Q: I been having back pain off and on for years, and lately it seems to be getting worse. My doctor prescribed a pain killer that just makes me feel loopy. What else is there - does yoga really help?
A: As human beings we have probably been having problems with our backs ever since we first stood up on two legs a few million years ago. Chronic back pain is one of our most common health problems, resulting in substantial physical, emotional and financial distress. The costs associated with acute low back injuries have been estimated at over $50 billion annually when you add up the expense of diagnosis, treatment and missed work.
Although there are specific indications for surgical treatment, most back pain is best managed conservatively. Improved muscle strength and flexibility are the keys to a healthy back. At the Chopra Center for Well Being, we have had great success with yoga therapy. Using a consciousness-based program designed to enhance mind body integration, many of our patients with chronic pain experience increased flexibility and comfort.
A recent study from the University of Washington found that yoga was more effective than conventional therapeutic exercises and standard back care procedures in reducing back pain (Annals Internal Medicine 143:849-56, 2005). I would strongly encourage you to find an experienced yoga instructor in your area and take a few private sessions to see if your pain can be lessened.
Chiropractic care is the most frequently used alternative treatment for chronic back pain. Although there has been a long-standing rivalry between chiropractors and medical doctors, recent studies have suggested that chiropractic care can be evaluated scientifically. A recent review of 36 studies on spinal manipulation (Spine 21:2860-2871, 1996) found that slightly over half showed some benefit from manipulation, mostly in patients with acute pain. A recent report from Sweden (Spine 22:2167-2177, 1977) found that chiropractic and physiotherapy treatment provided equal benefit at a similar cost.
Acupuncture treatments for chronic pain have recently been approved by an NIH committee. Although the pain relieving mechanisms behind this ancient system of medicine are not fully understood from a Western perspective, it is clear that this mode of treatment can be very effective in some people. A recent report found that acupuncture that used electrostimulation may be more effective than acupuncture alone.
There has been recent interest in the anti-arthritic potential of "chondroprotective" substances such as glucosamine sulfate and chondroitin sulfate. These agents may support the development of healthier joints and are worth trying when facing a degenerative spine condition. A recent report could not demonstrate overall value in people with chronic knee pain, but suggested that the combination may improve symptoms in those with moderate to severe pain. The usual daily dose is 1000 to 1500 milligrams for glucosamine and 800 to 1200 milligrams a day for chondroitin sulfate divided into two to four doses during the day.
It's often the simple things that can provide the greatest relief. Find a good chair that provides back support while you are working. Get a lumbar support pillow to use in the car. Make certain that you have a good mattress. The small additional cost of buying ergonomically designed furniture will save you money and suffering in the long run. Techniques such as Feldenkreis and Alexander that focus on improving posture can also be of value.
Whenever there is chronic physical pain, there is emotional pain. Learn a simple meditation technique to relieve stress, develop healthy relationships and create a future for yourself that inspires you.
