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Low Back Pain

Low back pain affects 60 to 80 percent of the adult U.S. population at one time or another. Low back problems affect the spine's flexibility, stability, and strength, which can cause pain, discomfort, and stiffness.

Signs and Symptoms

bulletTenderness, pain, and stiffness in the lower back
bulletPain that radiates into the buttocks or legs
bulletDifficulty standing erect or standing in one position for a long time
bulletDiscomfort while sitting
bulletWeakness and leg fatigue while walking

 

What Causes It?

Low back pain is usually caused by strain from lifting, twisting, or bending. However, some low back pain can be a symptom of a more serious condition, such as an infection, a rheumatic or arthritic condition, or ovarian cysts. It may be caused by a ruptured or bulging disk, the strong, spongy, gel-filled cushions that lie between each vertebra. Compression fractures of the bones in the spine can also cause low back pain, especially in older women with osteoporosis. In addition, poor overall fitness, smoking, and general life dissatisfaction increase a person's risk for low back problems.

What to Expect at Your Provider's Office

Your health care provider will ask you to stand, sit, and move. He or she will likely check your reflexes and perhaps your response to touch, slight heat, or a pinprick. He or she may also recommend strength testing on a treadmill. You may also need a blood test, X rays, a magnetic resonance imaging scan, or computed tomography scan.

Treatment Options

Treatment Plan

Low back pain can often be relieved and prevented with lifestyle changes. Exercising to strengthen your muscles, maintaining a healthy weight, and practicing good posture lowers your risk. Physical therapy helps relieve pain for some people. For more severe or long-term back pain, your provider may recommend medication or surgery.

Drug Therapies

Prescription

 

bulletMuscle relaxants—for pain relief, especially at the onset of pain; various side effects
bulletNonsteroidal anti-inflammatory drugs—used continuously for chronic pain; various side effects
bulletOral or epidural steroids—reduce inflammation and can have dramatic results for pain relief, but have little lasting benefit; less effective with repeated use; various side effects

 

Over the Counter

 

bulletAspirin or acetaminophen (Tylenol)—for pain relief; used continuously for chronic pain; various side effects

 

Complementary and Alternative Therapies

Alternative therapies can be effective for easing muscle tension, correcting spinal imbalances, relieving discomfort, and averting long-term back problems by improving muscle strength and joint stability.

Nutrition

 

bulletB-complex: B1 (50 to 100 mg), B2 (50 mg), B3 (25 mg); B5 (100 mg); B6 (50 to 100 mg); B12 (100 to 1,000 mcg), folate (400 mcg per day) all reduced with stress and pain
bulletVitamin E (400 IU per day), vitamin C (1,000 to 3,000 mg per day)
bulletCalcium (1,500 to 2,000 mg) and magnesium (700 to 1,000 mg) to regulate muscle contraction and ease spasm
bulletBromelain: (250 to 500 mg three times per day on an empty stomach) anti-inflammatory, works especially well with turmeric

 

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers;10 to 20 minutes for roots. Mix three to six of the following (one cup tea or 30 to 60 drops of tincture three to six times per day).

 

bulletRelaxants: Black haw (Viburnum prunifolium) relaxant; petasites (Petasites hybridus), acute muscle spasm, not for long-term use; valerian (Valeriana officinalis), antispasmodic, especially with sleeplessness; wild yam (Dioscorea villosa), antispasmodic, especially with joint pains and long-term stress; turmeric anti-inflammatory, especially with digestive problems; Jamaican dogwood (Piscidea piscipula), relaxant
bulletPain relief: White willow bark (Salix alba), anti-inflammatory and analgesic; devil's claw (Harpagophytum procumbens), analgesic, anti-inflammatory; St. John's wort (Hypericum perforatum), anti-inflammatory
bulletCirculatory stimulants: rosemary leaves (Rosemariana officinalis), especially with digestive problems; gingko (Ginkgo biloba), especially with poor circulation
bulletTopical treatment may be helpful for acute problems. Mix one to two drops of essential oil or 5 to 10 drops of tincture into 1 tbsp. vegetable oil, and rub into the affected area. St. John's wort for nerve pain; leopard's bane (Arnica montana) anti-inflammatory, external use only; lobelia (Lobelia inflata) antispasmodic

 

Homeopathy

Some of the most common remedies for this condition are listed below.

 

bulletAesculus for dull pain with muscle weakness
bulletArnica montana especially with pain as a result of trauma
bulletColocynthis for weakness and cramping in the small of the back
bulletGnaphalium for sciatica that alternates with numbness
bulletLycopodium for burning pain, especially with gas or bloating
bulletRhus toxicodendron for stiffness and pain in the small of the back

 

Physical Medicine

 

bulletChiropractic or osteopathic manipulation can help relieve pain.
bulletContrast hydrotherapy. Alternate hot and cold applications. Alternate three minutes hot with one minute cold. Repeat three times. This is one set. Do two to three sets per day.
bulletCastor oil pack. Apply oil directly to skin, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes.

 

Acupuncture

May help relieve spasm and increase circulation to the affected area.

Massage

Massage may be helpful both acutely and to prevent chronic problems.

Special Considerations

Chronic low back problems can interfere with everyday activities, sleep, and concentration. When symptoms are severe, your mood and sexuality may be affected. While depression is usually not the cause of chronic low back pain, it often complicates treatment.

Supporting Research

Balch JF, Balch PA. Prescription for Nutritional Healing. 2nd ed. Garden City Park, NY: Avery Publishing Group; 1997:149–150.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:238–239, 277–278.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:81–82, 136–137, 183, 197, 222–223, 226–227, 230–231.

Gruenwald J, Brendler T, Jaenicke C et al, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998:662–663, 786–787, 871–872,

Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (2nd report): schedule of administration and clinical effects in low back pain and tooth extraction. Acupunct Electrother Res. 1990;15:121–135.

Kruzel T. The Homeopathic Emergency Guide. Berkeley, Calif: North Atlantic Books; 1992:30–38.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:36–39, 59–61.

Mowrey D. The Scientific Validation of Herbal Medicine. New Canaan, Conn: Keats Publishing; 1986:223–227.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin, Calif: Prima Publishing; 1998:338.

Snider RK, ed. Essentials of Musculoskeletal Care. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 1997.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc.; 1987:1987: 342-345.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.