Back Pain Treatments What Works
and What Doesnt
December 11, 2015
Mechanical low-back pain, typically triggered by injury
or strain, is best managed by controlling inflammation
and engaging in a variety of exercises to restore range
of motion, and improve strength
Movement appears to be the most effective strategy to
address most forms of back pain. Simply standing up as
much as possible each day may improve back pain
A wide variety of pain-relieving tools are reviewed,
including helpful exercises and stretches,
pain-relieving herbs and supplements, physical
therapies, and various mind-body techniques
By Dr. Mercola
Back pain is perhaps one of the most common health complaints
across the globe. Worldwide, 1 in 10 people suffer from lower back
pain, and it's the No. 1 cause of job disability.
Seventy-five to 80 percent of back pain cases do resolve
within two to four weeks,1
with or without treatment. This is particularly true for mechanical
low-back pain (LBP), which is the second most common
symptom-related reason for doctor's visits in the U.S.
LBP is typically preceded by some form of injury or strain, such
as lifting an object or twisting while holding something heavy,
operating vibrating machinery; car collisions, or falls.
Prolonged sitting is also on this list, which may explain why
simply standing up more is part of the solution in many cases.
lists a number of tests used to diagnose LBP, as well as a number of
ways to manage such pain. This includes:
Restoring range of motion
Improving muscle strength and endurance
Coordination training and cardiovascular reconditioning
Maintaining an exercise program
First Line of Treatment Stay Active!
As you can see from the list above, the emphasis is on exercise.
Indeed movement appears to be the most effective
strategy to address most forms of back pain, not just LBP.
Most people automatically want to "baby" the pain and avoid
moving about as much as possible, but this may actually be
contraindicated in most cases. As reported in The Guardian:3
"Despite a host of treatment options including
acupuncture, manual therapies, drugs, injections, and surgery,
nothing is more likely to work than staying active. Just when
you least feel like it, and it hurts the most, is when experts
say you have to get moving ...
Lesley Colvin, a pain medicine specialist in Edinburgh,
says the best evidence is for exercise. 'If I had back pain, I'd
do exercise that strengthens the core, such as yoga, pilates,
and stretching.' [Dr. Christopher] Williams advises: 'Avoid bed
3D Dynamic Movement
Your body needs regular activity to remain pain-free. For
example, when you sit for long periods of time, you typically end up
shortening your iliacus, psoas, and quadratus lumborum muscles that
connect from your lumbar region to the top of your femur and pelvis.
When these muscles are chronically short, it can cause severe
pain when you stand up as they will effectively pull your lower back
Imbalance among the anterior and posterior chains of muscles
leads to many of the physical pains you experience. By rebalancing
and strengthening these muscles, you can remedy many pains and
discomforts, including low back pain.
Also, when there's insufficient movement in your hip and thoracic
spine, you end up with excessive movement in your lower back. As
noted in a recent Epoch Times article,4
"the solution is a combination of mobility exercises for the hips
and thoracic spine and stability exercises for the lumbar spine."
In short, one of the bestthings you can do to prevent
and manage back pain is to exercise regularly to keep your back and
abdominal muscles strong and flexible.
Foundation Training an innovative method developed by Dr. Eric
Goodman to treat his own chronic low back pain is an excellent
alternative to band-aid options like
painkillers and surgery, as it actually addresses the cause of
Another approach is creating and maintaining a balance between
stability and mobility, as well as your body's ability to move
efficiently and resiliently on all planes.
This is what Lisa Huck's 3-Dimesional Dynamic Movement Techniques
do, as explained and demonstrated in the video below. Both of these
strategies are far more effective than the typical conventional
medical approach for back pain.
Unresolved Back Pain Is a Leading Cause of Drug Addiction
In the U.S., an estimated 8 in 10 people struggle with
back pain, and it has become a primary cause of pain killer
addiction and lethal drug overdoses in this country. In 2013, 16,000
Americans died from overdosing on prescription painkillers.5If you have back pain and suffer depression or anxiety, you're
at particularly high risk for opioid abuse and addiction, according
to recent research.6
Prescription painkillers are in turn fueling
According to CDC Director Dr. Thomas Frieden, opioid painkillers
like Vicodin, OxyContin, and Percocet increase your susceptibility
to heroin addiction, and the vast majority 75 percent of heroin
users report starting out on
Steroids and NSAIDs Also Have Their Drawbacks
Steroid shots are also commonly prescribed, but recent research7
reveals they're no better for back pain than placebo. As reported by
The New York Times:8
"... [R]esearchers combined data from 30
placebo-controlled studies of epidural steroid injections for
radiculopathy (back pain that radiates to the legs) and eight
studies of spinal stenosis (back or neck pain caused by
narrowing of the spinal canal).
The study showed that for radiculopathy, injections
provided some short-term pain relief, but over time were no more
likely to be helpful than placebos, and they did not reduce the
need for later surgery. The pooled data showed similar results
with injections for spinal stenosis some moderate temporary
pain relief, but no differences between treatment and placebo in
pain intensity or functional ability lasting six weeks or longer
after the shot."
Other recent research9
shows that prescription-strength naproxen (Naprosyn) provides the
same pain relief as more dangerous narcotic painkillers. The study
compared three different drug treatments for lower back pain:
500 milligrams (mg) of naproxen (brand name: Naprosyn. Lower
doses are also available over-the-counter, sold under the brand
500 mg of naproxen plus 5 mg of cyclobenzaprine (a muscle
500 mg naproxen plus Percocet (which contains 5 mg oxycodone
and 325 mg acetaminophen)
The latter two provided no better pain relief than taking
naproxen alone. While naproxen may be a slightly better alternative
to narcotic painkillers, it still comes with a very long list of
potential side effects,10
and the risks increase with frequency of use. Considering the side
effects and long-term hazards of drugs and surgery, it's important
to find safer, less invasive ways to address your back pain.
Fortunately, there are many options. I've mentioned some already,
but there are many more. The key is to keep experimenting until you
find a combination that works for you. It's worth noting thought
that in MOST cases, part of the solution is to avoid inactivity.
Avoiding Sitting May Be Part of the Long-Term Solution for Back Pain
Indeed, avoiding seated inactivity may very well be part of the
long-term solution for back pain, and I can vouch for the
effectiveness of this strategy myself. I suffered from lower back
pain for many years and tried a host of treatments, including
chiropractic, massage, stretching, grounding, back-strengthening and
posture-improving exercises, and using an inversion table.
Nothing got to the root of the problem until I learned about
the hazards of sitting, and began standing more. Simply increasing
the amount of time I spend standing up I'm now at the point where
I sit for less than 30 minutes daily completely, 100 percent,
resolved my back pain.
This was an unsuspected but pleasant surprise, as resolving my
back pain wasn't the primary reason why I avoided sitting. But, that
turned out to be the key puzzle piece in my case. These days, I
don't even experience back pain during long plane flights.
Paradoxically, standing initially caused pain and it was
difficult for me to stand in an hour lecture without pretty severe
back pain. But, once I reduced my 12 to 14 hours of daily
sitting to under one hour, my back pain quickly vanished. Now I
stand most of the day barefoot on a 2 foot by 4 foot cushioned
grounding pad I designed and that we hope to offer sometime next
If you have a desk job, I highly recommend investing in a
stand-up desk. I'm so convinced of the benefits of standing up
rather than sitting down, I've provided all employees at my office
with stand-up desks. These desks should be available in our store
around Christmas. They'll also receive cushioned grounding pads once
we have them available. Below is the video I shot for our 18th
anniversary celebration of my home office stand up desk.
Why Medical Scans and Surgery Are Typically Unnecessary
As soon as it starts to hurt, most people tend to want an x-ray
or other scan, but experts generally agree that imaging is not
necessary for low-back pain. Exceptions include cases of known
trauma to the spine, pain lasting for more than a month, and cases
where there are warning signs of underlying disease causing the pain
(such as cancer).
"In rare cases, back pain can be due to dangerous
pressure on the spinal cord ... cancer in the spine or
infection. Warning symptoms or 'red flags' for this include
significant trauma, long-term steroid use, and a history of
cancer. If your back hurts and you can't stand up, pass urine,
or feel your anus and genitals, you need to call an ambulance."
Contrary to popular belief, disc degeneration does NOT cause back
pain, so getting a scan and receiving a structural diagnosis of a
bulging disc for example, is not going to be very helpful at least
not in terms of dictating a course of treatment. In many cases, such
a diagnosis may simply lead to unnecessary surgery, which in many
cases sends patients in a downward spiral of increasing pain and
Even though it's well-recognized that disc degeneration is not a
cause for back pain, spinal fusions are still popular. Some 600,000
spinal fusions are performed in the U.S. each year, with a high
percentage of them being performed for non-specific low-back pain,
at a cost of more than $600 billion. The results however are
According to the medical literature, spinal fusions for back pain
have a success rate of about 20 to 25 percent. For 75 to 80 percent
of these patients, the surgery simply results in lifelong pain and
Dr. David Hanscom, an orthopedic surgeon with a practice in
Seattle, discusses these and many other facts in a recent interview,
along with a
novel system for treating back pain that addresses a wide
spectrum of contributing factors, including sleep hygiene,
nutrition, relaxation, physical therapy, and emotional processing.
Stretches and Yoga Poses That Can Help Ease Back Pain
At the end of this article, I will summarize a wide variety of
pain-relieving tools, including herbs and supplements, physical
manipulation, and various mind-body techniques. But first, let's
take a look at some more exercises that may be particularly useful
for back pain. First, by strengthening your core muscles, you add
internal support for your back. Four simple core- and
back-strengthening exercises reviewed in The Guardian12
magazine also recently published articles detailing a variety of
yoga-based stretches for back pain relief. Here's a summary of some
of the recommended poses. For visual demonstrations, please see the
Seated neck stretch. Sit on a chair or
cross-legged on floor. Place your left hand on the right
side of your head and gently pull it toward your left
Avoid raising your shoulder. Once you feel the stretch, hold
for a few seconds, then return to starting position and
repeat on the other side.
Hip-buttock stretch. Lying on your
back, lift your feet off the floor and cross your right
ankle over your left knee. Grasp the back of your left thigh
near the knee, and gently pull legs toward your chest.
The stretch should be felt through your right hip and
buttock. Hold for a few seconds, then switch legs and
Seated spinal twist. Sit on the floor
and cross your left leg on top of and across your right
thigh. Extend and place your right arm on the outside of
your left knee. Keep your left hand on the floor behind you
and twist your entire torso, head, and shoulders gently
toward the left.
The stretch should be felt along your spine. Hold for a few
seconds before returning to center. Switch legs and repeat
on the other side.
Child's pose. For this yoga pose, start
by sitting on your knees on the floor. Lean forward and
extend your arms out front on the floor.
The stretch should be felt from your shoulders to your lower
back. Take several deep breaths and release the tension in
Back relaxer. Lie on your back with
your knees bent over your chest. Hold the back of your
thighs and gently pull your knees toward your chest, until
you feel a stretch in your lower back. Hold for a few
seconds, then release.
Bridge pose. Lie on the floor with your
knees bent, feet on the floor, and arms parallel to your
body. Raise your hips toward the ceiling, and hold for
several seconds. Interlacing your fingers together can help
stabilize the pose.
Chest stretch. This pose can be done
seated or standing. Bring your arms behind your back, and
interlace your fingers.
Gently pull your shoulders back, stretching your chest.
Lower your chin toward your chest, and roll your head gently
from side to side.
Malasana. Stand with feet hip-width
apart, toes turned out. Squat down as far as you can,
maintaining a straight-backed posture.
If you want, you can use a yoga block beneath your buttocks
for support. Bring your hands together in prayer position,
pressing your elbows into your inner thighs.
Stretches for Sciatic Nerve Pain
Sciatic nerve pain is another common problem. Sciatica
results when your sciatic nerve gets pinched in your lower back, but
the pain is typically felt as originating in your buttock,
radiating down your thigh.
Stretching exercises can be helpful here as well. Your sciatic
nerve runs through your piriformis, a muscle located deep in your
glutes. If the piriformis gets too tight, it can impinge the sciatic
nerve, causing pain, tingling, and numbness in your leg. Sometimes,
stretching your piriformis may be enough to reduce the pain.
The following video illustrates a simple one-minute daily
that can help reduce sciatic pain stemming from an overly tight
piriformis muscle in your buttocks.
Tapping Away Your Pain
As emphasized by Dr. David Hanscom in his book, "Back in Control:
A spine surgeon's roadmap out of chronic pain," addressing your
emotions is another important component. Depression and anxiety tend
to reduce or slow down your body's innate capacity for self-healing,
so when pain strikes, it may be a sign that you've let emotional
difficulties and stress go unaddressed for too long.
Your brain, and consequently your thoughts and emotions, actually
play a large role in your experience of pain. Your central nervous
system "remembers" any pain that lasts more than a few minutes at
the neuronal level. These memories can become so vivid that the pain
persists even after the injury has healed, or re-occurs when it
shouldn't, such as from a gentle touch.
Retraining your brain using mind-body techniques like the
Emotional Freedom Techniques (EFT) can be very helpful in such
instances. In the following video, EFT practitioner Julie Schiffman
shows how you can use EFT to relieve your pain, be it acute or
Other Non-Drug Alternatives for Pain Relief
With all the health risks associated with opioid painkillers and
surgery, I strongly urge you to exhaust other options before
resorting to these interventions. Below I list some of the most
effective non-drug alternatives for the treatment of pain that I
know of. Also remember that preventing back pain is surely
easier than treating it, and staying active tops the list
for both prevention and treatment.
Beneficial Physical Activities
Avoid sitting down
One of the most common causes of pain is low back pain.
Even I struggled with it for many years. The only thing that
eliminated it entirely was radically reducing the number of
hours I spend sitting each day.
Exercise and physical activity will help strengthen the
muscles of your spine. Make your exercise time count by
high-intensity sessions. You probably only need this
once or twice a week at the most.
You'll also want to include exercises that really challenge
your body intensely along with those that
promote muscle strength, balance, and flexibility.
Yoga, which is particularly useful for promoting
flexibility and core muscles, has been proven beneficial if
you suffer with back pain. As reported in Prevention
"A study in the journal Pain reported that people with
chronic back pain who practiced Iyengar yoga for 16 weeks
saw pain reduced by 64 percent and disability by 77 percent.
Although yoga's effects on sciatica are less clear, gentle
forms may be beneficial."
The Yoga Journal has an online page17
demonstrating specific poses that may be helpful.
A recent Spanish study18,19
found that older women with back pain can reduce their pain,
improve balance, and reduce risk of falling by adding
Pilates to their physiotherapy routine.
All of the 100 women in the study received 40 minutes of
nerve stimulation and 20 minutes of massage and stretching
twice a week. Half of them also did one hour of Pilates
twice a week.
At the end of the six-week long study, those taking Pilates
reported greater improvements.
Many studies have confirmed that chiropractic management
is much safer and less expensive than allopathic medical
treatments, especially when used for back pain.
Qualified chiropractic, osteopathic, and naturopathic
physicians are reliable, as they have received extensive
training in the management of musculoskeletal disorders
during their course of graduate healthcare training, which
lasts between four to six years.
These health experts have comprehensive training in
Research has discovered a "clear and robust"
effect of acupuncture in the treatment of: back, neck,
and shoulder pain, osteoarthritis, and headaches.
published in the Journal of Traditional Chinese Medicine
found that 17 out of 30 patients with sciatica experienced
complete relief with acupuncture. You may need about a dozen
treatment sessions to see improvement.
Both have been shown to be effective for painful
conditions such as torn cartilage and arthritis.
Trigger point therapy, where the therapist applies firm
pressure to points on your piriformis, lower back muscles,
and glutes, can help release the pressure and impingement on
the sciatic nerve.
K-Laser Class 4 Laser Therapy
Infrared laser therapy treatment helps reduce pain,
reduce inflammation, and enhance tissue healing both in
hard and soft tissues, including muscles, ligaments, or even
These benefits are the result of enhanced microcirculation,
as the treatment stimulates red blood cell flow in the
treatment area. Venous and lymphatic return is also
enhanced, as is oxygenation of those tissues.
The infrared wavelengths used in the K-Laser allow for
targeting specific areas of your body.
The K-Laser is unique in that it is the only Class 4 therapy
laser that utilizes the appropriate infrared wavelengths
that allow for deep penetration into the body to reach areas
such as your spine and hip.
Methods such as yoga, Foundation Training, massage,
meditation, hot and cold packs, and other mind-body
techniques can also result in astonishing pain relief
without any drugs.
Grounding yourself to the earth, also known as
Earthing, decreases inflammation in your body, which can
help quiet down back pain and other types of pain.
Your immune system functions optimally when your body has an
adequate supply of electrons, which are easily and naturally
obtained by barefoot/bare skin contact with the earth.
Research indicates the earth's electrons are the ultimate
antioxidants, acting as powerful anti-inflammatories.
Whenever possible, take a moment to venture outside and
plant your bare feet on the wet grass or sand.
Walking barefoot is also an excellent way to strengthen your
feet and arches.
Eat real food
Avoiding processed grains and refined sugars
(particularly fructose) will lower your insulin and leptin
levels and decrease insulin and leptin resistance, which is
one of the most important reasons why inflammatory
prostaglandins are produced.
That is why stopping sugar and sweets is so important to
controlling your pain.
High-quality, animal-based omega-3 fat
Omega-3 fats are precursors to mediators of inflammation
called prostaglandins. (In fact, that is how
anti-inflammatory painkillers work, they manipulate
prostaglandins.) My personal favorite is krill oil.
Vitamins D and K2
Optimizing your vitamin D level by getting regular,
appropriate sun exposure and taking a vitamin D3 supplement
can help reduce pain via a variety of different mechanisms.
Medical cannabis has a long history as a natural
At present, 23 U.S. states22
have legalized cannabis for medical purposes. Its medicinal
qualities are due to high amounts (about 10-20 percent) of
cannabidiol (CBD), medicinal terpenes, and flavanoids.
As discussed in this previous interview with
Dr. Allan Frankel, varieties of cannabis exist that are
very low in tetrahydrocannabinol (THC) the psychoactive
component of marijuana that makes you feel "stoned" and
high in medicinal CBD.
Just be sure to seek out a knowledgeable cannabis physician,
as many have no idea of the proper dosing.
If you are seriously considering medical cannabis for pain,
it is imperative that you view my interview with
Dr. Allan Frankel, who is one of the leading medical
cannabis physicians in the U.S.
He can do consultations on the phone if one needs specific
In a study23
of osteoarthritis patients, those who added 200 mg of
curcumin a day to their treatment plan had reduced pain and
also found that a turmeric extract composed of curcuminoids
blocked inflammatory pathways, effectively preventing the
overproduction of a protein that triggers swelling and pain.
Also known as boswellin or "Indian frankincense," this
herb contains specific active anti-inflammatory ingredients.
This enzyme, found in pineapples, is a natural
anti-inflammatory. It can be taken in supplement form but
eating fresh pineapple, including some of the bromelain-rich
stem, may also be helpful.
Cetyl Myristoleate (CMO)
This oil, found in fish and dairy butter, acts as a
"joint lubricant" and an anti-inflammatory.
I have used this for myself to relieve ganglion cysts and a
mild annoying carpal tunnel syndrome that pops up when I
type too much on non-ergonomic keyboards. I used a topical
preparation for this.
Also called capsaicin cream, this spice comes from dried
hot peppers. It alleviates pain by depleting the body's
supply of substance P, a chemical component of nerve cells
that transmits pain signals to your brain.