If you have ever suffered from low back pain, then you know how uncomfortable it can be. Simple everyday things such as putting on socks, sitting in a chair, sleeping in bed, and walking upstairs can become big challenges. Today I will explore how massage therapy can help relieve back pain symptoms.
Over 75 percent of adults experience back pain at some point in their lives. Those who are older or overweight are at a greater risk for developing back pain. This is not just something that impacts athletes or people who have physical jobs. Over 50 percent of Americans who have low back pain spend the majority of their workday sitting in a chair. Sedentary lifestyles are one of the main initiators of chronic back pain.
In addition to physical pain, back problems carry serious economic consequences. Low back pain is the second most common cause of disability in adults in the U.S., and the leading cause of missed workdays. Americans spend approximately $60 billion each year in medical expenses related to back issues.
What Causes Back Pain
Research is still being done to understand the root causes of back pain – however, we already know a lot today. First, let’s start with the symptoms.
Back Pain Symptoms
Back pain often takes the form of muscle aches. This is when muscles release a steady stream of throbbing that a person perceives as painful. A more serious symptom of back pain is muscle spasms. A muscle spasm is a sudden, involuntary contraction of one or more muscles. A spasm results from an abnormally sustained muscle contraction and is often painful. Muscle spasms can be acute or chronic, meaning that they can come on suddenly without warning (also known as a cramp or charlie horse) or be persistent and long-lasting, respectively.
Another symptom of back pain is shooting or stabbing pain. These can often be related to a ruptured disc or impinged nerve in the spine, but a person must consult a doctor to get a full evaluation.
Finally, a symptom of back pain can be what is called piriformis syndrome. This is a condition in which the piriformis muscle, located in the buttocks region, spasms and causes hip pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).
Back Pain from Stress and Inflammation
Today, a large percentage of back pain cases are due to excess inflammation in the body. Inflammation is the body’s response to injury and a vital part of the immune system’s response to injury and infection. It is the body’s way of signaling the immune system to heal and repair damaged tissue, as well as defend itself against foreign invaders, such as viruses and bacteria. However, poor nutrition, excess alcohol, and increased stress levels can all contribute to inflammation and also back pain. Stress is a significant concern. When the body is under long-term, low-level stress, it creates a hormone called cortisol, which triggers the body’s immune response which often leads to back pain caused by inflammation.
Back Pain from Strain or Injury
Another common source of back pain is injury or muscle strain. The most common is strained muscles and ligaments in the back area. Lumbar (lower back) muscle strains and sprains are the most common causes of low back pain. Muscle strains and sprains are common in the lower back because it supports the weight of the upper body and is involved in moving, twisting and bending. Lumbar muscle strain is caused when muscle fibers are abnormally stretched or torn. A lumbar sprain is caused when ligaments (the tough bands of tissue that hold bones together) are torn from their attachments. Both of these can result from a sudden injury or gradual overuse. Lumbar strain or sprain can be debilitating.
A more serious condition is herniated or ruptured disks. Herniated disks are also called ruptured or bulging disks, or slipped disks, although the whole disk does not rupture or slip. Only a small area of the disk is affected. Compared with a bulging disk, a herniated disk is more likely to cause pain because it generally protrudes farther and is more likely to irritate nerve roots.
Finally, overworked or stiff and tight muscles can also lead to back pain. Back pain can have causes that aren’t due to underlying disease. Examples include overuse such as working out or lifting too much, prolonged sitting and lying down, sleeping in an uncomfortable position, or wearing a poorly fitting backpack. When muscles that are connected to the back are stiff or overworked, such as the hamstrings and psoas muscles, this can create tension and pain in the back. Massage is especially helpful and important to help relieve symptoms in this final category which will be the topic of discussion in the next section.
How to Treat Back Pain
Each year, more and more U.S. health care dollars are spent treating back and neck pain than almost any other medical condition, but much of that money may be wasted, a new study suggests. Researchers from the University of Washington in Seattle found that the nation’s dramatic rise in expenditures for the diagnosis and treatment of back and neck problems has not led to expected improvements in patient health. Their study appears in the Feb. 13, 2018 issue of The Journal of the American Medical Association. After adjustment for inflation, the total estimated medical costs associated with back and neck pain increased by 65% between 2007 and 2015, to about $86 billion a year. That is in line with annual expenditures for major conditions, including cancer, arthritis, and diabetes.
Yet during the same period, patients reported more disability from back and neck pain, including more depression and physical limitations.
What does this say? It’s saying that traditional Western treatments are not being effective for back pain and that we need to look to other treatments such as massage therapy.
Traditionally, back pain has been treated with western medications such as Over-the-counter (OTC) pain relievers like NSAIDS, muscle relaxants, narcotics such as opioids and antidepressants.
NSAIDs. NSAIDs are often the go-to drugs for back pain relief. They can be purchased over the counter (or, in higher doses, by prescription) and include ibuprofen (Advil) and naproxen (Aleve).
NSAIDs help reduce pain, swelling, and inflammation in muscles and around damaged spinal discs or arthritic joints. Acetaminophen (Tylenol) is also a pain reliever and often sold alongside NSAIDs, but it’s not an NSAID and does not help with inflammation.
Because NSAIDs are easy to get, people tend to overuse them, which can expose them to possible side effects like stomach pain, ulcers, bleeding, or even kidney damage.
Opioids. When back pain becomes more severe, a doctor may offer a stronger prescription drug like an opioid. Opioids, such as oxycodone (OxyContin) and an acetaminophen/ hydrocodone combination (Vicodin), interact with receptors on nerve cells in the body and brain to reduce pain.
Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce a euphoric effect, there is a chance of addiction. They should be considered a last resort after careful consideration with your doctor due to the possible risk factors and addictive qualities.
Muscle relaxants. Prescription muscle relaxants act on the central nervous system to reduce acute pain for the short term and are often recommended when muscle spasms are present. However, many make you drowsy, so you have to be careful about how you use them.
Antidepressants. Doctors prescribe certain antidepressants off-label to help manage pain, including chronic low back pain, even if the person is not depressed. Some research has found duloxetine (Cymbalta), which is used to treat depression and anxiety, to be one of the more effective antidepressants for treating pain.
Keep in mind that the traditional medical solutions to back pain only treat the symptom and very often have adverse effects on long term health. When it comes to soft tissue injury or pain, western doctors tend to be at a loss, sending you off with prescription drugs, but not leaving you with a true remedy for your suffering, and feelings of hopelessness and depression. Medications also do not get at the source of the problem whether it is stress, an underlying injury or another issue.
As anyone who has ever enjoyed a soothing spa massage might testify, bodywork can relax the muscles and undo tense knots. Beyond that, researchers are still identifying the precise ways that massage can alleviate long-term pain. One possibility is that regular massage can reduce the body’s production of the stress hormone cortisol and a neurotransmitter linked to pain, and it boosts the level of mood-enhancing serotonin, according to the Arthritis Foundation. This can mute pain caused by both skeletal issues, such as the typical disc degeneration of aging, or spasms in the muscles caused by overuse and poor posture.
Massage Therapy helps release tight muscles, release surrounding muscles (QL, glutes, hamstrings, psoas, hip flexors, neck, etc.). A good massage therapist also works with your body’s fascia. Fascia is the biological fabric that holds us together. It is a thin, tough, elastic type of connective tissue found between the layers of muscle fibers, between muscles, around organs and connected in a web throughout the entire body.
Many people hold stress in their muscles, causing the muscles to become contracted or inhibited. It is believed that fascia can create tight knots or adhesions that act as trigger points, constrict muscles, and decrease blood supply, causing pain and decreased range of motion. And yes, quite often, back pain!
Therefore, regular massage is a great tool to help decrease your back pain while avoiding powerful medications.
If your back pain is associated with misalignment of the spine, I do recommend also seeing a chiropractor in conjunction with regular massage. Please speak to me as I have several recommended chiropractors in the area. Don’t just go to anyone!
And finally, as with most issues related to healing, it’s very important to have good nutrition, rest, and self-care routines. These are all things I am happy to speak to you about and hopefully, I will blog about in the near future.