Q. Every once in a while, without overdoing, my back “goes out.” It isn’t bad enough to see the doctor, and I’m nervous about trying a chiropractor. What else is possible?
A. You are in the same boat as about 80% of Americans who suffer occasional low back pain. About half the time it can be managed with simply giving your back a rest. Otherwise there are several things to try, with considerable hope that at least one of these remedies will help.
First, check to see if there is a removable cause for the backache. The common contributors are improper lifting, sitting for long periods of time (driving for instance), and wearing high heels or uncomfortable shoes. Pregnancy is not a removable cause, but it does often require extra rest time.
A combination of B-vitamins has proven useful for preventing the common type of back pain that results from overexertion. The research on these vitamins involved very high amounts, the amounts you would get by taking two or three of the “B-50” tablets per day, so you shouldn’t use these quantities for more than three months or so unless you have professional evaluation. Always take these vitamins with food, and don’t be alarmed when your urine becomes bright yellow. Magnesium supplements of several hundred milligrams (mg) per day can be tried, but if it provokes diarrhea, decrease it.
Athletes for years have used certain anti-inflammatory enzymes to relieve the pain of back injuries. Double-blind trials using supplements of a combination of two of the enzymes found in pancreatin, trypsin, and chymotrypsin, for low back pain found statistical improvement. Bromelain and papain, enzymes from pineapple and papaya respectively, also have good reputations among athletes for relieving the aches and pain of minor sprains.
Research involving humans suggest that an amino acid, D-phenylalanine, reduces pain by hindering the breakdown of endorphins. Endorphins are the natural pain relievers released by the brain in response to trauma. D-phenylalanine is the mirror image of L-phenylalanine, the amino acid natural to our body, and unless you have a tendency toward hypertension (high blood pressure) you can try it at 500 to 1,500 mg per day. It is easiest to find in combination with L-phenylalanine and will likely be labeled as “DL-phenylalanine.”
Topical cayenne pepper, now available as a special extract called capsaicin, has been used for centuries to reduce pain. Capsaicin cream causes a burning sensation the first few times it is used but this decreases, and the pain also decreases with each application. This odd observation results from depletion of substance P by capsiacin. Substance P is one of the chemical messengers that induce pain, so although it is initially increased, once the local supply is consumed there is reduction of pain. When you use it, avoid transferring the cream from your hands to your mouth, nose, or eyes, since this can produce extreme discomfort. Also, capsaicin cream should not be applied to broken skin.
Topical aspirin cream is available and can be used in much the same way as capsiacin cream. Aspirin cream works like oral aspirin but is more concentrated in the afflicted area to reduce inflammation and relieve pain.
If you are apprehensive about chiropractic intervention, acupuncture may not be any more attractive, but both have proven effective in some cases and deserve consideration.
Low back pain costs us a lot, in lost work time, even sometimes unnecessary surgery. If a simple remedy restores your ability to function, it pays big dividends.
This article appears in February 1 • 2002.