Chronic back pain is a major concern in the healthcare industry in America right now. Figures show that 29% of Americans have some form of lower back pain, and 85% of those must deal with a non-specific issue. The physicians understand that they have ongoing pain with no clear cause of the back pain. The result is a large portion of the population struggling on a daily basis. It also costs the nation as much a $90 billion a year in healthcare and disability.
This is an on-going problem within the US for a couple of reasons. First of all, there is the simple fact that there seems to be no cure for chronic back pain. There are too many variables between patients and not enough of an understanding of the problem. New research on pain and neurological connections is helping, but there are still too many questions in place.
The other problem is the divide between treatment options. There is a basic issue of conventional vs alternative therapies. Doctors may push one option onto patients as the accepted norm, despite poor results. The other has some potential but remains the subject of negativity.
Many medical practitioners still push the conventional route of treatment for chronic back pain.
The best place to start when looking at the different options available for chronic back pain patients is the conventional route. This basically means all the measures prescribed when patients attend medical professionals. These are the methods that meet national standards and recommendations. This is the case even though the results and costs are often questionable. Three of the most common methods here include spinal surgery, opioid painkillers, and steroid injections.
Spinal surgery seems like quite an extreme option to suggest for patients dealing with back issues. It might make sense in cases where there is a determined, specific issue, such as a tumor, herniated disc or something else that shows up in a scan.
But what about the other 85% of people?
How can surgical procedures help when there is no clear problem to fix or remove?
Skeptics would say that this costly measure brings in revenue, so makes more sense for the hospital than the patient. Some patients may be happy to give surgery a try if they expect significant improvements after the procedure.
A common alternative is the use of opioid painkillers to help manage the pain of the problem. This is something that patients will need to take regularly. But, the right drug and dosage could help them go about their daily routines with relative ease.
Then there is the option of steroid injections to target the areas in pain and help reduce the problem. This is something that medical professionals can administer on a regular basis. It becomes part of on-going conventional therapy.
There are thousands upon thousands of people on prescription painkillers to numb the pain and manage the condition. Others may be on waiting lists for questionable surgical procedures. The trouble here is that there are a number of issues with conventional practices. They are:
- Create new side effects and possible dependency issues
- Not really a lasting effect or any form of “cure”
- Limited due to the lack of understanding of back problems and the related conditions
These solutions can do more damage than good.
There is an opioid dependency epidemic right now. Thousands become hooked on painkillers and as many as 14,500 died from these drug in 2016. The additional problem here is that these drugs often aren’t the best choice. Some can cause opioid-induced hyperalgesia, which means even more pain.
Other, non-opioid painkillers are often more reliable and safe. This all shows that opioids really shouldn’t appear in the treatment of ongoing problems. This is especially true when there are less damaging, more effective options available. It is no wonder that the US is struggling to break the cycle of opioid addiction when doctors are such willing enablers.
Then there is the lack of results with spinal surgery. There are patients that put themselves through the stress of surgery and hospital visits for nothing. The procedures often do little to alleviate the condition, usually because it targeted a symptom, not a cause. This is unnecessarily costly for all concerned.
Figuring out how to cure chronic back problems
As mentioned above, there is little understanding about the causes of back pain and the best forms of treatment. None of these options can cure a non-specific condition because doctors don’t have the full picture in front of them. They can’t remove pain with invasive action in muscles and disc if the pain comes from neurological issues.
Are alternative therapies a better option for patients with chronic back pain issues?
The scope of the problems with conventional treatments leads to a need to turn to alternative therapies instead. Alternative therapy is an interesting term for those that actually see these options as go-to, helpful aids. Alternative means therapies without surgical procedures, medication and other measures from medical professionals. They are the ones that aren’t available on prescription but are, in some cases, free to pursue in a patient’s own time.
There are two categories here: active and passive approaches. The passive approaches are the ones where chronic back pain sufferers turn to other specialists for help. They enjoy a massage, acupuncture needles, reiki or whatever other solution they choose.
Then there are the active approaches. These are the ones where sufferers take an active step to improve their pain through exercise and movement. Some may try and work out each morning, while others turn to gentle motions with yoga or tai chi. Another thing to check is how you sleep, your position in bed, and the support your mattress is giving you or possibly lacking due to being old.
Passive options are always a popular choice for those that want to put their faith in the hands of others. There are alternatives that act as a compromise between the medical professional and the self-help route. Users that can’t obtain treatment and guidance the conventional way can still turn to professionals.
Practices can help to manipulate the body, ease stress and pressure or work with other theories on health and well-being. Some are effective, others may not produce the results desired.
Massage therapy is a great place to start for those new to alternative therapy. Massage doesn’t seem like that big a step from the conventional to the alternative. After all, physiotherapy and sports therapy often include massage of deep tissue for pain relief. Patients can pay for a series of sessions to work at the back problem and enjoy additional benefits in the process. Acupuncture has always been a little more controversial, despite its popularity in other cultures. Again, some respond well to this method and that is the most important thing.
Some people with back issues are a little more reluctant to try active forms of alternative therapy. There is the fear that the activity may worsen the issue, or that they may suffer due to their lack of mobility or strength. However, it is possible to create a personalized workout plan that allows for regular, helpful motion.
Yoga is one of the most popular options these days because of the results and accessibility of the treatment. There is actually scientific research that supports the use of the practice for back issues. Yoga helps with flexibility, especially in the spine, hips, and legs. This could reduce chronic lower back pain by anywhere from 18.5 to 58%.
Similarly, yoga helps to improve core strength, which itself can aid pain by between 39 and 76.8%. The difference between these numbers comes down to the poses and regularity of the sessions. Light yoga a couple of times a week will help, but not as much as a daily session with targeted poses.
McGill’s Big 3
There are some people that will assume that yoga isn’t for them. They either believe that they don’t have the time to complete a helpful session, or that they aren’t capable enough. But, there are three poses that anyone can use, at any time of the day. This is the famous McGill’s Big 3 Exercises for lower back pain. These poses are:
1. The Curl up
This is somewhere between a crunch and a sit up, but not as intensive. Patients lie on the floor with one leg bent and one extended. They then place their hands under the lumbar area and raise their neck slightly. This helps to strengthen muscles without straining them.
2. Side Plank
From there, they then lift themselves up into a side plank on one elbow. Again, one leg remains bent while the other is straight. This provides support and stability.
3. Bird Dog
Some yoga enthusiasts may know this as the broken table, rather than the bird dog. Users start off in the table pose on all fours, then extend one leg and the opposite arm out straight. There should be a straight line between the heel and fist for complete stability. This helps to stretch the spine out but also improve core strength and balance.
Source: FHP Health Tips
There is a lot of potential for patients that undergo these alternative therapies, but also some downsides.
The methods of these alternative therapies are encouraging. It appears as though this is a far more beneficial approach than the ineffective methods of conventional treatments. However, there are some downsides to alternative solutions that users should be aware of. They include:
- accessibility to regulated provisions
- the costs of the treatments and health insurance provision.
- the ongoing confusion over the best solutions for chronic back pain.
Negative attitudes toward alternative therapies can lead to poor accessibility and high costs due to lack of coverage from health insurance plan.
One benefit of conventional treatment is that all patients should receive a similar package of care. They receive a regulated dose of a particular painkiller or a recognized surgical procedure at a hospital. The standards and approaches in acupuncture and massage can vary between establishments. Also, while a local clinic will offer the basics in prescriptions, there may not be a respectable acupuncturist in town.
Then there is the problem of financing a new healthcare plan. Patients need health insurance plans that allow for these alternative methods. At the moment, health insurance remains focused on conventions, not solutions with better success rates.
This helps to push patients onto a more dangerous path because that path is the most affordable. Those that are adamant about acupuncture and massage may need to find the funds from somewhere else. Those disabled by their lower back pain may struggle to do so.
So How To Determine Your Best Option
This is a problem on both sides of the issue. There isn’t enough clear evidence of success for any methods to ensure it becomes a priority. There never will be because each case is different and requires a personalized approach to treatment and pain management.
Still, many healthcare providers still act as though there is that magic cure for everyone somewhere. Some experts now state that doctors should never view non-specific lower back pain as a homogenous condition. The term means that it is the same with all patients. Instead, it is best to treat patients case by case, even if that means a trial and error approach to treatment plans.
Source: IHMC Evening Lecture Series
So which is the best approach these days: alternative therapies, conventional treatments or a combination of the two?
The argument between these two options comes down to two clear issues – modest effects vs potential harm. There are many medical professionals opposed to alternative therapies. This is because of the variation in effects and minimal responses.
The treatments mentioned here are effective, but not with the regularity and strength required. Then there are those opposed to conventional methods that cite the potential harm of invasive measures. Is it really worth the risk of surgery and opioid dependency for minimal relief?
The tide seems to be turning in favor of the alternative side, regardless of how minimal those effects are. Back in February 2017, the American College of Physicians released advice to those dealing with non-specific back pain. Exercise, acupuncture, and yoga all made the list of recommendations.
Prescription drugs and surgical options came under the list of things to avoid. Yet, these prescriptions remain the go-to option. There is still a vicious cycle in an unwinnable war on lower back pain.
The answer may be a combination of the two, or at least an open mind to different possibilities.
The complexities of back pain issue mean there cannot be a perfect course for everyone. Due to every patient being different you may need to try the trial and error approach again. Patients and doctors need to work together to look at options, work with those that offer relief and rule out those that fail.
There is no need to pump patients full of opioids when yoga and exercise are helpful. But, pain medication and surgery should be on the table if problems worsen or if there is a more specific issue.
The hope is that as this argument progresses, alongside the war on opioids, alternative therapies may become a more common choice. Patients need access to different options, with the right health care plan and insurance. More importantly, they need to make their own choices without doctors pushing them in the wrong direction. Patients in pain should be open to trying all options available and affordable.