Ouch — you are hurting. The good news is you are not alone. An estimated 100 million Americans suffer from chronic pains of all kinds. According to the National Institutes of Health, eight out of 10 people will have back pain at some time in their life. The month of September is designated Pain Awareness Month by the American Chronic Pain Association.
Why do we hurt?
As a pain management physician, my personal theory is that our pain is derived from standing upright most of the time. In animal skeletons, the orientation of the spine is horizontal. For us humans, after our first birthday, our spines are mostly vertical. I don’t think the spine was designed to be vertical, so we spend decades doing things with our spines that it was not designed to do. When we are horizontal, in order to sleep or swim or watch the ballgame from our lounge chair, the aches usually go away — until we get up again.
Why bother to relieve pain?
Uncontrolled pain keeps us from participating in life. We become a burden on others, and we become less healthy with a shorter life span.
So, what can we do?
- We can improve our body weight with diet and exercise. The low back has a normal convex forward curve called lordosis. With weight gain, the growing gut starts to tug on this curve, placing more force in such a way as to exaggerate the curve and stress the joints in the back of the spine. The additional vertical load, will also squeeze the discs and bones. Sooner or later, pain will develop.
- We can move more. Stretching can prevent muscle aches and keep nerve pathways open. Yoga, McKenzie, and other methods can be easily learned and are usually helpful. Regular steady exercise will stimulate blood flow through the entire body, including the spine. This will carry away inflammatory chemicals and replenish spinal structures with nutrients and life-giving oxygen. Also, with steady exercise, the body will produce two classes of chemicals that resemble morphine, sometimes causing “runner’s high.” The effect on body aches is predictable — it usually feels better.
- We can build muscle. The back is more than just the spine. It is the core muscles of the back, flanks and abdomen that keep us upright. Keeping the core muscles strong helps to reduce loads carried on the spine. In my opinion, if every adult spent 5 minutes daily doing core strengthening exercises, the need for spine specialists would decline significantly. Although back supports are useful in specific circumstances, chronic use can allow the core muscles to weaken over time. Topical medications, including transdermal patches, may be useful for some superficial muscle aches, but penetration to deeper structures is limited as are the benefits. Similarly, applying heat or cold may calm down an acute muscle strain, but is not likely to be a long-term solution.
Getting back into life
Life is not predictable. Despite healthy behaviors, our spines can complain. Sometimes the pain shoots down an arm or a leg. Rather than suffer unnecessarily, or give up doing the things that make you happy, it makes sense to see your physician sooner rather than later. You may only need a core exercise program or massage or spine adjustment. An over the counter anti-inflammatory medication such as ibuprofen or naproxen can be helpful. Your physician may prescribe a muscle relaxant to relieve spasms that frequently accompany acute pain.
If those approaches do not give you much relief, your physician may order a picture of your spine and an evaluation by a spine specialist. In most instances, surgery is not needed.
More educational materials, including videos, are available at www.paineasedoctor.com.
Dr. Jonathan Herland is an Interventional pain physician focused on diagnosing and treating those with chronic spine pains in order to return them to activities that they love. In the past 20 years he has treated thousands of people at 8 locations — Pittsfield, Lincoln, Bangor, Dover-Foxcroft, Millinocket, Caribou, Presque Isle, Fort Kent and Calais.
