Prescriptions
What is the best response to lower back pain?

By Laurie Steelsmith

It's Sunday morning. You bend over to pick up your copy of The Advertiser in the driveway and — ouch! — your back goes out! Lower-back pain can happen that suddenly, that easily.

It wasn't just the single event of picking up the newspaper that did your back in, it was the way you did it and it was most likely the straw that broke the camel's back, so to speak. Stress, poor muscle tone, extra body weight and improper body mechanics can all contribute to a lower back problem.

If you have lower back pain, you're not alone; 80 percent of American adults will suffer from this condition at some time in their lives. The U.S. Department of Health and Human Services estimates $50 billion is spent on back pain every year.

It's important to find out what's causing your lower back pain. See your doctor for a physical exam and diagnostic tests. X-rays and, if necessary, a CT or MRI scan and blood tests can help zero in on the problem. Some causes of lower back pain include muscle and ligament sprains, inflammation or infection in the bone, fractures, tumors, and compression of the spinal cord and nerves by bulging discs or bone spurs.

For acute back pain, the goal of treatment is to decrease pain and inflammation. If your back pain is acute, ice it down, rest and relax, and seek out a specialist who can assess your condition.

While surgery can help in serious cases of low back pain, it is usually recommended only as a last resort.

Consider physical therapy or see a naturopath, chiropractor or osteopath who can do spinal and pelvic adjustments to alleviate pain and increase your mobility. Typically herbal or pharmaceutical anti-inflammatory drugs or muscle relaxants are prescribed to help decrease pain and inflammation.

Another option is acupuncture. The National Institutes of Health has endorsed acupuncture's effectiveness in the treatment of lower back pain. Exactly how it works is still largely unknown, but some studies have shown that acupuncture stimulates the production of endorphins, the body's own analgesic.

According to traditional Chinese medicine, chi (the life force) flows through the body's pathways of energy (meridians). Back pain is due to stuck chi. When acupuncture needles are inserted into contracted muscles, the muscles relax and allow the chi to flow. By releasing tight muscles, pressure is taken off the spine, where there could be pinched or irritated nerves causing problems such as sciatic pain. Chinese herbs can also be used in the treatment of back pain to move stuck chi and decrease pain.

Once your back pain has been alleviated, start a program to keep your back in tip-top shape. I recommend the following to help maintain the function and health of your lower back.

• First of all — and I'm quoting your mother here — "Sit up straight; don't slouch!"
• Learn healthy body mechanics. Because your thighs are a lot stronger than your lower back, use the strength of your legs when picking things up. Keep your back straight as you bend your knees to lower your body, then lift the object close to your body. When putting an object down, always bend your legs, not your back.
• Buy back-support pillows for your favorite chair and for your car.
• Sleep on a firm mattress that supports your spine and back.
• Begin a gentle exercise and stretching program that specifically addresses strengthening your back and abdominal muscles. Yoga and tai chi are good choices for increasing flexibility.
• Avoid high-impact exercises and contact sports.
• Wear sensible shoes such as flats and sneakers. Some people benefit from orthotics, a device inserted into shoes which gives excellent arch and foot support.
• Get massages regularly for relaxation and for keeping your back muscles supple.
• Most importantly, keep your body weight within a healthy range and manage your stress levels.

Although back pain is a common affliction, the good news is that by supporting your back with the tools and techniques mentioned above, your back will continue to support you!

Laurie Steelsmith is a naturopathic physician and licensed acupuncturist in Honolulu.

Hawai'i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.