The opioid crisis shines a spotlight on the problem of chronic pain. Over 64 million people seek treatment for low back pain every year, and 80% of us will have low back pain in our lifetimes. Before heading for medications or surgery, or even an adjustment or acupuncture, here are research-proven ways to address low back pain at home or work.
1. Address the cause: 54% of people with low back pain spend most of their time sitting at a desk. Slumping over puts extra strain on the lumbar back. The stretched muscle fibers then spasm, or are weak and at risk of injury. If you can’t get a standing desk or change careers to lumberjack, two products that address this are BetterBack and Posture Pals mechanical tape. Both make it easier to sit properly and reduce the strain of the slump.
2. Reduce pain sensitivity: 50% of people are magnesium deficient. Since magnesium relaxes smooth muscles, reduces inflammation and reduces the amount of pain medication needed to get the same effect, magnesium deficiency is a problem. Got pain? Take 365mg - 500mg provided as magnesium citrate, gluconate, or aspartate twice a day for adults. Warning (or bonus, depending) - the side effect of magnesium is low blood pressure.
3. Use temperature: Heat reduces spasm, and the comfort of heat can calm overactive pain receptors. Ice reduces inflammation, and activates gate control pain relief by overriding pain receptors with a stronger sensation. Ice also causes pain inhibition centrally by something called “Descending Noxious Inhibitory Control”. In a low back pain study comparing Naproxen alone to Naproxen plus either heat or ice for 20 minutes twice a day for a week, both temperature treatments significantly reduced pain…even after the treatment week stopped!
4. Use vibration: Massage increases blood flow, separates spasmed muscles, and feels good. Turns out what massage can do, vibration does faster! For muscle soreness after the strain of a workout, 5 minutes of vibration was equal to 15 minutes of massage at reducing pain. Vibration also directly stimulates gate control through the ABeta motion nerve, like rubbing a bumped elbow blocks pain. One study found 3 minutes of vibration reduced low back pain after 2 hours of standing; and the combination of ice with high frequency vibration has been extensively proven to reduce sharp pain.
5. Exercise: Movement and strength training reduce stress, depression, weight… there’s really not a downside to exercise for most people. For low back pain, specifically Yoga, Pilates, and Core Strengthening exercises all showed somewhat better improvement than general exercise.
What about the home remedies that DON’T work? Overall, while the research on the following treatments does NOT support they work, everyone is different.
TENS, or transcutaneous electrical nerve stimulation, is designed to use the ABeta motion nerve to reduce pain through gate control. Instead of directly stimulating motion nerve like vibration, TENS indirectly simulates motion by twitching muscle fibers with electricity. TENS is effective for post-surgical pain at high intensity, and diabetic neuropathy, but has not been found effective for low back pain. It is safe for all trimesters of pregnancy, though, and even though it was not found significantly effective for labor pain, most women said they would try it again.
While people with low back pain are more likely to have Vitamin D deficiency, taking Vitamin D supplements has NOT been shown to improve back pain. Maybe it’s just that people with back pain can have a harder time getting outside in the sun!
The most important take home messages about pain are that pain is complicated. Pain involves muscles, nerves, mood, fear, movement, strength, and much more. Pain is personal - what it means and how it is perceived to each person is different. Taken together, it makes sense that resolving pain usually takes several months, experimentation, and will be different for each person. There won’t be one answer for most people - find the mix of treatments that works for you, and believe that your pain WILL get better!