©2008 Robert A. Weissberg, M.D.
Chronic
back pain is a common problem, especially as we age. Certainly, part of this can be attributed to the
wear-and-tear effects of daily life, sometimes with the addition of one or more
mechanical traumas, such as falls, sudden twists or strains. These factors can
lead to stretching and tearing of the ligaments which connect the bones,
unbalanced muscle activity, subtle and gross mal-alignments of the bones, all
contributing to pain via stimulation and pressure on nerve fibers.
There may be
genetic factors, which encourage the discs between the vertebrae to weaken and
collapse or herniate, or the cartilage surfaces of the other joints in the
spine to degenerate. Most people
are losing bone mass after their mid-20's, and this has increased in the
population related to more sedentary life-styles, with less regular weight
bearing activity. Other factors
include prevalent vitamin D deficiencies, excess protein intake with inadequate
calcium, magnesium, and trace minerals.
Bone loss can lead to gradual or acute collapse or compression of one or
more vertebrae, causing acute and chronic pain, and postural and mobility
changes, leading to further pain and dysfunction.
Postural and
habitual movement problems or imbalances can also be involved. There can be a strong mind-body
component, where the way you feel about yourself, the way you connect to the
world and people around you, affects the way you move, stand, and position your
body. Some of these postural and
movement patterns will place unbalanced forces on the spine, leading to
degeneration and pain.
Energetic issues
are also a consideration. Much of
lower back pain is connected to the1st and 2nd Chakra
centers, involving the body and its functions in the region below the
navel. Difficulties or conflicts
in the areas of security, ties to family and community, earth connection,
sexuality, creativity, accepting and receiving, trust may be reflected in the
energetic functions in that part of the body, and potentially manifest as lower
spinal pain or dysfunction. The cervical spine is particularly vulnerable
energetically, with 5th chakra functions related to communication,
both being heard and hearing, and creativity. Shifting from the Ayurvedic to
the TCM-derived systems, it is known that each energy meridian/organ system is
associated with certain muscle groups, often remote anatomically from the
involved organs. Energetic, or Qi
imbalances and blockages may result in weakness or spasm of muscles which
impact on spinal function, leading to pain and discomfort.
An understanding
of these factors leads us to potential preventive and therapeutic approaches.
Maintaining vitamin D levels, Calcium and Magnesium intake, and avoiding
excessive protein are important in maintaining normal bone mass, reducing
osteoporosis risk. If supplements are taken, the Citrate forms of Magnesium and
Calcium are best absorbed. Regular
weight-bearing exercise is also very important in maintaining spinal bone mass.
It is important to maintain flexibility and strength through regular
activity. Practices such as yoga,
taichi, Pilates can be very helpful.
Chiropractic and Osteopathy are therapeutic methods which can help realign
vertebrae and spinal muscles which become out of balance due to trauma and
strain. Movement re-education
methods, such as Feldenkreis and Alexander Technique are very helpful both
chronic back discomfort, and preventing back strains and strains, as well as
other musculoskeletal imbalances.
Energy Medicine practices, such as Shiatzu, acupuncture, Eden Energy
Medicine, Zero Balancing, and others can also be helpful by addressing the
energy imbalances mentioned before.
It is important
to personalize the approaches to preventing and treating back pain, as with all
health and wellness practices.
Adapting the potentially helpful methods to individual needs, and
collaborating with the appropriate health and wellness professionals is the
best path to success.