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Eight out of ten Americans will experience a backache at some point. Back pain is the second most common reason for visits to the doctor in the U.S. The causes of lower back pain are numerous.
Chronic Lower Back Pain. Most medical physicians rely too heavily on diagnostic tests, especially for lower back problems. As a consequence, many patients that suffer from lower back pain do not find relief: the tests may show that little is wrong, or show abnormalities that are not the cause of the problem. In one magnetic resonance imaging study of 98 people, none of whom had back pain, bulging disks were detected in 52% at one or more intervertebral disks and 27% had protrusions. These findings emphasize the importance of matching test results with the patient's description of symptoms before contemplating surgery. Some specialists recommend being very conservative in managing patients with back pain. Before ordering an MRI there really should be a reason.
Causes & Development
Acute Lower Back Pain is usually due to muscle strain.
Some causes of chronic low back pain include: prostatitis, hidden food allergies, hypothyroidism, autointoxication or intestinal toxemia (self-poisoning by harmful gut bacteria), mercury toxicity (if stored in the sensory ganglia near the low back), arthritis, kidney involvement, and psychological issues. In women, gynecological conditions such as endometriosis, menstrual cramps, fibroid tumors, and pregnancy are sometimes the cause.
Diagnosis & Tests
Further diagnostic work is not necessary for acute back pain unless there are red flags such as:- Possible fracture (following major trauma, or minor trauma in older patients or patients who may have osteoporosis)
- Possible tumor or infection of a patient aged over 50 or under 20, a history of cancer, constitutional symptoms such as fevers, chills and weight loss, risk factors for spinal infection, recent bacterial infection, intravenous drug use or immunosuppression, pain that is worse when lying on back, or severe night-time pain.
- Possible cauda equina syndrome (saddle anesthesia, bladder dysfunction, severe or progressive neurologic dysfunction in the legs, lax anal sphincter, major motor weakness in quadriceps (knee extensors), ankle plantar flexors, evertors, and dorsiflexors (foot drop).
Treatment & Prevention
Found Not to be Helpful: Traction - In evaluating 151 patients over 6 weeks for nonspecific low back pain it was found that traction was not effective for patients with low back pain. ["Efficacy of Traction for Non-Specific Low Back Pain: A Randomized Clinical Trial", by Beurskens, Anna, J., et al, The Lancet, December 16, 1995;346: pp.1596-1600]
Back Belts. In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain. [JAMA. 2000;284: pp.2727-32]
Prognosis
Approximately 90% of patients with acute low back pain recover within 4 weeks without therapy.
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Signs, symptoms & indicators of Low Back Pain: | | | | | Symptoms - Skeletal |  Lower back pain (confirmed)
 Having poor posture | A lifetime of poor posture and poor lifting and bending habits may stress ligaments posterior to the intervertebral disk to the point that even a minor stress precipitates a herniation and low back pain. |
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Conditions that suggest Low Back Pain: | | | | | Nutrients |  Copper Deficiency| | A copper deficiency has been associated with weakening of connective tissue that can be a contributing factor for the development of slipped or herniated discs. |
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Risk factors for Low Back Pain:
Low Back Pain suggests the following may be present: | | | | | Autoimmune | Ankylosing Spondylitis| | The inflammation occurring in cases of ankylosing spondylitis usually starts around the sacroiliac joints i.e. the areas where the lower spine is joined to the pelvis. The pain is worse during periods of rest or inactivity, often awakening patients in the middle of the night. Symptoms typically lessen with movement and exercise. Over a period of time, pain and stiffness may progress into the upper spine and even into the chest and neck. |
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Infections |
West Nile Virus |
Nervous System |
Guillain-Barre Syndrome| | Pain in the lower back, buttocks or thighs is common, and is often the earliest symptom. |
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Tumors, Malignant |
Ovarian Cancer |
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Recommendations and treatments for Low Back Pain: | | | | | Action |  Book Reading| | John E. Sarno, MD, has successfully educated a high number of chronic low back pain sufferers by teaching them how psychological issues can be converted into back pain. The pain is then eliminated or controlled by a new awareness of the real reason behind the pain. When no structural or organic cause is detected, his success rate is 80-90%. All required information is in his book, The Mindbody Prescription. |
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Amino Acid / Protein |
L-Phenylalanine| | The brain responds to pain signals by producing and activating morphine-like hormones called endorphins. This pain relief effect lasts for about 30 hours (longer than known analgesics), and without side-effects when given frequently. It was discovered that d- and dl-Phenylalanine (DLPA), but not l-Phenylalanine, inhibit several of the enzymes responsible for endorphin destruction. DLPA appears to restore endorphin levels to a normal range, while simultaneously producing a reduction in pain. It often equals or exceeds morphine or other opiate derivatives in its effect and is non-addictive. Start with 500mg qd and work up to 3-4gm qd. This is a precursor for epinephrine and phenylethylamine (PEA). PEA has amphetamine-like stimulant properties. Chocolate contains high levels of PEA. |
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Botanical |
Boswellia| | Boswellin is a standardized extract from the Boswellia Serrata tree in India. It is the first herbal remedy to have documented clinical evidence that it is useful in rheumatoid arthritis, osteoarthritis, low back pain, soft tissue rheumatism and myosistis symptoms. |
Chlorella| | Chlorella or other algae may reduce circulating toxins and bowel autointoxication, and consequently improve chronic lower back pain. |
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Diet |
 Increased Water Consumption| | Drink lots of water to maintain optimal hydration for disc integrity, and help reduce any acid buildup in muscles. Often two large glasses of water helps within minutes. Consistent rehydration may eliminate and prevent future low back pain. |
Therapeutic Fasting |
Digestion |
Bromelain| | See the link between Lower Back Pain and Digestive Enzymes. |
Digestive Enzymes |
Drug |
NSAIDs| | Use pain medication, if necessary, such as Tylenol, Aleve or another NSAID, such as aspirin. |
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Habits |
 Posture Improvement| | Be careful when getting out of bed. Turn to your side, bring your knees up, and then push up as knees swing down toward the floor. Most importantly, always follow the advice "bend with your knees, not your back" - especially when lifting heavy objects. Better still, don't lift heavy objects!
There is a particular exercise that has relieved back pain that occurs after prolonged periods of sitting. The technique is: "Sit up straight. Put your feet on the floor, then raise both feet off the floor at the same time 1 inch. This lightens the abdominal muscles and is the sitting-up equivalent of the old bent knee sit-up exercises". This exercise can be done almost anywhere. |
Aerobic Exercise| | For ACUTE lower back pain, exercise should be avoided during the recovery period. [The New Eng J of Med. Feb. 9, 1995;332(6):35 pp.1-55]
However, in cases of CHRONIC lower back pain, normal activity produces better recovery than bed rest, so you should stay mobile. The success of using exercise as a treatment of low back pain and rehabilitation is overwhelming. The tissues of the vertebral column need the stresses of exercise, even under conditions of back pain. Exercises to strengthen the back and abdominal muscles can be useful, but only after recovery from the acute phase. |
Weight Training| | See the link between Lower Back Pain and Aerobic Exercise. |
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Mineral |
MSM (Methyl Sulfonyl Methane)| | Many have reported that the use of MSM has relieved chronic lower back pain and spasms/cramps. |
Magnesium| | Some doctors consider the use of magnesium to be beneficial for reducing muscle spasm. |
Molybdenum| | Margaret Moss, MA, found that taking oral molybdenum over a 28-day period produces a "statistically significant improvement" in patients with arthritis and other aches and pains as well as in their general health. Moss monitored
14 middle-aged people with symptoms of arthritis, low back pain, frozen shoulder, rheumatoid and osteoarthritis, as they took 400-500mcg daily (in 4-5 doses of 100mcg) of molybdenum amino acid chelate. |
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Nutrient |
TMG (Tri-methyl-glycine) |
Oriental Medicine |
Acupuncture| | Acupuncture can help in cases of chronic lower back pain. |
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Physical Medicine |
Calming / Stretching Exercises| | Yoga has consistently been used to cure and prevent back pain by enhancing strength and flexibility. Both acute and long-term stress can lead to muscle tension and exacerbate back problems. A number of components of yoga help to ease back pain. Yoga postures provide gentle stretching as well as movements that increase flexibility and help correct bad posture. Breathing exercises can affect the spine in various ways, such as movement of the ribs and changes in pressure within the chest and abdomen. Exhaling can help relax muscles; relaxation provides a physiologic antidote to stress. |
Neurostructural Therapy| | Neurostructural therapy can help remove chronic low back pain permanently. |
Hydrotherapy| | A warm bath with Epsom salts and/or heating pad two to three times for 20-30 minutes or longer, can help. |
Manipulation| | Spinal adjustment can help in acute cases, but not in chronic cases unless a single adjustment proves helpful. |
Not recommended:
 Rest| | Inactivity is definitely detrimental to patients with low back pain. |
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Surgery/Invasive |
Prolotherapy| | Chronic lower back pain is one of the easiest conditions to treat with prolotherapy. See Pain, Pain, Go Away, by William J. Faber, DO and Morton Walker, DPM. |
Surgery| | Some dentists report treating chronic low back pain patients by removing infected bone in the third molar area. Chronic fatigue and arthritic pain disappear in many patients with these conditions after removing dental infections. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | May do some good | | | Likely to help | | | Highly recommended | | | May have adverse consequences |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Adrenaline (Epinephrin, Epinephrine)
A hormone secreted by the adrenal medulla that is released into the bloodstream in response to physical or mental stress, as from fear or injury. It initiates many bodily responses, including the stimulation of heart action and an increase in blood pressure, metabolic rate, and blood glucose concentration.
Aerobic (Aerobically)
Using oxygen. For example, aerobic exercises such as running, swimming, bicycling or playing tennis use up lots of oxygen and burn up lots of calories and fat.
Allergy (Allergies)
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Amino Acid (Amino Acids)
An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.
Analgesic
Agent which relieves pain without causing loss of consciousness.
Anesthesia
Loss of sensation caused by neurological dysfunction or a pharmacological depression of nerve function.
Anti-inflammatory (Antiinflammatory)
Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.
Arthritis (Arthritic)
Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Chlorella
A freshwater, nutritive, single-celled green algae superfood; a regenerative tonic, blood builder, anti-viral, anti-biotic, and anti-carcinogenic that enhances the immune system. It facilitates heavy metals being removed (chelated) from the body.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Chronic Fatigue Syndrome (CFS, Chronic Fatigue)
A disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.
Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.
DLPA
D.L-Phenylalanine: A 50-50 mixture of d-phenylalanine and l-phenylalanine. May help alleviate chronic pain by increasing endorphin activity (the body s natural painkillers).
Endometriosis
A condition whereby endometrial tissue builds up in parts of the uterus where it does not belong or areas outside of the uterus, forming 'ectopic implants'. Unlike the normal tissue lining the uterus, ectopic tissue has no place to shed in response to a decline in estrogen and progesterone. This results in debris and blood accumulating at the site of the implant leading to inflammation, scarring and adhesions that ultimately cause symptoms and complications. Symptoms typically occur in a cyclic fashion with menstrual periods, the most common being pelvic pain and cramping before and during periods; pain during intercourse; inability to conceive; fatigue; painful urination during periods; gastrointestinal symptoms such as diarrhea, constipation, and nausea.
Endorphins (Endorphin)
Natural polypeptide opiate-like substances in the brain. One function of endorphins is the suppression of pain.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Extensor (Extensors)
A muscle that opens a joint.
Flexor (Flexors)
A muscle that closes a joint.
Ganglion (Ganglia)
A group of nerve cell bodies clustered together in a uniform mass outside of but often close to the brain or spinal chord. Nerves run to or from the ganglia in passage to or from the brain to specific sites on the body.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hypothyroidism (Hypothyroid)
Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.
Leiomyomas (Fibroids, Fibromyoma, Leiomyoma, Myofibroma)
Benign tumors of the involuntary muscle. An encapsulated tumor made up of disorganized and irregular connective tissue. The most common of these is the "fibroid" tumor that develops in many women. It is really a leiomyoma of the uterus.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Magnetic Resonance Imaging (MRI)
A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Microgram (mcg, Micrograms, ug)
0.000001 or a millionth of a gram.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Molybdenum
An essential trace element. It helps regulate iron stores in the body and is a key component of at least three enzymes: xanthine oxidase, aldehyde oxidase and sulfite oxidase. These enzymes are involved with carbohydrate metabolism, fat oxidation and urine metabolism. The average adult has about 9mg of molybdenum concentrated mostly in the liver, kidney, adrenal glands, bones and skin. Molybdenum deficiencies are associated with esophageal cancer, sexual impotency and tooth decay.
NSAID (NSAIDs)
Non-steroidal anti-inflammatory drug.
Osteoarthritis (Osteoarthritic)
A condition involving degeneration of cartilage and supporting joint tissue, which results in pain, swelling and reduced mobility, as the cartilage wears away and allows bone to rub against bone.
Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Papain
The protein-digesting enzyme derived from papaya.
Pelvis
The lower part of the abdomen between the hip bones. Organs in a woman's pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder and rectum.
Precursor (Precursors)
A biochemical substance, such as an intermediate compound in a chain of enzymatic reactions, from which a more stable or definitive product is formed.
Prolotherapy
A single or series of injections that stimulates the body to regrow, tighten, and strengthen ligaments or tendons. It is unequaled for pain relief and restoration of normal function for any body joint where connective tissue is weak or has been damaged.
Prostatitis
Inflammation of the prostate. The causes may be varied, ranging from infection to portal congestion to cancer to increased adipose estradiol release in the middle-aged male... to over-use.
QD
Once a day.
Rheumatism (Rheumatoid)
General term applied to conditions of pain, or inability to articulate, various elements of the musculoskeletal system.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Spasm
Involuntary contraction of one or more muscle groups.
Spondylitis
Inflammation of one or more vertebrae.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Last updated: Nov 08, 2009
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