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Back Pain Be Gone! - massage and low back pain

While many are convinced that various and sundry of life's annoyances are a pain in the neck, millions of Americans find that life quite literally is a pain in the back – the low back!



According to the National Center for Health Statistics Report: Health, United States, 2006, Special Feature on Pain, of four common types of pain experienced by survey respondents, low back pain was the most common (27%), followed by severe headache or migraine pain (15%), neck pain (15%) and facial ache or pain (4%). In fact, over 26 million Americans aged 20-64 report having frequent back pain. Women report more back pain than men (29% vs. 25%).

Not only is it prevalent, but it is expensive. Researchers in a 2004 study at Duke Medical Center found that patients with back pain racked up over $90 bil annually in health care expenses, with roughly $26 bil of that directly attributed to treating the back pain. There are also significant indirect costs, as low back pain is a leading contributor of missed work and reduced workplace productivity and the most common cause of job-related disability.

As anyone who has had acute or chronic pain can attest, pain - including low back pain – takes an emotional toll as well. Those with low back pain in the NCHS study were four times as likely to experience serious psychological distress as those without back pain.

What causes it?

There are a range of factors contributing to low back pain, including muscle strain; overexertion; organ dysfunction; stress; obesity; smoking; misaligned bone(s); poor posture; improper lifting; poor sleeping position. Specifically identifying the source of the pain, though, can be challenging, and medical experts often disagree on the most effective approach to treat the problem.

What exactly is my low back?



The low back is roughly six inches long, and consists of the five lumbar vertebrae (L1, L2, L3, L4, L5) which begin at the lower end of the rib cage. Between each vertebra is a cushion called an intervertebral disk. The 5th lumbar vertebra joins at the top of the triangle-shaped bone called the sacrum; functionally, the lumbar vertebrae and the sacrum work together.

Massage to the rescue!

While most occurrences of low back pain go away in a few days, others can persist for much longer and if left untreated, can develop into more serious conditions. Traditional treatments for low back pain include pain medications, cortisone injections and surgery. While frequently necessary, they generally treat only the symptoms and not the cause of the pain.

Over the years, use of complementary and alternative medicine (CAM) has risen significantly. While people suffering from any acute or chronic pain problems are advised to consult with their physician, research is proving that massage therapy not only alleviates back pain, but may reduce the costs of care.

In a study published in the June 2003 Annals of Internal Medicine ("A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain," Cherkin, et al.), researchers evaluated the effectiveness, safety and costs of three popular CAM therapies for the treatment of back pain. Although the conclusions were preliminary, initial studies found massage to be effective for the relief of persistent back pain. Moreover, preliminary evidence suggested that "massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy" (approximately 8 sessions). The initial costs of a course of massage therapy may be justified "by the substantial improvements in functional outcomes and reduced use of health care services for back pain during the year after treatment."

More recently, research published in the May-June 2010 Journal of the American Board of Family Medicine ("Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain," Kanodia, et al.) shows that 60% of those surveyed who received at least one CAM therapy in the preceding 12 months found significant relief using the top six CAM modalities (chiropractic; massage; yoga, tai chi and chi gong; acupuncture; herbal therapies; and relaxation techniques). Chiropractic and massage were the two most common CAM modalities used to treat back pain.

References:

Annals of Internal Medicine 6/03. Cherkin, Daniel C., et al. "A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain."

Duke University News Release 1/12/04. "Back Pain Carries Significant Economic Costs." http://www.dukenews.duke.edu/2004/01/backpain_0104.html

Institute for Integrative Healthcare Studies 3/30/10. Cutler, Nicole. "Four Tips to Help Prevent Back Injury Reoccurrence." http://www.integrative-healthcare.org/mt/archives/2010/03/four_tips_to_he.html

Journal of the American Board of Family Medicine May-June 2010. Kanodia, Anup K., et al. "Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain." http://www.jabfm.org/cgi/reprint/23/3/354?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=massage&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Massage & Bodywork Dec./Jan. 2006. Benjamin, Ben E. "The Mystery of Low Back Pain: Part I." http://www.massagetherapy.com/articles/index.php/article_id/1024/The-Mystery-of-Low-Back-Pain%3A-Part-I

Massage Today 9/01. Crownfield, Peter W. "Massage for Back Pain: Let's Look at the Research." http://www.massagetoday.com/mpacms/mt/article.php?id=10312

National Center for Health Statistics. "Health, United States, 2006, With Chartbook on Trends in the Health of Americans." http://www.cdc.gov/nchs/data/hus/hus06.pdf

National Institute of Neurological Disorders and Stroke. "Low Back Pain Fact Sheet." http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

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