We’ve all had back pain
I would be willing to bet a pretty penny that you, at some point in your life, have experienced back pain. NIH estimates put the lifetime probability of experiencing acute or chronic back at 8 out of 10 individuals (1). Perhaps you are experiencing back pain right now as you read this article, and maybe you’ve experienced acute back pain lasting for days or weeks. Because back pain is so common, I feel it’s imperative to offer you information as to why we experience it and what we can do about it from a natural standpoint.
Causes of back pain: a crash course
Sadly as we age, our bodies break down from basic wear and tear and our ability to heal and rebuild lessens, which is why we see so much back pain in the elderly. Also common among the elderly is osteoarthritis, disc degeneration, and loss of bone density which can lead to pain due to the friction of bone-on-bone, spinal nerve compression, and shifting vertebrae.
This is not to say you can’t have a healthy, pain free back at any age, it just becomes something we all eventually have to invest more time and effort into.
These causes of back pain include pain from injury, strains, tears, sprains or bulges (a “noxious stimulus”). The convenient thing (I hate to put it that way) about this type of back pain is that we can refer to the incident or injury that caused the pain. Rheumatoid arthritis is in this category.
More difficult to identify are pain patterns that involve “peripheral sensitization” or “central sensitization”. Chronic back pain is often due to peripheral sensitization, which involves the actual anatomy of our nerves changing to become more sensitive and on high alert. The challenge with this type of pain is it results in an experience without an identifiable cause. Central sensitization is the most mysterious pain pattern, where microscopic changes are actually occurring in the areas of the brain where we process the experience of sensation. Fibromyalgia is now understood as a form of central sensitization.
Read more about chronic pain patterns
Using food to relieve pain
Perhaps the best natural inflammatory reducers are the herbs Boswellia serrata (also known as frankincense) and Curcuma longa which allow for necessary inflammation while keeping excessive inflammation and pain in check. Fish oil and essential fatty acid supplements are the most efficient way to supply your body with the precursors to anti-inflammatory substances that our bodies produce naturally. The list of herbs, supplements, and homeopathic remedies to treat pain is lengthy, and I’m happy to chat with you in more detail one on one.
Read more about using nutrition to relieve chronic pain.
Acupuncture to release the body’s natural opioids
There are a number of in-office procedures that can address both acute and chronic pain. Some need to be applied with caution, so I will perform the appropriate physical exams prior to treatment. As you might have guessed, acupuncture works great for acute and chronic pain since it reduces inflammation. It also promotes the release of natural compounds that our bodies produce which mimic the action of opioid drugs (don’t worry, these compounds are natural and not habit-forming).
Acupuncture also is what new pain science calls a “novel stimulus”. Remember what I said about “noxious stimulus”? Well, a novel stimulus can interrupt and negate a noxious stimulus in acute cases, and in chronic cases with long term therapy, can recalibrate nerves towards normal functioning.
Manual therapies to supplement acupuncture
Manual therapies, which include spinal and joint adjustments (chiropractic-type care) massage, reflexology, rolfing and myofasical release, craniosacral, cupping, and gua sha can be used in addition to, or in lieu of acupuncture. Some folks simply respond better to manual therapies. In case you’re curious, yes, manual therapies have overlapping actions with how acupuncture reduces pain levels.
Therapies like massage, rolfing, myofascial release, gua sha, and cupping also have the ability to address the component of fascial tightness and adhesion (fascia is a thin, contiguous, connective tissue membrane surrounding muscles and organs throughout the whole body). Gua sha and cupping are also great ways to move lymph, hence all the bruising and redness that follow these therapies…which I would encourage you to wear as badges of honor.
Manual spinal and joint adjustments work by these same mechanisms, and I often combine acupuncture and adjustments in the same treatment, since I find that they are highly synergistic and yield benefits where the whole is far greater than the sum of the parts. I would, however, be very cautious about utilizing adjustments in cases of acute pain and injury, as well as in cases of degenerative issues.
Physiotherapy devices
Finally, physiotherapy devices also have their place in the natural pain management toolbox. Cold laser (near infrared) therapy is a very easy therapy to apply, and I can do that as you relax with acupuncture needles.
Laser therapy is a user friendly, non invasive therapy that reduces inflammation and pain, speeds healing and slows degeneration, moves body lymphatics, and helps to remove cellular waste products that are often the consequence of tissue damage and inflammation (2). It also allows me to target very specific body locations that manual therapies and acupuncture may have difficulty addressing. All while being a comfortable experience for you (you might feel a little warmth from the device, that’s about it).
I might also apply a mild electrical stimulation to acupuncture needles, which helps overly tense muscles to relax. Certain frequencies will help tendons, ligaments, and bone to heal more quickly from injuries, and slow degeneration, and may even yield some regeneration by increasing local stem cell proliferation and cellular growth factors.
Inflammation isn’t bad
Acute pain due to an injury involves some degree of inflammation, and inflammation is necessary for healing. Acute inflammation due to injury leads to the formation of new cartilage and other connective tissue. We don’t want to suppress inflammation completely, but rather “modulate” or lessen so that we experience less pain and can still effectively heal.
Chronic inflammation, on the other hand, is never good and has been implicated in basically every chronic disease, including cancer, heart disease, arthritis, and diabetes. Your diet will play a significant role in the degree to which your body will experience chronic inflammation.
The problems with conventional care for back pain
I have tremendous respect for conventional medicine, especially orthopedic surgery, as medical miracles can be performed, of which I’ve received myself. It’s exciting that natural medicine and conventional medicine are now finding more common ground, and it is my belief that as these two medical branches become more intertwined, we will make major advances in public health. However in treating pain, whether acute or chronic, the conventional medical toolbox has its limitations.
Commonly prescribed drugs for pain encompass non-steroidal anti-inflammatory drugs (aka NSAIDs, which included aspirin and Ibuprofen), corticosteroids (pharmaceutical derivatives of the hormone cortisol), and opioids like oxycodone and hydrocodone. The problem with these drugs is that they only can treat pain from injury (nociceptive pain) cases effectively, and their long term use is associated with negative consequences like stomach ulcers, kidney and liver damage, impared synthesis of cartilage (yes, ironically Ibuprofen inhibits healing), and the tragic possibility of dependency and addiction. They are not particularly effective against the other types of pain (peripheral sensitization and central sensitization).
Major surgery has its limits. Orthopedic procedures are expensive and sometimes unnecessary. They may alter our biomechanics in negative ways. But sometimes surgery is absolutely necessary. I ruptured my distal biceps tendon the summer before my last year of medical school while weightlifting – no amount of natural medicine or acupuncture would have been able to mend that injury.
The next step in addressing your back pain
I love my job for many reasons, chief among them is providing patients like you with at least some degree of same day relief from pain. If we invest towards addressing back pain, your life can become more enjoyable and active, and this enjoyment of life and physical activity are perhaps the best medicines of all. I would invite you to schedule an initial office visit with me where I can conduct a focused interview so that we can determine which natural treatment strategies are going to offer you the greatest benefit. I can offer you treatment in that same office visit. But realistically, treating your chronic back pain is going to happen gradually over several visits. I’m looking forward to working with you towards a more comfortable, enjoyable life.
In health,
Dr. Nesbitt
Dr. Grady Nesbitt is a naturopathic physician at Heart Spring Health in Portland, Oregon whose mission is to provide same day pain relief so that you can fully enjoy all that life has to offer. Using a diversity of modalities such as acupuncture, spinal adjustments, and physiotherapy devices, combined with naturopathic staples such as herbal medicine, homeopathy, and nutritional counseling, Dr. Nesbitt provides solutions for sports injuries, all types of chronic and acute pain, and degenerative conditions such as osteoarthritis and osteoporosis. His skills were acquired over nine years of medical training and orthopedic focused preceptorships at both the prestigious National University of Natural Medicine (NUNM) and Bastyr University, as well as decades of athletic pursuit. Click here to learn more about Dr. Nesbitt.
Footnotes
- US National Library of Medicine – MedlinePlus – Back Pain (2020-10-13)
- The wavelengths of light emitted by cold laser devices are often barely in the visible spectrum (near infrared), or infrared (most devices will feature both). Mitochondria, our cellular power plants, contain enzymes that incorporate iron in order to pass around electrons and drive energy production, and iron happens to have a very high affinity for these wavelengths of light. The result is that our mitochondria function at a higher level of activity, and since basically every cellular process involves mitochondria, we are able to heal faster, and experience reduced pain, acute and chronic.
