Back Pain and Lumbago - Natural Approaches

Back pain is extremely common and has been experienced by almost everyone at one point in life. The official name for low back pain is lumbago, and it is literally defined as pain in the lower back. There are many possible causes for back pain, and often it is not even possible to identify a specific cause. If this is the case, it might be called nonspecific. Back pain, like all other types of musculoskeletal pain, can be caused by injuries or trauma. The most common injuries are sprain or strain injuries (which is basically damage or inflammation to the muscles, tendons, or ligaments).

There are a few medical conditions that can be the cause of low back pain. First, there is the possibility of a herniated disc. Discs are cushions that are found between each of the bony spinal vertebrae, and for various reasons (again, usually injury), they can move out of place and also cause compression of a nerve.^[1] In these circumstances, sometimes the only symptom is back pain, but more often than not, there are other accompanying symptoms like numbness or tingling down the back and leg (called sciatica). Sciatica by itself is another cause of back pain, and it can occur without an accompanying herniated disc. Sciatica can occur because there is any type of irritation to the nerves in the back. For example, infections and tumours can cause sciatica.^[2] The third and reasonably large category of causes for back pain is bone-related problems or conditions of bone. Ankylosing spondylitis and spondylolithesis are both medical causes for back pain. In ankylosing spondylitis, there is swelling of the joints and spine, which causes stiffness that is worse in the morning and improves with movement.^[3] In spondylolithesis, there is a bone that slips out of position, and this creates similar symptoms as the herniated disc (pain, stiffness, numbness, and tingling). In this article, we will start by discussing different prevention measures for back pain. After that, we will discuss natural treatment options that may offer relief. Some treatments address the underlying cause directly, but many treatments are geared specifically towards improving symptoms. With many of the causes of back pain and with nonspecific back pain, time (coupled with rest) will usually lead to improvement. This is especially true if the underlying reason is due to injury, where the natural course will be moving from the acute phase to the chronic phase, which is another way of saying things should ameliorate on their own without intervention.

Preventing Back Pain

There are multiple strategies that can help prevent back pain that can be performed while at home, or even while commuting or while at work.^[4] One of the best things you can do is make sure that you maintain a healthy weight and stay active! Many people develop back pain simply because they are overweight, or they are and don’t engage in enough exercise. Additional weight means more strain on the back. Regular physical activity is extremely important. Both aerobic activity and resistance-training (or weight-lifting) can be helpful. The key in this regard is getting muscles active and increasing heart rate. Many recommendations suggest exercising for at least 30 minutes, three to five times per week. Obviously, making sure that you don’t injure yourself while exercising is extremely important. Make sure that you connect with a personal trainer or with someone who is knowledgeable about how to perform various exercises if you are not comfortable with the process. This is especially true if you are lifting heavy weights. In this case, you’ll need to make sure you are bending your knees, engaging your abdominal muscles, and avoiding twisting—as all of these manoeuvres can help prevent back injuries.

Another set of factors to be aware of is how your body is routinely positioned for long periods of time. You’ll spend approximately a third of your life sleeping, so how you are positioned in bed is very important. There are typically two sleeping positions that are considered optimal for the body; one is lying on your back. If you opt for this position, make sure you use a thinner pillow so that your head is not propped up too high (as this can cause neck pain, which can then lead to back pain). The other position that is easiest on the body is side-lying. In this position, it is encouraged to have a pillow between the knees and sometimes between the ankles, as well as between the arms. The idea is to keep your body in an untwisted position as much as possible. The pillow being used for the head should be of medium thickness, such that the head is straight on the neck, creating a 180-degree angle, not tilted up or down.

Finally, you should ensure that your posture during the day (driving, sitting, while at work) is correct. It is worthwhile investing in setting up an ergonomic workspace, because such a significant portion of our days are often spent working. You can set up lower-back support on your chair by using a small pillow. If using a computer, make sure you are set up such that you are not uncomfortable when typing or looking at the monitor. Along the same lines, make sure that you wear comfortable clothing and comfortable shoes. It’s surprising how much these things can impact back pain, especially if they shift your centre of gravity (like high heels or very tight clothing, for example). Make sure that no matter what strategies you are employing, you take breaks. Even if your setup is optimal, it’s important to make sure you don’t allow your body to become inactive or stiff. Try to take at least a five-minute break every hour.

Treatment Options for Back Pain

Your naturopathic doctor will first do an assessment to try to identify the cause of your back pain. If a cause is discovered, that will be the target for treatment. If no clear cause can be identified, then treatment will likely revolve around improving the symptoms. One of the most common approaches naturopathic doctors have for pain of any kind is acupuncture. Acupuncture involves using very thin needles, and inserting them into specific locations (this process is most often completely painless). For cases of back pain, many naturopathic doctors would probably use acupuncture in a Western context, rather than in a traditional Chinese medicine context. This means likely inserting the needles wherever the areas of most pain or muscle tightness are found, as well as manipulating the needles up and down to help release trigger points. Trigger points are tight areas of muscle that often develop and can be a large factor in aggravating pain levels. Acupuncture will often be combined with other manual therapies, such as massage. Although naturopathic doctors are not massage therapists, they are trained in various massage techniques. Lastly, therapeutic devices are another common treatment options. These include devices such as ultrasound or laser. Each of these devices has specific indications or reasons to use them, but one or both have been used successfully to treat back pain.

Other common treatments include nutritional supplements and herbal treatments. These treatments as well will be individualized based on the specific elements of the patient’s case. In general, anti-inflammatories are commonly used. This includes herbs like curcumin or boswellia, which can be provided in tincture form (alcohol extracts), or in capsule or tablet forms. Usually, anti-inflammatories may take a week or more to become fully effective, but some people may see results almost immediately if inflammation is a big component of the back pain. Some nutritional supplements focus on the building blocks of the musculoskeletal system, such as glucosamine and chondroitin sulfate, or minerals like calcium and magnesium. Others focus strictly on the pain component, such as Natural Eggshell Membrane (NEM®).

One of the more rigorous studies available on naturopathic medicine looked at the treatment of back pain.^[5] The study was a randomized clinical trial. 75 postal workers received naturopathic care or standardized physiotherapy over a period of 12 weeks. Those receiving naturopathic care received dietary counseling, deep-breathing relaxation techniques, and acupuncture. The control intervention received education and instruction on physiotherapy exercises using an approved education booklet. Back pain was measured using a number of metrics. The results showed that participants in the naturopathic-care group had significantly lower back pain and higher quality of life. All secondary outcomes were also significantly improved in the group receiving naturopathic care, including spinal flexion, weight-loss, and body mass index. Overall, it is strongly recommended that you seek care for your back pain and know that while seeing your naturopathic doctor, you are in good hands.