Back in Business
by Vonalda M. Utterback, C.N.

Back pain can originate from a dramatic sports injury or the mere act of bending over to tie your shoe. Either way, when it hits, it hurts — and can leave you, literally, flat on your back.

Jennifer Korbelik, a coordinator in human services for the City of Boulder, Colo., suffered from chronic back pain and discomfort, stemming from a cracked tailbone she received as a child. "Through the years," says Korbelik, now 32, "my back would 'go out' for small reasons, seemingly at random. Often, I would be flat on the floor in pain, trying to stretch out my back so I could move again."

The bad news is that back pain like Korbelik's is a common problem. According to research conducted at Johns Hopkins University School of Medicine, doctors estimate that 80 percent of Americans will eventually have trouble with their lower backs. Although back pain can occur at any point along your spine, the lower back is the most common site since it bears the most weight and stress. Cited as second only to the common cold as a reason for seeing a doctor, back pain is reputed to cost the United States $16 billion a year in medical treatment and $80 billion in lost wages and productivity.

The good news, however, is there are holistic ways to prevent back pain from returning — or even occurring in the first place — plus ways to help alleviate the pain when it does hit. Remember, this information is not intended as medical advice. Any chronic or severe back pain should be addressed immediately by your health care practitioner for analysis and diagnosis.

Stop the Pain
"It's critical to rest the injury and control pain," says Helen Healy, N.D., owner/director of Wellspring Naturopathic Clinic in St. Paul, Minn. "To not do so can lead to a chronic cycle of unremitting pain. After the pain is controlled, you can look at its root cause and deal with it more effectively."

Healy, who has spent more than 15 years treating patients holistically, advises a number of natural remedies for pain relief, often recommending a combination of anti-inflammatory herbs that include turmeric (Curcuma longa), citrus bioflavonoids and ginger (Zingiber officinale).

"Herbs have anti-inflammatory properties without the potential side effects nonsteroidal anti-inflammatory drugs (NSAIDs) can have," she says. NSAIDs such as aspirin and ibuprofen not only irritate the stomach, but, if taken for too long or in too high of a dosage, can also cause ulcers through micro-hemorrhaging of the stomach lining. According to Healy, other herbs that could help with muscle spasms — a common problem with back pain — are black cohosh (Cimicifuga racemosa) and wild yam (Dioscorea villosa).

Healy's top suggestion to her patients in need of an anti-inflammatory, however, is taking digestive enzymes. Digestive enzymes — sometimes called pancreatic enzymes when they're derived from animal sources — include three classes: proteolytic enzymes needed to digest protein, lipases needed to digest fat, and amylases needed to digest carbohydrates.

"Instead of aiding in food digestion, if taken on an empty stomach — at least two hours after you have eaten — the enzymes will circulate in the system and digest proteins and other substances that are responsible for inflammation," Healy says. Proteolytic enzymes such as trypsin, chymotrypsin and bromelain, in addition to lipase and amylase enzymes, may all be helpful. Healy often recommends a combination formula. "The trick is to take them at the first sign of injury and, in the acute phase of your pain, as often as every two hours," she says.

James A. Duke, Ph.D., in his book The Green Pharmacy (Rodale), suggests red pepper (Capsicum spp.) for topical pain relief. He also recommends assorted essential oils, including peppermint (Mentha piperita), sage (Salvia officinalis), rosemary (Rosmarinus officinalis) and thyme (Thymus vulgaris) — all of which are rich in thymol and carvacrol, compounds that help muscles relax. Add a few drops of essential oil to several tablespoons of any vegetable oil before massaging it into the affected area, as undiluted essential oils may burn or irritate skin.

Long-Term Solutions
When back pain would strike Korbelik, she would do body stretches and seek out a massage therapist. "Both provided me with short-term pain relief," she says. But it wasn't until 1993, when she tried Rolfing, that she found permanent relief. This structural integration is a form of manual soft tissue therapy that targets fasciae, the sleeves of connective tissue surrounding the body's muscles.

"I now can cross-county ski and run marathons, both activities that were very uncomfortable for me before," she says. Her back rarely goes out these days. And, perhaps most importantly, Korbelik says, "since I've been through Rolfing, I can feel when I'm out of whack and do something about it immediately. It's increased my awareness of my body."

Korbelik also regularly does yoga for maintenance, which she says increases her strength and flexibility. Yoga and Rolfing are but two choices in more than 100 types of bodywork or movement exercises available. Other well-known options include acupuncture, Alexander Technique, chiropractic, Feldenkrais, Hellerwork, massage, Pilates, Trager and Reiki.

An Ounce of Prevention
Most experts can't stress it enough: exercise, exercise, exercise. "Back pain is a message that you've got to exercise those muscles," says Healy. Gayla and John Kirschmann, in their book Nutrition Almanac (McGraw-Hill), agree — exercise not only prevents backaches but can also cure back problems 80 percent of the time. Active people, they report, generally have less back pain.

Don't allow back pain to get you down. Although there are many underlying factors that can cause it, it's reported that nine out of 10 back-pain episodes will clear up with simple self-help measures. By taking a proactive approach you can prevent pain before it starts, and your back will support you all the way.

Vonalda Utterback is a certified nutritionist and freelance writer/editor in Erie, Colo.