“Although the world is full of suffering, it is also full of the overcoming of it.” ~Helen Keller

You feel a twinge in your back as you get into your car, and don’t think much about it. You go to work, meet a friend for happy hour, make dinner for your family, and go to bed. A normal day in your life. You wake up the next morning and as you roll over to get out of bed, you are seized with the worst pain you’ve ever had. It feels as if your back has become a rock. A painful rock. You roll onto your side and use both hands to push yourself into a seated position, then again to push yourself out of the bed. You try to stand up, but you can’t get your back to straighten up enough to get your hips under you. You stumble to the bathroom like a debilitated 90 year old even though you’re relatively young. A shower helps ease the tension a little, but it still hurts like crazy to turn your spine and you are wondering how you will ever make it through the day. You call your doctor, and he calls in a prescription for muscle relaxers and a pain reliever. You know the meds will make you groggy, but you don’t know what else to do.

Does this sound familiar? 8 out of 10 people will experience back pain at some point in their lives. It is most common in people age 40-80, and more prevalent in women than men. Back pain is one of the most common reasons for lost time from work in the United States, and accounts for nearly 20% of injuries occurring at work.

Back pain may last for an hour or two, a day, several days, weeks, or become a chronic problem. It may be caused by muscle spasm, muscle strain, injuries to ligaments or discs, arthritis, tumors, or for no apparent reason at all. The pain can be steady and localized to the back, or it can radiate into the buttocks or down one or both legs. Sensation in the legs can be painful, or it can be weird and tingly. Some people report feeling weakness in their legs when their backs hurt.

Most adults over age 30 have a degree of degeneration in their spines with arthritic changes, disc compression, and some vertebral subluxation, yet relatively few have symptoms. Some people experience significant pain and x-rays or an MRI show no structural changes at all.

If you go to your doctor with back pain, chances are you will be offered a course of physical therapy. This can be extremely effective at stretching out tight muscles, strengthening weaker muscles, relieving pain, and restoring function. But for some people, the pain is too much to allow them to do the recommended exercises. Physicians also typically offer pain relievers which could be a prescription dose of an anti-inflammatory, a muscle relaxer, or even a narcotic pain reliever. Some will provide steroid cream to be rubbed onto the painful area.

Chiropractic is another commonly used treatment for back pain. Chiropractors relieve subluxations which, simplistically put, are joints which have become “stuck” in a way which is incompatible with optimal function. Studies have shown chiropractic adjustment to be more effective than medication for some back pain.

Acupuncture is another effective treatment. Insertion of tiny needles, sometimes near the site of pain and sometimes in distal areas like the hands and feet has been demonstrated in a number of studies to be more effective than medication, physical therapy, and exercise for treatment of low back pain. Additionally, people receiving acupuncture for their back pain have been shown to make 50% fewer appointments with their physicians for their pain than people with back pain who do not receive acupuncture.

Acupuncture is generally well tolerated, not painful, and inexpensive compared with other back pain care. What can you expect in an acupuncture treatment? The acupuncturist will ask questions about your back pain history. She may also ask about your sleep, digestion, body temperature regulation, and other pain. Depending on the acupuncturist, examination may be as simple as taking your pulse and looking at your tongue, or may be as complex as a complete orthopedic evaluation with range of motion, reflexes, strength and sensory testing. Once the history and examination are done, you will likely be asked to bare your back and lie down on the treatment table. Needles are inserted and may be connected to a machine which uses a small electrical current to stimulate the needles. You will be left to relax with the needles for 20 minutes or longer, and then the needles will be removed. Many acupuncturists include other modalities such as cupping, gua sha, moxibustion, or massage after the needles are removed. All of these help to loosen up tight muscles, stimulate blood flow to speed healing, and relieve pain. Some acupuncturists will apply a little metal ball to points on your ears which you can stimulate between visits to help when the pain worsens.

Treatment of back pain often seems like it is one step forward and one step backward for a while. Pain comes and goes. While there may be good and bad days, the overall direction should be positive. Better range of motion, more hours or days with less pain, improved ability to return to normal activities.

If you or someone you know is experiencing back pain, I urge you to get help as soon as possible. If what you are doing is not making the pain go away, try something else. Some people go through medications, physical therapy, chiropractic, AND acupuncture before they find the right combination of treatments to break the cycle of pain!

References:
Hutchinson AJ, Ball S, Andrews JC, Jones GG. The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature. J Orthop Surg Res. 2012 Oct 30;7:36. doi: 10.1186/1749-799X-7-36.

S Moritza, MF Liub, B Rickhia, b, c, TJ Xua, P Paccagnana, H Quand.Deutsche Zeitschrift für Akupunktur. Volume 55, Issue 3, 2012, Pages 25–26. Reduced health resource use after acupuncture for low-back pain.

Weiß, Johannes, Sabine Quante, Fuping Xue, Rainer Muche, and Monika Reuss-Borst. “Effectiveness and Acceptance of Acupuncture in Patients with Chronic Low Back Pain: Results of a Prospective, Randomized, Controlled Trial.” The Journal of Alternative and Complementary Medicine (2013).

Xu M, Yan S, Yin X, Li X, Gao S, Han R, Wei L, Luo W, Lei G. Acupuncture for chronic low back pain in long-term follow-up: a meta-analysis of 13 randomized controlled trials. Am J Chin Med. 2013;41(1):1-19. doi: 10.1142/S0192415X13500018.