When you are being consumed by the iron jaws of back pain, it's easy to forget what your lovely, ache-free days were like — and that there are methods of relief. Here are a few common ones.
Medical doctors used to wildly overreact to back pain, throwing drugs and surgery at the mystery, until the federal Agency for Health Care Policy and Research issued new clinical treatment guidelines in 1994. "The era of routine radiography, strict bed rest, corsets, and traction has passed," says Dr. Richard A. Deyo, a member of the AHCPR panel. "It's been replaced by early return to normal activity and greater emphasis on exercise to prevent recurrences or to treat chronic pain." Now your family practitioner is more likely to send you for some ibuprofen and to look at epidural cortisone injections or surgery only as last resorts.
Gone are the days when your HMO balked at covering chiropractic bills. The AHCPR also endorses manipulation as a safe and effective form of back pain treatment, largely stifling those accusations of quackery that dogged chiropractors in the past.
"Compression equals back pain," explains chiropractor Leroy Perry, president of the International Sports Medicine Institute. By twisting, pushing, or pulling the spine, a chiropractor relieves compression, thus increasing mobility. Long a satisfying avenue for a majority of lower-back pain sufferers, chiropractic certainly has allure — instant relief — over the ibuprofen approach.
It's a helpful oversimplification to think of osteopathic physicians as a cross between chiropractors and medical doctors. An osteopath will crack your back just like a chiropractor, but D.O.'s also enjoy the same legal status as medical doctors, meaning they can diagnose and treat illness, employ medical technology, prescribe medications, and perform surgery. However, the osteopathic approach tends toward the noninvasive: They prefer to lay hands on the musculoskeletal system, help to improve posture, and prescribe prevention by exercise. For osteopaths, tugging on the spine is only the starting point for curing what ails you, whereas it's the raison d'Štre for chiropractors.
Widely accepted for treating chronic symptoms, acupuncture can also alleviate acute back problems. "If you walk into an acupuncturist's office with low-back pain, there's a good chance that you'll feel better in the next 24 hours," says Whitfield Reaves, cofounder of the National Sports Acupuncture Association. In Eastern terms, acupuncture releases blocked energy (qi, pronounced "chee") that should flow freely through so-called meridians in the body, thereby restoring homeostasis. If you must look at it from a Western point of view, studies suggest that needling certain points on the body boosts the production of endorphins, those feel-good hormones familiar to athletes of any bent.