New ways to ease back pain
Does your back always ache?
Back pain is chronic if it continues for more than 12 weeks, impacting 40% of young adults and 50% of older ones. Some of the most effective back pain strategies require no medication. People tend to take inappropriate medications such as muscle relaxants or opioids because some think that behavioural treatments are ineffective.
To help you ease chronic back discomfort, here’s a look at the research behind non-drug treatments and advice on how to use medication effectively.
The power of the mind
Research suggests that talk therapy may help you retrain your brain to experience less pain and cope better. With that in mind, no one means that your pain is not real or “all in your head.” The journal PAIN Reports published a study in September 2021 examining psychophysiological symptom relief therapy (PSRT), which addresses stress and other psychological issues that can contribute to persistent discomfort and helps break associations that may set off the pain, like bending or sitting. This study found that 64 percent of back pain sufferers who tried PSRT reported being pain-free six months later.
Also promising is pain reprocessing therapy (PRT), which “teaches people to perceive pain signals sent to the brain as less threatening.” In a JAMA Psychiatry study, 66 percent of participants with chronic back pain reported much less or no pain after four weeks of the therapy.
Because PSRT and PRT are relatively new and considered experimental, they are not always easily accessible or covered by insurance. Other talk therapy often is—and may be available in programs where patients work with a team of experts.
A study published in the journal Spine in 2019 found that people who participated for 10 to 12 weeks said afterward that their pain was less debilitating and that they felt less stress, depression and anxiety, which can cause muscle tension.
A prescription for good posture
Pandemic posture comes from slouching over a computer or tablet from the comfort of your couch, causing a rise in back and neck pain. It’s not natural to sit at computers for 8 to 10 hours a day at any age. Spending so much time on electronics may also lead to back muscle spasms and fatigue.
To help with posture-related pain, try sitting in a chair, not a couch. Sit with your back straight, your rear end touching the back of the chair, and your feet flat on the floor. You can use a small, rolled-up towel to help support your back and a footrest, a phone book, or a step stool to help your feet reach the ground while sitting. If you don’t have a chair that provides good back support, consider buying one. Take frequent movement breaks as well. Every half hour, get up and stretch or take a short walk to relieve pressure on your spine.
Practice good standing posture, too: Whenever you’re on your feet, remind yourself to stand straight and tall with shoulders back, abdomen pulled in, and feet shoulder-width apart.
Care for your core
While it may hurt to move around, staying active can ultimately help relieve back pain, says Daniel Park, MD, a spine surgeon at Beaumont Hospital in Royal Oak, Mich., and a spokesperson for the American Academy of Orthopaedic Surgeons. Weight loss, if appropriate, is also beneficial. “Even losing just 5 pounds takes about 20 pounds of pressure off your spine,” Park says.
But Louw may be the key to strengthening your back and core muscles—those around your pelvis, lower back, hips, and abdomen. These naturally weaken as we age, leading to a loss of back support. That can cause chronic pain and, in turn, make everyday activities like reaching to grab an item from an upper cabinet challenging.
Though core and back exercises are plentiful online, physiotherapists can teach you practical and safe strengthening moves.
Pain meds: What to try and what to skip
Medication for chronic back pain “should be an adjunct for older adults and not the main treatment. It’s important to be cautious and use the lowest dose possible for the shortest period.” Here’s what to know about over-the-counter (OTC) and prescription medication options.
Over-the-counter drugs: Nonsteroidal anti-inflammatories such as ibuprofen (Advil, generic) are usually the first treatment of choice but may not be appropriate for older adults because frequent use may raise heart attack and GI bleeding risks. (The same goes for prescription anti-inflammatories.) You can try acetaminophen (Tylenol, generic) for a week or two, staying under 3,000 mg daily
Prescription drugs: If pain persists after a few months, you can ask your doctor about the antidepressant duloxetine (Cymbalta, generic). Groups like the American College of Physicians advise against addictive opioids like oxycodone (Oxycontin, generic) as first-line therapy for similar reasons. Older adults should use muscle relaxants with caution as they can cause dizziness and increase falls.
How to handle a ‘back attack.’
If your back starts to hurt suddenly, consider this expert advice:
- Ice it intermittently. After a few days, try applying a heating pad or heat wrap.
- Take acetaminophen, following package directions, for three to five days.
- Move around as you can.
- At night, lie on your side with your upper knee bent and a pillow between your knees.
Alert or see your doctor ASAP if:
- You are experiencing unusual symptoms like incontinence, pain or weakness in your legs. These may signal a serious issue.
- You have fallen or injured yourself.
- Have osteoporosis, and back pain is sharp and jolting. You’ll want your doctor to rule out a compression fracture.
Tell your doctor if you:
- Have fever along with sudden back pain or are in discomfort even when you are lying down.
- Find that the pain lingers for more than four weeks.