Low Back Pain

08 Apr , 2021

Low back pain is well documented to be an extremely common health problem, and is in the top list of reasons why someone would see their primary care doctor. It has approximately a 50-80% chance of occurring in one’s lifetime based on the current reported literature. 

Multiple environmental and personal factors influence the onset and course of low back pain. Studies have found the incidence of low back pain is highest in the third decade, but can develop as early as childhood and with overall prevalence increasing with age until the 60–65-year-old age group and then it gradually declines. Factors like workplace environment, repetitive lifting, emotional/psychological stress and general physical deconditioning all contribute to this problem.

Most therapies for acute and chronic low back pain involve a tincture of time and therapeutic exercises like stretching and yoga, along with topical therapies like ice and/or heat. Unfortunately, low back pain has a high recurrence rate often necessitating more aggressive treatment. Patients will often require manipulative therapies like chiropractic or osteopathic adjustments along with the use of NSAIDS and muscle relaxants to achieve relief. Despite these interventions some patients may go on to be prescribed medications for neuropathy, like Gabapentin and Lyrica or even anti-depressants like Cymbalta. Some stress induced back pain and back muscle spasms are treated with anti-anxiety drugs like Valium and Xanax, which can bring about dependence and unwanted side effects. In the 1990’s and the 2000’s a strong push for controlling back pain occurred with the prescribing of opiates in escalating doses. This was a large component of the opioid epidemic we saw unfold over the past two decades which has claimed hundreds of thousands of lives. 

Sadly, low back pain treated with surgery has a poor track record with nearly 30-46% of those surgeries offering little to no help or even making conditions worse.  This actually has a recognized name in the medical community it is called ‘Failed Back Surgery Syndrome’.  

With low back pain being so prevalent many adjunctive remedies have been used, including natural products like topical creams and ointments containing things like CBD (cannabidiol), arnica and mentholatum. Oral use of herbal anti-inflammatories like white willow bark, turmeric (curcumin), bromelain and Green Maeng Da (kratom) have all been used to some degree or another to address this problem. Many of these approaches have been shown to provide some temporary relief, while time and gentle exercise provide for healing. As the future of medicine unfolds other remedies like stem cell therapy and exosome therapy may offer a new way of addressing these problems in a regenerative way.

As with many things in medicine there is always some common-sense methods to help deal with possibly prevent future low back pain events, they include reaching and maintaining a healthy weight, stress reduction exercises (meditation and breath work), regular stretching and light weight training along with appropriate aerobic exercise. At the end of the day you still are what you eat, so please try to follow an organic, whole food diet with a healthy balance of carbohydrates, fats and protein. If you are plagued with acute or chronic back pain please reach out to your primary care provider to seek help in clarifying your diagnosis and obtaining appropriate therapies for relief.

Sean Devlin D.O. 

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