How To Avoid the Leading Cause of Disability
Back pain is one of the most common health complaints across the globe, with an estimated 80% of people experiencing back pain at some point in their life.1 Not only is back pain the No. 1 cause of job disability,2 it’s also one of the most common reasons for opioid dependence, the side effects of which can be lethal. In fact, opioids are now the leading cause of death among Americans under the age of 50.3
According to a 2018 study,4,5 opioids — which modulate your brain’s reaction to pain — are the most commonly prescribed medications for people with chronic low back pain and, as you’d suspect, these drugs are typically used long-term in this population.
According to Pharmacy Times, about 20% of patients on long-term opioid therapy end up developing an opioid use disorder.6 Up to 25% of opioid users also end up with other substance-abuse disorders,7 which have additional risks.
The use of opioids for back pain flies in the face of guidelines8 from the American College of Physicians, which recommends heat wraps and exercise as a first line of treatment, stressing that prescription drugs should only be used as a last resort, as they completely fail to treat the underlying problem.
Research9 has also shown opioids (including morphine, Vicodin, oxycodone and fentanyl) fail to control moderate to severe pain any better than over-the-counter (OTC) drugs such as acetaminophen, ibuprofen and naproxen. In fact, those taking nonopioid pain relievers actually fared “significantly better” in terms of pain intensity.
Considering the immense risks associated with opioid use, you’d be wise to exhaust all other alternatives before jumping on that bandwagon to disaster. The good news is there are a wide variety of non-drug options available.
Unlearning Chronic Back Pain
Most recently, researchers have shown you can successfully reverse chronic back pain by retraining your brain with Pain Reprocessing Therapy (PRT).10 As reported by DW.com:11
“PRT aims to rewire neural pathways in the brain to deactivate pain and train the brain to respond to signals from the body more appropriately, using what’s called pain education. Ultimately, the goal is to reduce a patient’s fear of certain movements, so that when they do move in those ways, they are confident that it won’t cause them any pain.”
The article tells the story of one of the study participants, Daniel Waldrip, who had suffered chronic debilitating back pain for 18 years. One month after the conclusion of the study, Waldrip was 100% pain free, and he’s remained pain free in the four years since. “It completely changed my life,” he told DW.com.
Pain Processing Gone Haywire
If pain can be “unlearned,” what does that say about the nature of pain? Contrary to popular belief, chronic back pain is not always due to some structural or mechanical problem. More often than not, it’s actually caused by nerves sending incorrect or faulty signals to your brain. As explained by DW:12
“Pain is like an alarm system that alerts us when we may have hurt ourselves or become injured. But regardless of where a person hurts themselves physically, their sense of pain is formed in the brain.
Nerves send signals to the brain to let it know that something has happened in the body and the brain then decides whether to produce a pain sensation, and that depends on whether the brain thinks there is danger.
Pain draws a person’s attention to potential harm and diminishes when that warning signal is no longer needed. This is called acute pain … But pain that persists for more than three months despite treatment is considered chronic.
‘It’s really important that people are able to experience pain. It’s critical for survival, and yet some people [continue to have] pain even though their bodies have recovered,’ said James McAuley, a psychologist and professor at the University of New South Wales (UNSW).
While scientists have their theories, it is still unclear what causes chronic pain or how acute pain becomes chronic, said McAuley. But they do know that some changes occur in the brain when pain goes from acute to chronic.
‘The nerves are misfiring and advising the brain that the patient is having pain or is at a risk of damage,’ said Steven Faux, director of the Rehabilitation Unit at St Vincent’s Public Hospital in Sydney, Australia.”
In all, two-thirds of the volunteers in the PRT group were either pain free or nearly pain free at the end of the treatment, compared to just one-fifth (20%) of those in the placebo group. Functional MRI scans performed at baseline and at the end of the trial also demonstrated that pain processing in the brain had been noticeably altered.
The Importance of Staying Active and Minimizing Sitting
Staying active and minimizing sitting are two strategies that can go a long way toward preventing — and treating — back pain. Both will improve muscle strength and coordination, reduce stiffness and improve blood flow, which may reduce back pain and lower your risk of developing back pain in the first place.
Oftentimes, back pain originates from tension and muscular imbalances. For example, sitting for long periods of time ends up shortening the iliacus, psoas and quadratus lumborum muscles that connect from your lumbar region to the top of your femur and pelvis.
When these muscles are chronically short, it can cause severe pain when you stand up as they will effectively pull your lower back (lumbar) forward. By bringing these muscles into better balance, you will remedy many of these common pains and discomforts.
This was certainly true for me when I had debilitating back pain about 10 years ago that failed to respond to all interventions. The only thing that worked was to stop sitting for over 12 hours a day. I shifted to a standing desk and the problem permanently resolved: Address the cause and you typically have a cure.
Overuse and misuse of the muscles supporting your spine, poor muscle strength and inappropriate posture while sitting, standing and walking are other common causes of low back pain. For instance, when walking with your toes pointed outward, the muscles in your hips and lower back tighten, increasing your risk for lower back pain.
Sitting with your shoulders hunched over a computer screen stretches muscles in your upper back and places added stress on your lower back, increasing your risk for both lower and up
Article from LewRockwell