Back pain is one of the most common health complaints across the globe, and the No. 1 cause of job disability. It's also one of the most common reasons triggering opioid dependence, the side effects of which can be devastating.
According to a recent population study, opioids are the most commonly prescribed medication for people with chronic low back pain, and as you'd suspect, these drugs are typically used long-term in this population.
Meanwhile, other recent research shows opioids (including morphine, Vicodin, oxycodone and fentanyl) fail to control moderate to severe pain any better than over-the-counter (OTC) drugs such as acetaminophen, ibuprofen and naproxen. In fact, those taking nonopioid pain relievers actually fared "significantly better" in terms of pain intensity.
Stand and Move More (and Correctly) to Protect Your Back Health
Two effective means of preventing lower back pain are closely related: staying active and minimising sitting. Both will improve muscle strength and coordination, reduce stiffness and improve blood flow, which may reduce back pain and lower your risk of developing back pain in the first place.
Oftentimes, back pain originates from tension and muscular imbalances. For example, sitting for long periods of time ends up shortening the iliacus, psoas and quadratus lumborum muscles that connect from your lumbar region to the top of your femur and pelvis. When these muscles are chronically short, it can cause severe pain when you stand up as they will effectively pull your lower back (lumbar) forward.
By bringing these muscles into better balance, you will remedy many of these common pains and discomforts. Overuse and misuse of the muscles supporting your spine, poor muscle strength and inappropriate posture while sitting, standing and walking are other common causes of low back pain.
For instance, when walking with your toes pointed outward, the muscles in your hips and lower back tighten, increasing your risk for lower back pain. Sitting with your shoulders hunched over a computer screen stretches muscles in your upper back and places added stress on your lower back, increasing your risk for both lower and upper back pain.
Walking with your head down is yet another posture-related problem that has repercussions on the rest of your back and hips, as your head is the single heaviest part of your body and will throw everything out of alignment. If poor posture is a culprit, consider doing some exercises to stretch out your shoulders, open up your hip flexors, and lift your chest.
Acupuncture, Massage and Breath Work
Acupuncture and massage also have their place. Research has discovered a "clear and robust" effect of acupuncture in the treatment of back, neck and shoulder pain specifically, while massage therapy releases endorphins that help induce relaxation, relieve pain and reduce levels of stress chemicals such as cortisol and noradrenaline. It also reverses the damaging effects of stress by slowing your heart rate, respiration and metabolism, and lowering raised blood pressure.
Certain breathing techniques can even be helpful. Compression breathing is actually an important aspect of Foundation Training that helps re-educate the muscles surrounding your axial skeleton (the spine of your rib cage), teaching them to be in a state of expansion rather than contraction.
Many Cases of Back Pain Have an Emotional Root
Last but not least, there's evidence that back pain may originate in, and is certainly exacerbated by, psychological or emotional issues. The late Dr. John Sarno, a professor of rehabilitation medicine, gained notoriety using nothing but mind-body techniques to treat patients with severe low back pain.
His speciality was those who have already had surgery for low back pain and did not get any relief. This is a tough group of patients, yet he claimed to have a greater than 80 percent success rate using techniques like the Emotional Freedom Technique (EFT).
The "what" that is going on is not a physical problem at all — it's emotions: anger; fear; frustration; rage. When these kinds of emotions are suppressed, your brain redirects the emotional impulses to restrict blood flow to certain parts of your body, such as your back, neck or shoulders, thereby triggering pain.
This pain acts as a distraction from the anger, fear or rage you don't want to feel or think about. The pain essentially acts as a lid, keeping unwanted emotions from erupting. You may feel anger at the pain, but you won't have to face the fact that you're actually angry at your spouse, your children or your best friend, or that you hate your job, or the fact that you feel taken advantage of.
As noted by Sarno, working hard and constantly trying to do everything perfectly to keep everybody around you happy, "is enraging to the unconscious mind." The term Sarno coined for this psychosomatic pain condition is "tension myoneural syndrome, and he firmly believed most people can overcome their pain by acknowledging its psychological roots.