Most of us will experience serious back pain at some point in our lives. The New England Journal of Medicine puts the numbers at 8 out of 10 Americans, with 31 million people in pain at any given time. Back pain is second only to the cold or flu as the most common reason people seek a doctor's advice.
The good news is that most people recover from serious back pain -- studies say 90 percent will get better, most within seven weeks. But what can we do to reduce, eliminate, or prevent back pain? Many patients and doctors recommend over-the-counter or prescription anti-inflammatory drugs -- ibuprofen, naproxen, aspirin, and others -- when back pain flare-ups occur. Ice packs also come in handy. Below, five secrets to help you stay pain free.
1. Trace the pain to its source.
That tight, throbbing knot in your upper back? It might not have anything to do with heavy lifting or playing too much golf. The source of the pain might be somewhere else entirely. Like your feet.
High heels, shoes without enough arch support, or physical problems like flat feet or high arches all can contribute to back pain. For example, patients with exaggerated arches often experience pain throughout the body, including the back, because their feet don't absorb shock well, says Mark Wolpa, a podiatrist in Berkeley, California.
Also, a surprising number of people have legs of slightly different lengths. Wolpa says about 80 percent of his patients show signs of "limb length discrepancy," some caused by uneven bone length and others due to long-term positioning problems, where muscles have developed unevenly, shortening one side of the body. This uneven stance throws the whole body off balance, causing one part to compensate for another, often resulting in pain.
Another possible source of back pain is nerve damage. Ask your doctor if an EMG (electromyogram) test is in order, especially if the option of back surgery is on the table. If a doctor rules out specific disc, nerve, or malformation issues, it might be time to visit an alternative medical practitioner.
Massage therapists, chiropractors, and acupuncturists are known to take a more holistic approach to treating pain, which can involve asking questions about multiple aspects of your life, from nutrition to emotions. Check your health insurance plan to see if these treatments are covered, even partially.
What you can do:
Consider acupuncture or chiropractic care. Ask for recommendations from your primary care doctor as well as friends and others. If the same name keeps popping up, it's more likely you'll have a positive experience with that practitioner. Whether it's acupuncture or chiropractic care, if your first experience isn't positive, try a different practitioner whose technique works better for you.
Find a massage therapist skilled in therapeutic or medical massage (as opposed to simple feel-good massage). Personal recommendations are always best, so ask friends or colleagues for names. Neighborhood or regional e-mail groups or websites such as Yelp.com can help narrow down choices. Avoid most spas, where practitioners tend to focus on a soothing experience rather than on relieving a specific ailment.
2. Listen to your emotions.
Emotions can be key players in the pain game. Joe Smith, a certified athletic trainer in an orthopedic clinic at the University of California, San Francisco, says he encourages clients with severe pain to name the place in their body where they hold their stress. Then he asks them to talk about what's bothering them emotionally, such as an upcoming professional event or difficulties at home. "Sometimes that's enough for people to identify why they're having this pain," he says.
Numerous studies document the close ties between chronic pain, especially back pain, and a sufferer's psychological state. Medical studies also show that psychological interventions such as biofeedback and cognitive behavioral therapies can be far more successful than traditional medical approaches.
Renee Bonjolo, a licensed massage therapist and owner of Body Central in Rhinebeck, New York, sees a clear link between what people are going through psychologically and how their bodies feel. Often these emotions involve guilt and anxiety, she says, especially with clients who are juggling work while caring for a parent, spouse, or child. She's found that the process of releasing tension and recognizing emotions relieves some of her clients' physical pain.
Attitude can also help, says podiatrist Wolpa. He's noticed patients who don't believe their pain will go away will often have difficulty completing treatment, creating a self-fulfilling prophesy. "Emotions have a lot to do with one's well-being," he says.
What you can do:
Relax and do breathing exercises to eliminate stress, which reduces pain.
Say out loud the place where you are hurting, Smith recommends. Then name your reasons for stress. Do this alone or with a friend.
Try therapy or support groups, or visit a health practitioner to reduce stress and address underlying psychological issues that can contribute to pain.
3. Strengthen key muscles.
People can live fairly pain free if they continue to move like they did when they were younger. Lack of exercise and movement leads to decreased flexibility, which leads back to less movement, creating a vicious cycle. The solution? Get more exercise.
By finding one or two simple exercises, says John McKenzie, a physical therapist with Heartland Rehabilitation Services in New Jersey, sufferers can build up the core muscles their bodies need to support their daily movements and increase their flexibility. If pain is severe or the result of injury, it's important to consult a doctor who will likely recommend working with a physical or occupational therapist to develop an exercise plan. Those intent on preventing pain can follow a self-directed exercise course, though an initial consultation with an experienced athletic trainer or physical therapist can insure that you're doing the exercises properly.
What you can do:
Write down one simple goal -- like taking a walk several times a week -- and post it in a visible place, says Indiana University certified personal trainer Scott Catanzaro.
Tell a friend or family member about your exercise goals, however small, and encourage that person to ask you about your progress regularly. This is especially helpful if you're not working with a physical or occupational therapist who provides built-in support.
4. Vary your daily routine.
Constant sitting and staring at a computer screen -- while slouching forward and taking too few breaks to get up and stretch -- leads to poor posture. To prevent pain from becoming chronic, physical therapist McKenzie recommends breaking up your sitting routine as much as possible.
What you can do:
Stand up and move for 1 minute every 10 or 15 minutes. Shake out your arms and legs, pull your shoulders back, and do a few simple stretches. Set an egg timer or computer reminder and get up when the alarm goes off.
Practice standing and sitting with good posture, aligning the ear, shoulder, hip, and ankle every morning. Revisit this stance throughout the day. Post sticky notes throughout your home or office to remind yourself.
Lie flat on the floor, facing upward. This basic exercise reverses the forward-sitting slump many of McKenzie's patients experience.
5. Change everyday actions.
When we pay attention to the little things we do every day that put pressure on our bodies, we can take steps to correct bad habits. A lifetime of bending over in awkward positions to lift a heavy bag can mean unnecessary back strain. The same goes for driving, sleeping, and bending over to put dishes in the dishwasher. Making these small changes pays off in the end. "All that stuff really adds up," says physical therapist McKenzie.
What you can do:
Lighten your load. If you carry a purse or other bag every day, take out the nonessentials to reduce back strain. Don't carry it on the same shoulder all day. Or try a backpack-type purse to distribute the load.
Focus on one daily activity at a time. Experts say breaking a habit can take three or four weeks of consistent focus. When emptying the dishwasher, for example, try different ways to move your body to minimize overextension or awkward positions. Apply those same strategies to doing the laundry or taking out the trash.
When driving, support your lower back with a rolled-up towel or specially designed wedge to avoid slumping over.
Try sleeping with a body pillow, with your knees straddling the pillow, to help keep your spine in a neutral position.
Hold on to a table when picking up something off the floor, McKenzie advises. This distributes some of your body weight onto the arm instead of only the legs and back.