Let’s Talk About Back Pain
Almost everyone will experience some sort of back pain at some point in their lives, and it is the number one reason my new patients initially come in for treatment. Here are some facts about back pain (from the ACA):
● Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
● Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
● One-half of all working Americans admit to having back pain symptoms each year.
● Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.
● Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
● Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.
Western medicine is amazing at so many things, but for the most part they do not treat muscles! (Unless of course you are working with a sports medicine doctor). Painkillers, cortisone shots, and even surgery provides only temporary relief without addressing the musculature, and the circumstances that created the pain in the first place.
In my experience, the first step in any pain condition should be treating the muscles involved. The only way to do this is with hands on work. Acupuncture, Massage and Physical Therapy are your best bets and the three therapies work very well together. Acupuncture is uniquely positioned to release the fascia, muscles, and energetic blockages involved in most back pain. Trigger point work specifically is one of the most effective methods I know of to relieve muscle spasms and chronic muscular pain.
A trigger point is a perfect storm of stuck muscle fibers and referred pain. It can feel like a pinched nerve and can be completely debilitating. It can also be misleading, as it refers pain to other areas. For example, a trigger point in your Upper Trapezius muscle can refer pain into your head, creating an ache in your temple, or mimic “tension headache” symptoms. It can also refer into your jaw or create a “stiff neck”. A trigger point in your Quadratus Lumborum muscle (a deep lower back muscle that runs from your 12th rib to your sacrum) can cause pain in your glutes, hips, lateral thigh, anterior thigh, low back, or lower abdomen. It can even cause bloating, nausea or abdominal cramps!
If you are experiencing any kind of back pain, here are some things you should know:
1. Back pain is almost always muscular in nature -- Yes, go ahead and get the MRI or the X-Ray just to rule out anything serious, but just because it shows arthritis or stenosis, that does not mean that is the cause of the pain. Everyone over 40 has some arthritis and stenosis. Not everyone over 40 is in pain. Unless you have been in an accident that affected you structurally the cause is most likely muscular, or at least partially muscular in origin. Even if you have a disc issue, you cannot treat the pain without treating the muscles surrounding it.
2. Repetitive Stress is the number one cause of back pain -- This means every movement and posture you repeat daily, including sitting at your desk, driving to work, or hunching over your computer. Your body treats this the same way it would treat a muscle tear - it starts to lay down a sticky substance called fibrin which impedes the flow of blood and creates congestion in the area. This affects range of motion, restricts fascia, creates trigger points and eventually can develop into chronic pain. The best way to counteract this is to “clean out” the tissue periodically with body work or use physical therapy to balance out the repetitive motions.
3. There is usually not a quick fix -- Repetitive stress conditions develop over time, and time is needed to resolve them. Occasionally I can release one trigger point and like magic the pain is gone (this can happen with piriformis syndrome/sciatic nerve pain) but for the most part, it is going to take some time, and multiple treatments to heal. Generally, 1-3 months is a good estimate. That said you should feel some results right away, with less pain after each session.
4. Do not ice! -- I know everybody loves to put ice on everything that hurts, but ice tightens muscles and creates trigger points, so it can do more harm than good. As long as the area is not red or hot, try heat instead -- a heating pad, heat lamp, or hot Epsom salt bath works wonders and relaxes tight muscles instead of constricting them.
5. Please stretch! -- Most of our workouts are focused on tightening muscles -- usually muscles that are already tight! It is very important to make sure you are counteracting all of that tightening with opening and lengthening exercises. Take a yoga, pilates or stretching class, or have your trainer do a “just stretching” session once a week.
6. You must make lifestyle changes -- Pain of any kind is a wakeup call. Your body is letting you know that something is not working. If you are in pain, you must examine your habits -- from the position of your computer, to your desk chair, to your workouts, to the number of hours you spend at work, to your mattress and pillow, to your diet, to how much water you drink, to your stress levels. You have to change the circumstances that created the pain in the first place to experience any kind of lasting relief.
7. Pain is an opportunity to create a better relationship with your body -- When pain impacts your quality of life it can be frustrating, but I like to look at is as an opportunity. We spend most of our time tuning out the signals our bodies are sending us -- the general attitude seems to be “mind over matter”. Toughing it out and working through the pain are encouraged. But in my experience if you don’t listen to your body when it whispers, eventually it will scream, and then you are lying on the floor immobile after leaning down to tie your shoe. Don’t tune out discomfort! Pay attention to the signals your body sends every day, and address them early before they become serious problems.