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Back pain relief:

Traditional or alternative treatment?

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June 22nd, 2016

Back pain is a fact of life for up to 80% of older adults, according to the National Institute of Neurological Disorders and Stroke (NINDS). This pain can have numerous causes, but in seniors it is often due to degenerative changes in the anatomy. “The gel-filled discs that act as shock absorbers in the back deteriorate over time,” says James McGowan, M.D., pain management specialist at the Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore, Md. “The pain spreads outward to other structures and muscles in your back.”

Arthritis is another common cause. “Any of the back joints can develop arthritis,” McGowan says. “Having arthritis can predispose you to other back problems such as spinal stenosis and nerve damage.”

Pain and quality of life

Studies show that the influence of pain on functional disability and quality of life is significant. In fact, the longer pain persists, the more profound the effects and the harder it can be to reverse the downward trend in daily functioning. Chronic back pain is associated with depression, and some researchers have found an association between back pain and an increased risk of heart attacks. 

Research studies have also shown that back pain is an independent risk factor for falls among older adults, especially women. “Bone density screening can be an important defense against wrist, hip, or spine fractures that occur from falling or as a result of degenerative bones,” says Raymond J. Hah, M.D., assistant professor of clinical orthopedic surgery at Keck Medicine of University of Southern California in Los Angeles.

Even though back pain is such a significant burden for many people, scientists have not discovered any magic cures, nor are they likely to. “Treatment should be based on the severity of the cause and how much the resulting pain affects your daily life,” Hah says.

Traditional treatment

Medications, which are usually part of a pain management plan, work within the brain or directly at the site of pain to provide relief. Examples of medications for back pain include analgesics, anti-inflammatories, anticonvulsants (which stabilize nerves), muscle relaxants, antidepressants, and counter-irritants (topical medicines).

Years ago, patients with back pain would have been told to get plenty of bedrest. But decades of research evidence reveals that physical activity is at the heart of treatment for back pain. While a short period of bedrest after certain types of surgery or trauma might be recommended by your doctor, most people should get up and move. A physical therapist can be a crucial part of your activity plan. “Physical therapy strengthens the supporting structures of your back, which takes the pressure off your discs,” McGowan says.

Other important parts of a back pain reduction plan include ergonomic adjustments, weight loss, and smoking cessation.  “There is a significant link between smoking and back pain,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich. “Research shows that smoking may impede blood flow to the spine and interfere with healing.”

Complementary medical treatments

The adverse effects of medications limit treatment options for older adults who are taking several other medications for underlying health problems. Thus, more research has been focused on complementary (alternative) medical treatments, and some have been gaining favor in the mainstream as viable options.

Chiropractic care has always been a popular choice for back pain relief. Chiropractors use spinal adjustments and other therapies such as hot or cold treatments; electrical stimulation; rehabilitative exercise; and counseling about diet, weight loss, and other lifestyle factors. “Research supports the effectiveness of chiropractic care for back pain,” says Thomas Morris, D.O., medical director at Ashby Ponds, an Erickson Living community in Ashburn, Va. “It can help decrease pain and increase flexibility and mobility.” 

More people are turning to the ancient techniques of acupuncture. Although most studies show that acupuncture is safe, its effectiveness for seniors with low back pain is unclear. One issue is that there is no one-size-fits-all acupuncture procedure. “Most research reviews of acupuncture have shown no consistent pain-relieving efficacy to this technique,” says Matt Narrett, M.D., chief medical officer of Erickson Health Medical Group. 

Yoga, biofeedback, and meditation are all mind-body practices. Although a few studies show that mind-body practices alone may provide short-term pain relief, the best evidence for their long-term effectiveness is when they are combined with a comprehensive traditional treatment program. 

In fact, research shows that a combination approach is probably best for most people. Any new treatment that you want to try should be discussed with your doctor. “Even something that seems harmless might not be best for your health,” Suneja says. “Your safety needs to be a top priority.”

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