Low Back Pain - Why it’s the #1 thing acupuncturists treat
As acupuncturists, we see patients with a wide variety of complaints. This week I have treated headaches, anxiety, excessive sweating, phantom limb pain, constipation, infertility, incontinence, neuropathy and so on. Some patients who seek acupuncture for something like insomnia, do not even know that acupuncture also treats pain, and vice versa.
Acupuncture is very effective for a variety of pain conditions, and that is why insurance will often cover acupuncture for the treatment of pain - nerve pain, pain from an injury, chronic pain, etc. Low back pain stands out because of the abundance of evidence that acupuncture is beneficial, as well as the lack of great treatment options within the standard medical model, and the prevalence of low back pain in the general population.
Why is low back pain so prevalent? I would argue that it has something to do with how sedentary we have become. Our backs do a lot to support us in our day to day activities, but we just don’t move in all the ways that humans used to. Back pain is often involved with other types of pain like sciatica, pelvic pain, even urinary issues and constipation. Back injuries often become chronic, reoccurring in times of stress or with a sudden “wrong” movement. They can keep us from doing the things we love like lifting up our kids, sports, or even just sitting comfortably to enjoy a movie. Surgical options, while they might be effective for a while, can result in scar tissue that limits long term mobility. Likewise, cortisone shots or epidurals provide temporary pain relief but do not necessarily help the area to heal in the long term.
Prevention is our best long term strategy to deal with low back pain, and I have a lot of ideas about that, but first, why is acupuncture such an effective treatment for low back pain? Acupuncture works on multiple levels. On the most basic level, the insertion of needles increases circulation to the affected muscles, nerves, ligaments and other tissues in the area of injury. Muscle trigger points (aka “dry needling”) are used to release tension in specific muscles that are tight or spasmed, helping them to relax and put less strain on joints. Acupuncture also works on nerves and connective tissue pathways, improving communication between the nervous system and other structures to restore balance. Relaxation of the nervous system also improves our pain response, reducing tension and allowing for the body to go into healing mode.
Acupuncturists evaluate to determine the likely cause of the low back pain from a structural perspective (bring your xray or MRI report if you have it!). And we also formulate a pattern diagnosis which includes contributing factors that are part of the cause or contribute to its reoccurrence. We treat that pattern with acupuncture and/or herbs, supplements and lifestyle advice. Something like magnesium, better hydration or specific core exercises may be the key to sustained relief.
You may have significant relief with a single acupuncture visit, but typically we expect to do a treatment series to achieve the most benefit. We can treat other complaints at the same time because we always approach you as a whole person with unique needs. These side benefits are often what make people fall in love with acupuncture.
Movement is the key to long term prevention for low back pain. This can look different for everyone but there are some key things to focus on. Core strength (your low back is part of your core, so this includes strengthening the low back) is essential. This can range from abdominal breathing to deadlift variations. Hip extension is also important because sitting involves having the hips flexed so much of the time, and those shortened hip flexors impact overall mobility. Walking is great for hip extension and so is yoga or simply lunges and split squats. I could go on, but let’s not underestimate the power of any movement. It helps to get blood flowing, loosen up muscles, regulate blood sugar and clear the mind. If you sit all day, it is better to get up and move for 5-10 minutes every hour than to squeeze in a 60 minute workout and otherwise be sedentary. If you are in too much pain to get moving, come get some acupuncture!
Want some help getting started with movements to help the low back? New York Times just created a gentle yoga routine for low back pain. My yoga teacher, Bonnie Weeks, has a class series available online for Low Back and SI Pain. The series is a one time purchase for $35, but feel free to check out her huge library of classes with a 7-day free trial. I can’t recommend her enough. If yoga is not a good fit, there are other movement practices that incorporate mobility work such as martial arts, pilates and functional fitness classes. It’s not just about getting out of pain, it is about the rest of your life. Studies show that mobility is strongly linked with longevity and reduced risk of disability and chronic disease, particularly in older adults. Maintaining good mobility, including flexibility, strength, and balance, is a key predictor of a longer, healthier life.
