Say Goodbye to Back Pain

Julian Whitaker, MD

For years, back pain was Joe’s constant companion. Every morning he awoke with throbbing and stiffness in his lower back that got better as the day progressed, but never really went away. An avid backpacker, Joe managed to stay fairly active in spite of his discomfort. However, unrelenting pain can wear down even the best of us.

Joe tried over-the-counter drugs and months of chiropractic treatments with minimal results. He saw an orthopedic surgeon who ordered X-rays and an MRI, and gave him steroid injections that provided some relief, but the pain quickly returned. Then Joe picked up an issue of Health & Healing and read about a unique treatment we use at the clinic to alleviate chronic back and neck problems. Even though it wasn’t covered by insurance, he figured it was worth a try. Anything was better than living with pain.

Today, two years later, 60-year-old Joe feels like a million bucks. Last year he trekked 68 miles of Yosemite’s John Muir trail, and over the holidays he hiked the Grand Canyon—free from back pain.

“Why Didn’t My Doctor Tell Me About This?”

If you have chronic back pain, you’re probably familiar with steroid injections—shots of the hormone cortisone into the area around the spinal nerves to curb inflammation. These shots only help about half the people who get them and relief lasts a few weeks at best.

The therapy that eliminated Joe’s back pain, prolotherapy, also involves injections, but of a different sort. Prolo targets the ligaments, the bands of connective tissue that hold the vertebrae in proper position. When these ligaments are weak or lax, the spinal column becomes misaligned, triggering muscle spasms, compression and irritation of nerves, and pressure on disks that may lead to degeneration and herniation (bulging). During a typical prolotherapy session, dextrose or another sugar-based, slightly irritating solution is injected into the weakened ligaments, initiating a healing response that repairs and strengthens them. Once these supporting structures are strong and taut, symptoms disappear—not for weeks but for years.

So why hasn’t your doctor told you about prolotherapy? There’s no logical reason, other than the fact that MRIs and other expensive diagnostics, drugs, and surgeries are so entrenched—and profitable. Costs associated with the treatment of back pain approach $86 billion per year, a 65 percent increase over the past decade. Spinal surgeons are the best paid of all specialists, with an average yearly compensation of $670,000 and more than $1,350,000 for top earners.

To Cut or Not to Cut…

More than a million back surgeries are performed annually. For patients with sciatica (pain in the hip radiating into the leg caused by nerve irritation from a herniated disk), a lumbar diskectomy, or removal of segments of the offending disk, is the most popular surgical procedure.

Dartmouth Medical School researchers found that this surgery does relieve pain—but no better than noninvasive treatment. They assigned 501 surgical candidates to have either diskectomy or conventional treatment (physical therapy, drugs, etc.) and followed them for two years. Both groups reported substantial improvements in pain, function, and disability, but 5 percent of the surgical patients had complications, and 4 percent required repeat surgery within a year.

Another popular surgery is spinal fusion, in which two vertebrae are joined together with bone grafts in an attempt to stabilize the spinal column and relieve pain. This surgery, too, often improves symptoms, especially in patients with degenerative disk disease. But when a Norwegian study compared it with noninvasive treatment, both groups fared equally well. The difference? A price tag of more than $50,000!

I understand that anything promising relief is mighty attractive when you’re in pain, but as you can see, back surgery isn’t what it’s cracked up to be. And don’t get sucked in by “hard” MRI evidence of herniated or degenerated disks. Studies show that such abnormalities are very common, even in individuals who have no pain at all.

What About Drugs?

Drugs are the first treatment most people turn to, and they can certainly be a blessing during an acute bout of pain. However, prolonged use of virtually all pain-relieving medications spells trouble. Tylenol is hard on the liver and kidneys. Ibuprofen and other NSAIDs damage the stomach and intestinal tract. COX-2 inhibitors increase risk of heart attack. And opiates are highly addictive—you may recall Rush Limbaugh’s widely publicized problems a few years back stemming from his addiction to painkillers he took for back pain.

You can sidestep some of the adverse effects of prescription painkillers by applying them topically. Although few physicians seem to know about this—and they do require a prescription—NSAIDs, such as ketoprofen, and anesthetics, like ketamine, can be mixed into rapidly absorbed creams or gels by compounding pharmacies. When rubbed into painful areas, these preparations provide fast and often dramatic relief with little systemic drug absorption.

Incredibly, one in four primary care physicians actually prescribes antidepressants for patients with back pain. That’s right, antidepressants. These drugs offer the worst of both worlds: They’re dangerous and ineffective. In a recent study, researchers reviewed studies comparing antidepressants to placebos for treating low back pain and found zero evidence that these drugs do any good. In fact, they didn’t even relieve depression in patients who also happened to be depressed! If your doctor makes such an ill-informed recommendation, find yourself a new doctor.

Nature’s Pain Relievers

Whether your pain is short-lived or longstanding, you have options other than drugs. One is fish oil, nature’s richest source of anti-inflammatory omega-3 fatty acids. When 250 patients with chronic back pain took high doses of fish oil along with their NSAIDs or COX-2 inhibitors for an average of 75 days, 60 percent reported symptomatic improvement—and more than half discontinued their drugs altogether.

We also have good success at the Whitaker Wellness Institute with two herbal pain relievers, Asalixx (a white willow bark extract from Germany) and Univestin (a blend of two herbs). Both of these botanicals have proven to be as effective as—and infinitely safer than—COX-2 inhibitors in relieving pain. Additionally, magnesium and potassium supplements have been shown to improve chronic low back pain, likely by correcting disturbances in acid-base balance.

Vitamin D supplements may be beneficial as well. Deficiencies in this vitamin can result in softened bones, a condition called osteomalacia that may manifest as persistent back pain. Researchers tested the vitamin D level of 360 men and women who had suffered low back pain for at least six months and found that 83 percent of them were deficient in this nutrient. Study participants then took 5,000–10,000 IU of vitamin D per day for three months. Significant improvements were noted in all patients who initially had low levels, and in a majority of those whose levels were already in the normal range.

Noninvasive Therapies That Really Help

A number of other noninvasive therapies are also very helpful. Acupuncture has a 4,000-year-old track record of safety and efficacy in relieving back pain. Chiropractic manipulations restore spinal alignment, increase mobility, and decrease pain. Massage relaxes muscle strain and spasm, which are common causes of back pain. Biofeedback reduces muscle tension and pain perception. Physical therapy improves function and discomfort by strengthening the supporting musculature. Infrared light therapy increases circulation, promotes healing, and relieves pain. And electrical stimulation, such as microcurrent therapy, is one of the most popular therapies at the clinic for all types of pain.

I can’t guarantee that prolotherapy or any of the noninvasive treatments we’ve discussed will completely eliminate your back pain. No single therapy works for everyone, but most people will find at least one treatment that really helps. The bottom line is that no one should have to live with pain.

Recommendations

• If you’d like to receive treatment for back pain at the Whitaker Wellness Institute, call a Patient Services Representative at (866) 944-8253 or click here.
• Look for the supplements discussed in this article in your health food store or order by calling (800) 810-6655. Suggested daily doses are fish oil 1.2-2.4 g EPA, Asilixx 2 tablets twice a day, Univestin 500 mg, and vitamin D 1,000-5,000 IU.

References

• Al Faraj S, et al. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine. 2003 Jan 15;28(2):177–179.
• Martin BI, et al. Expenditures and health status among adults with back and neck problems. JAMA.2008;299(6):656–664.
• Weinstein JN, et al. Surgical vs. nonoperative treatment for lumbar disk herniation. JAMA. 2006 Nov 22;296(20):2441–2450.

Modified from Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.