Back On Track
By Debra Bokur

Support your spine with holistic pain-relief therapies

Ellen Walden, a 35-year-old accountant, spends long hours sitting at a desk. As a result, her posture isn't as straight and sturdy as it once was. Lack of regular exercise, carrying a too-heavy backpack slung over one shoulder and wearing high-heeled shoes all contribute to her complaint: lower back pain.

She's certainly not alone. Back pain is the second-most-costly health problem in the United States, and the third-most common—and often unnecessary—reason for surgery, according to Jerome F. McAndrews, DC, spokesperson for the American Chiropractic Association. Although plenty of pharmaceutical drugs can dull persistent pain, Walden—like millions of Americans—is not seeking a temporary reprieve, but a solution to the underlying causes of her discomfort. Holistic therapies often can offer that relief. Here's a look at some of the most promising.

Massage
Massage comes in many strengths and styles, ranging from gentle Swedish to deep tissue manipulation. Kristin Lynn-Motter, certified massage therapist and student clinic director at the Baltimore School of Massage, explains that when using massage to treat back pain, it's important to address a variety of muscles. "You just can't separate the lower back from the rest of your body," she says. "For instance, when the hamstrings are too tight they can pull the lower back and pelvis out of balance."

Massage loosens muscle tissue, allowing it to relax and function normally. "It also increases circulation and the level of nutrients reaching the muscles as well as [increasing] the level of toxins leaving the body," adds Lynn-Motter. "By moving metabolic waste products out of the muscles and allowing oxygen and nutrients to move in, you can facilitate healing."

Massage might be a good choice for Walden because she is young enough to catch and correct posture problems before they become patterns. Massage would offer the added benefit of reducing stress. Pregnant women and those whose back pain is the result of trauma or injury should consult a health care practitioner before choosing massage therapy.

Acupuncture
Long a part of Traditional Chinese Medicine (TCM), acupuncture was recorded as a viable treatment in China as far back as 3,500 years ago. TCM practitioners seek to restore harmony to the body and its systems by facilitating the flow of qi (pronounced "chee"), or energy, via a network of meridians that runs throughout the body. One of the fundamental theories of TCM is that pain and illness are the direct result of stagnant or blocked qi. Acupuncture treatments seek to release this blocked energy with the insertion of needles along the meridians, restoring the body's systems to normal.

Jim Dowden, executive administrator of the American Academy of Medical Acupuncture (AAMA), says that back pain is one of the most common complaints addressed with acupuncture treatment. A number of mainstream studies in both the United States and Europe have shown acupuncture to be a viable treatment for pain relief, arthritis, and other musculoskeletal problems. However, while acupuncture is not usually painful, Walden has a needle phobia, making it a less-than-ideal choice for her.

Rolfing
Rolfing, a system of especially deep tissue work that helps align and balance muscles, aids both posture and mobility. In Rolfing, "We look at the whole person, the entire body, rather than just the troubled areas," says Larry Koliha, a Rolfing practitioner in Fort Collins, Colorado. What happens in your foot can cause a reaction in your hip, lower back, or even in your head, he says. "The feet would be a place I'd look at. Are Ellen's feet supporting her? When I work on someone's feet, they can feel it in their back," says Koliha.

More concentrated than regular massage, Rolfing therapy generally includes ten sessions in which the patient and the practitioner work together, says Koliha. "The person being treated has to be mentally and physically present," he emphasizes. "If a person zones out, the mind-body connection zones out with it."

Because Walden's back has troubled her for years, the muscular problems she's developed through compensating for the discomfort make her an excellent candidate for Rolfing.

Yoga
Yoga has gained recognition for its therapeutic effects in strengthening muscles, promoting flexibility, and facilitating proper breathing—all of which are important factors in maintaining or regaining a healthy back. Kathleen Miller, a yoga therapist in Santa Rosa, California, has more than a decade of training in this now-popular wellness approach. In yoga practice, she explains, breathing is connected directly to the spine. Proper use of the breath, she says, promotes healing and encourages the body to function more efficiently by enhancing oxygen delivery to muscles and stimulating the nervous system. "With every breath," she says, "you are addressing the spine."

Originally developed as part of the Indian health system known as Ayurveda, yoga is a Sanskrit word meaning union. While a true yoga practice also incorporates lifestyle and spiritual components, the physical movements can be utilized as a therapeutic treatment, even when at work. Miller suggests that Walden perform short exercises throughout the day. While at her desk, she can stand up, inhale, lift her arms, and open her chest, keeping her elbows bent; then lower her arms and relax as she exhales. "It's important to get up and move your body gently on a regular basis," says Miller.

Walden's health club offers yoga classes during her lunch break. Practicing yoga during the middle of the day will not only help relax her neck and back muscles, it will also provide an outlet for stress and give her the energy and concentration to get through her workday in top form.

Chiropractic
Chiropractic theory holds that the spine is both the conduit for the central nervous system and the body's central support, and in order to maintain optimal body health and function, the spine must be in complete balance. Further, chiropractic theory maintains that proper adjustment of the spine can relieve a variety of health problems, including back pain.

McAndrews, of the American Chiropractic Association, explains that chiropractic treatment deals with the dynamics of the musculoskeletal system. "If you take a mobile hanging from the ceiling, lay it on a surface, and examine it, you'll see that each piece is stationary but potentially mobile," he says. "All of its parts work together in balance. If you damage or remove one piece, it becomes necessary to make an adjustment to restore that balance. In the case of back pain, it's quite possible for the initial problem to exist in the shoulder, and lower back pain becomes the result of compensation. Thus, it is essential to look at the entire person and not just the back."

Back In Business
Ultimately, Walden chose a combination therapy of yoga and massage. Not only has regular yoga markedly relieved her back pain, but she enjoys the sense of community that comes as a result of practicing with others. Her twice-weekly massage sessions have helped to rebalance her muscles and improve her posture. If you suffer from back pain, your decision, like Walden's, should be based on your personal schedule, budget and comfort level.

Debra Bokur writes for a variety of publications, including Yoga Journal and Spa.