Winter isn't quite over yet and that means one thing for about 16 million of us: an aching back.
There's conflicting advice on whether the cold causes back pain. But we do know that when you're exposed to the cold, your blood vessels constrict to try and conserve heat. That means reduced blood flow to all the muscles, tendons, and ligaments in your lower legs. When those get stiff, it puts more strain on your lower back, which leads to soreness and pain.
What's more, drops in barometric pressure may also trigger inflammation. That can lead to pain and pressure on your joints, too.
But before you rush to your doctor for some pain meds, know that most people are dangerously overtreated for back pain. In fact, back pain is one of the top reasons people see their doctor – along with skin problems and joint issues.
I've said for years that you should treat any back pain with simple strategies first, like stretching, massage, and exercise. And a few years ago, the American College of Physicians ("ACP") issued a new guideline for doctors that backed up what I'd already said.
Their evidence-based guideline for low-back pain states that any patient should first receive a non-medication treatment. This includes things like:
- Heat therapy
I've written about these four treatments before and why the ACP recommends them (you can read the issue here). But my focus today is on massage.
Massage not only helps back pain, but also gets the lymph fluid moving in your body. That fluid carries immune system cells. So, it's a great boost to help you fight off colds this season.
The ACP found that massage worked best for people suffering from chronic low-back pain, and it does even better when combined with other therapies.
A study in BMC Musculoskeletal Disorders found that manual therapy – including stretching and massage – lowered pain intensity by 64% in 12 weeks. After a year, that number was still an impressive 58%...
Massage on its own helps relieve back pain, though there aren't many massage-only studies. An older study published in the Annals of Internal Medicine compared types of massage (structural versus relaxation) and found both provided relief to patients...
Both massage groups experienced less pain interfering with their daily living activities. What's more, these groups reported lower levels of pain and better symptom tolerability six months later as well.
The problem with massage is that it's not covered by insurance. But another pain treatment option is, though – acupuncture.
Several studies show the benefits of acupuncture for relieving joint pain, back pain, and pain caused by surgery or chemotherapy.
A German study last summer showed that for back-pain patients, acupuncture and classical massage had similar effectiveness. But massage still isn't covered. That's something we hope to see changed soon.
And if you're trying to figure out the best type of massage to get, consider going deep.
Last year, a Turkish research team performed a randomized trial for treatment of chronic low-back pain. They found that folks who received connective tissue manipulation had the best results. (Connective tissue is the type of body tissue that holds all of our structures together.) A few studies point to damage in this tissue linked to low-back pain. Adding in deep tissue massage that targets this type of tissue gave the most pain relief to participants. They also experienced better mobility after treatment.
Everyone appreciates a massage. I try to get a full-body massage at least once a month. And it's a great gift for a loved one...
I like to look on coupon sites like Groupon and LivingSocial for big discounts at a variety of local centers and spas. And you can also find discount codes on RetailMeNot for gift cards to Spafinder.com. Spafinder is a convenient way to search your city for nearby massage centers, yoga classes, and more. It also lets you search by discount offers with their "Wellness Search."
There are also tools you can use to give yourself a massage. I use a Body Back Buddy to help relieve aches in my back. (You can find them on Amazon for less than $30.)
And remember, massage alone is great for back pain. But you'll see better, longer-lasting results if you also try out the other therapies. Stretch, exercise, and use heat on those sore muscles. Taking time to meditate will do wonders for your health – not only for your aching back, but for your overall well-being too.
If these treatments don't work, your back pain may require medication. If so, first talk with your doctor about opting for an anti-inflammatory like ibuprophen. Some doctors overprescribe opioids. With the dangerous side effects of those drugs (including a high risk of addiction), use them as a last resort.
What We're Reading...
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
February 18, 2020