CHRONIC LOW BACK PAIN: CONSUMER REPORTS GIVES THE SCOOP ON ALTERNATIVES
As I read through this month’s issue of Consumer Reports (Real Relief From Back Pain), there were several things that stuck out to me, the first being that active therapies (Yoga / Tai Chi) finished in first place as far as both efficacy and patient satisfaction were concerned; almost 90%. This should not be surprising considering that just a few days ago, the Annals of Internal Medicine released a study (Yoga, Physical Therapy, or Education for Chronic Low Back Pain. A Randomized Noninferiority Trial) which concluded that yoga was just as effective as physical therapy for chronic low back pain.
Of the over 3,500 chronic low back pain sufferers that Consumer Reports interviewed for their article, coming in third place at 83% (one point behind massage therapy and eight points ahead of physical therapy) was CHIROPRACTIC. Interestingly enough, four of the bottom five places were held by medical specialties. For instance, going to your family physician came in second to last and was rated 20 percentage points below going to a chiro. Why is this?
It seems that people are becoming increasingly interested in actually addressing their problems rather than taking drugs (with chronic back or neck pain, you will almost always end up with prescriptions for “THE BIG FIVE“). In fact, the author clearly stated that, “the first line of defense should be non-drug measures“.
Consumer Reports went on to say that, “Back pain is one of the main reasons people go to the doctor, accounting for more than 24 million visits each year…” Why might the drug free / surgery free approach be the best first approach to dealing with chronic low back pain?
After mentioning chiropractic treatment along with a few other conservative approaches, the author stated, “It used to be that those treatments were considered fringe, but no more. Growing research shows that a combination of hands-on therapies and other nondrug measures can be just as effective as more traditional forms of back care, including drugs and surgery. And they’re much safer.” Although many of you are already in the know, why would they be safer?
Namely because the Big Five (NSAIDS, CORTICOSTEROIDS, OPIOID PAIN MEDICATION, MUSCLE RELAXERS, and ANTIDEPRESSANTS) are, in a word, dangerous. In fact, study after study shows these approaches are more dangerous than we were ever led to believe. One of the MD’s being interviewed for this article actually stated that, “what has been considered conventional care [see above] can actually short-circuit healing“.
Darn straight it can, and this is not some new revelation. It’s just that the evidence for this has become so overwhelming that there is no way to gloss over it anymore. The opioid epidemic is a great example of this. And even though the problems with the others listed with opioids are not as well known, they are in many cases, just as bad or worse.
Under the header labeled Too Many Tests and Treatments?, the author gives us several physicians talking about the phenomenon of OVERDIAGNOSIS & OVERTREATMENT and then saying, “conventional approaches don’t always work and can cause other serious problems…. Conventional medicine often fails because it focuses on the broken parts.” What does this really mean? For starters, how many of you reading this realize how crazy much radiation one gets with a CT SCAN? Or why MRI’s are frequently used as an excuse to do SPINAL SURGERY (or other kinds of surgery) on those who don’t really need it (HERE)?
The authors also talk about a phenomenon I have addressed here; the fact that it is difficult to the point of impossible to try and correlate a patient’s symptoms to the DEGENERATIVE FINDINGS on their x-rays or scans.
Consumer Reports goes on to tell readers that there are five causes of back pain. At least two of them, HERNIATED DISCS and SPINAL STENOSIS can be effectively treated with SPINAL DECOMPRESSION THERAPY (a third, SPINAL DEGENERATION, frequently falls into this category as well). They did mention “muscles / soft tissues,” as a pain-generator, which is huge. Once you understand that most muscle injuries are actually injuries to the FASCIA, this point becomes that much bigger. This is particularly true in light of a very cool ten second video of a diagnostic ultrasound showing normal fascia side by side with adhesed fascia (HERE).
The final thing I want to mention here pertains to one of the several “missing links” I feel was not covered in this article. Under a section labeled Depression & Back Pain, Consumer Reports says, “up to half of people enduring pain for three months or longer also suffer from depression or another mood disorder.” Firstly, we can’t really say that this is surprising considering that people’s moods certainly change when they can no longer do their job, exercise, enjoy hobbies, or have sex, etc, etc, without pain.
All I can say is thank goodness Consumer Reports was not touting ANTIDEPRESSANT MEDICATIONS for chronic low back pain as many have. Instead they promoted CBT — Cognitive Behavioral Therapy. According to the National Association of Cognitive Behavioral Therapists, “Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events.” While this approach is great for many people and is completely non-invasive, my opinion is that it is not always true.
For instance, both Depression and each and every one of the five causes of back pain mentioned above are considered to be “INFLAMMATORY DISEASES” — diseases based on inflammation. And while anti-inflammation drugs mentioned earlier usually provide at least a degree of short-term relief (albeit at the expense of long-term degenerative changes and dysfunction), there are better ways to deal with inflammation (HERE).
In fact, if you are looking to not just cover up, but solve your chronic back pain (or for that matter your CHRONIC NECK PAIN), the foundation — the cornerstone — the building block — must include solving the problem of SYSTEMIC INFLAMMATION, which not surprisingly, was not addressed by Consumer Reports. If you are looking for a way to address chronic back or neck pain, a great starting point would be to READ THIS.