spinal fractures.
7. Gross mechanical deformity (e.g., via scoliosis)

The primary reason for spinal surgery is that of maintaining spinal stability and sparing the spinal cord and major nerve roots from injury. There are also numerous proximate smaller nerves that may cause symptoms. However, surgical procedures are not guaranteed to mitigate damage, inflammation, irritation of this collateral micro-neurovasculature. The posterior disc and adjacent longitudinal ligament are also innervated. As such, significant disc disruption and herniation may cause pain precipitated from within the disc itself or via distention (stretching) of the longitudinal ligament and its related nerves. The disc will heal to the degree that it can, over time, and does not warrant surgery unless its displacement or fragmentation compromises the spinal canal and cord and/or nerve roots as they exit the canals laterally.

As such, be very cautious regarding the reasons and terms for pursuing and accepting surgery as an intervention for back pain. There are specific indications for its use, but you need to work to alleviate (cure) your low back pain, and that work most frequently does not include surgery.

posted by editor on Sep 2

Whether due to economic challenges, personal health philosophies or other reasons, many people prefer to manage pain via methods that they consider natural pain care. There are numerous approaches taken. However, here are a few pain care precautions to consider.

1. Heat application. Avoid heat application for approximately 48 hours after an injury. Although it feels good, then increased local circulation may cause increased pressure on the irritated nerves with rebound increase in pain.
2. Ice application. Although great for the initial 48 hours after any injury, subsequently alternate with heat. Use of ice-only will decrease circulation to the injured tissues instead of promoting increased nutrition and oxygenation that would result from increased blood flow.
3. OTC anti-inflammatory pain relievers (OTC NSAIDs). Acute injuries may be associated with local small blood vessel injury. NSAIDs prolong bleeding tiem (thin blood) and may cause or expand local bruising if used immediately.
4. Cayenne. Whether used in food, as a poultice or in a topical pain cream, it may interact with NSAIDs to increase risk for stomach distress.
5. Ginger. Taken daily, it can complement a inflammation relief regimen. However, it also has some anti-platelet (blood-thinning) characteristics and may increase bleeding and bruising.
6. Green tea. Its antioxidant qualities may have anti-inflammatory benefits. However, most green teas are caffeinated, possibly increasing blood pressure or affecting heart rate and rhythm.
7. Licorice. Often used to treat painful Herpes cold sores, it may interfere with diuretic medications being used to address blood pressure.
8. Caffeine. Some of you need to take acetaminophen or an NSAID. Watch your caffeine intake timing. Caffeine speeds up absorption, affecting the onset and duration of action of your medication.

posted by editor on Sep 2

Many people live with inflammatory conditions causing joint pain, other soft tissue pain and diminished cerebral fortitude. The primary arsenal of medications includes NSAIDs, COX-2 inhibitors, and steroids, such as ibuprofen, celecoxib, and prednisone. However, there are numerous adverse health affects associated with use of the above listed products. Additionally, the U.S. incidence of arthritis has steadily risen since the early 1900s with the availability of processed foods and burgeoning obesity in our population, in spite of these products.

The following foods and dietary supplements are anti-inflammatory and can be part of a natural inflammation management. The list includes apricots and berries (blue, black, and raspberries), almonds, walnuts, fish (e.g., salmon, tuna, mackerel, sardines, but watch the mercury levels), flaxseed oil, B complex vitamins and antioxidant vitamins A, C, and E. Additionally, consider 1.500 mg of glucosamine, and/or 500 mg of ginger daily. As you increase omega-3 fatty acids in your diet (fish, walnuts, flaxseed), also consider reducing omega-6 oils (red meats). A high omgega-6 to omega-3 ratio can result in increased body production of arachidonic acid, triggering inflammation.

Lastly, obesity and otherwise excessive weight effects numerous adverse physiological changes on the body. Most simply, also note the mechanical inflammatory effects of excessive weight on load-bearing joints. As such, regular consideration of diet and weight control can be very effective in natural inflammation management.

posted by editor on Jun 6

Peripheral neuropathic pain is the numbness, burning, stabbing, fleeting electric shock type pain in the hands or feet in relation to a number of diseases or injuries that primarily affects nerves located distally in the extremities. Weight bearing and forceful gripping may worsen symptoms if the primary cause of the symptoms is decreased local blood flow. If primarily due to lumbar disease/injury, stenosis or disc compression in the L4/L5, and/or L5/S1 distribution of the spinal nerves, you may experience a variety of above described symptoms.

Assessment of patients will generally include physical examination to determine the presence or absence of gross motor or sensory deficits, observation of skin, observation of presence or absence of local tenderness and observation of circulation. Radiological and neurological studies to qualitatively and quantitatively assess muscle function and large nerve conduction may be performed.

Peripheral neuropathic pain is generally part of a disease process. As such, pain will be addressed as part of a more complete plan that addresses both the primary disease and pain effects. Non-surgical treatments for the pain can be quite variable and depend upon your diagnosis, age, tolerances, preferences, insurance coverage, history of response to previous treatment and State laws. Common non-surgical treatment options include for lumbar peripheral neuropathy include:

1. NSAIDs – Non steroidal anti-inflammatory products such as ibuprofen and naproxen are common components of treatment. GI tract injury is the primary potential side effect.

2. Anticonvulsants – Pregabalin and gabapentin.

3. Tricyclic antidepressants – Products such as amitriptyline have gone out of favor due to their sedating effects and increased risk for cardiac conduction effects in those with existing cardiac disease.

4. SNRIs – Duloxetine and venlafaxine.

5. Opiates – Numerous formulations are available and effective. However, you need to balance short acting with long acting product function to minimize breakthrough pain, and acknowledge issues of dependence and addiction potential.

6. Opioid – Tramadol has opiate and SNRI-type activity, the extended release formulation may be preferable.

7. Cannabis – It is very effective. However, it is not legally accessible in most states.

8. Topical agents – Lidocaine and capsaicin are effective if symptoms are localized. Duration of action is an issue for capsaicin as well as poor skin tolerance for some persons.

9. Acupuncture – It is more precise than other manual interventions. It is helpful to many. The mechanism of action is not yet understood by western medicine, the shortcoming being that it requires someone to deliver the intervention (versus self administration).

10. Electrical stimulation – It is available as portable TENS, inferential, H-Wave, and microcurrent. All may provide some complementary short term desensitization. The challenge is to find the type of current that works best for the individual, the product brand that is effective given variability in quality, and insurance support long term.

11. Mechanical intervention – Chiropractic and physical (C&P) therapy can be beneficial in some acute impingement cases, but should not be used as ongoing treatment. Inversion/traction can be as effective than C&P therapy and can be performed independently.

For all of these interventions, discuss your interests with a physician to assure that you do not have another concurrent medical problem that might be prohibitive regarding these treatments. Understand your back pain and be aware of the common non-surgical treatment options for lumbar peripheral neuropathy.