On any given day, 5 percent of Americans — 15 million people — have back pain. Eighteen percent (54 million) have suffered back aches in the past month. And over a lifetime, significant back pain bedevils two-thirds of the population. Not surprisingly, back pain is a leading reason why Americans consult physicians, accounting for 14 percent of primary-care doctor visits.
According to the American Academy of Family Physicians, the most frequent cause of back pain is muscle strain. The injury might result from overuse (a rowing machine) or twisting (a backhand tennis shot), or lifting incorrectly (using the back instead of the legs). But quite often, there is no trauma. You rise from a chair or bend over while dressing, and wham, you feel sharp pain in your back.
The No. 2 cause of back pain is a herniated (“slipped”) disk. Disks are the cartilage rings between the 33 small bones (vertebrae) that comprise the spine. The alternating bone-cartilage arrangement provides flexibility. But disk injury — which typically appears on X-rays and MRIs as bulging or a rupture — can press on nearby nerves and cause severe pain.
Rarely, back pain is caused by other conditions: infections, cancer or other diseases.
But no matter what the cause, according to back pain researcher Richard Deyo, M.D., a professor of medicine at the Oregon Health Sciences University, “Nearly everyone gets better.”
Here’s how to deal with back pain:
- As quickly as possible, press an ice pack against the affected area. Ice packs are standard first-aid for muscle injuries. They relieve pain and prevent swelling. Use ice cubes, a commercial cold pack, or a bag of frozen peas or corn. Frozen vegetables often work best because they mold easily to the shape of your back. Wrap the ice in a cloth and alternate applying and removing it for 20-minute periods. Do not apply ice directly to the skin or you may cause frostbite. Continue ice pack treatment for up to a few days as needed.
- Take over-the-counter anti-inflammatory pain relievers such as aspirin or ibuprofen (Motrin, Advil). Or try acetaminophen (Tylenol). Acetaminophen has no anti-inflammatory action, but it’s kinder to many stomachs and, according to a recent review of many studies by researchers at Oregon Health Sciences University, there is “good evidence” that even without anti-inflammatory action, Tylenol provides significant relief of back pain.
- Consider trying two pain-relieving herbs: white willow bark (Salix alba), a natural form of aspirin, and devil’s claw (Harpagophytum procumbens), a South African herb that has potent pain-relieving and anti-inflammatory action. A review of studies by University of Toronto researchers concluded that both are effective. White willow and devil’s claw are available at health food stores and supplement shops. Follow the directions on the package.
- Take it easy for a few days. Don’t do anything that makes the pain worse. But don’t climb into bed. Researchers in Oslo, Norway, analyzed all the research on bed rest for back pain, and concluded that it makes the pain worse. As quickly as possible, return to your normal activities, while taking care to avoid stressing the injury.
- After a day or two, take hot baths or use a heating pad. Heat is soothing and it opens the blood vessels, which brings more healing oxygen and nutrients to injured tissues. Australian researchers reviewed the studies and concluded that heat helps relieve back pain.
- Engage in gentle, low-impact exercise every day. The American Academy of Family Physicians recommends walking. You might also benefit from gentle stretching, swimming or gardening. But avoid running, jumping and major twisting until you feel better.
- Try the complementary therapies of your choice. The three most likely to help back pain are: chiropractic, massage and acupuncture. A recent review of 69 studies by researchers at Northwestern Health Sciences University in Bloomington, Minn., showed that chiropractic provides significant relief of back pain. Studies at the Institute for Work and Health in Toronto show that massage is beneficial. And several studies around the world show that acupuncture is good for back pain. Health insurance may cover these treatments. Check your policy.
- If you don’t begin to feel better after two weeks, or if your pain gets worse, see a doctor. Prescription muscle relaxants (Valium) might help. In addition, the doctor might recommend tests to identify the cause of your pain.
Whatever you do, don’t despair, notes Scott Kinkade, M.D., an assistant professor of family medicine at the University of Texas Southwestern Medical Center in Dallas. “Studies show that 30 percent to 60 percent of back pain sufferers recover in one week, 60 percent to 90 percent in six weeks, and 95 percent in 12 weeks.”
Michael Castleman is “one of the nation’s top health writers” (Library Journal).