Back Pain Management

By Marilynn Preston

June 15, 2017 5 min read

I've been waiting for some good news about U.S. health care, which is the world's most expensive but not even close to the world's best. So far, I've been seeing very little that sparks joy.

The Affordable Care Act is in limbo, to be kind, and that's creating deep anxiety nationwide.

All the talk from policymakers dealing with health care reform is focused on making insurance companies happy and prosperous. There isn't a peep about improved patient care, less illness and injury, more community health centers or fewer untimely deaths.

And none of the politicians dealing with "reform and replace" -- including our new secretary of health and corporate services -- ever mention prevention and patient education, two obvious ways to bring down the crippling cost of health care simply by lowering demand.

Think of it: If our citizens were healthier, we could save tens of billions of dollars every year. It's so simple ... and simply not part of the debate. That's because health care is viewed from the perspective of a for-profit business. And while a business-like mentality is fine in other contexts, when it comes to health care, it means that there is a built-in incentive to have as many customers, and tests, as possible.

And yet, something did happen on Feb. 14, a secret Valentine, that I consider very good news. And you should, too.

The American College of Physicians -- the largest medical specialty organization in the United States, with more than 140,000 internists and related subspecialists -- came out with new guidelines for treating lower back pain, and their advice is so revelatory and radically patient-centered, and such a reversal from drugs, drugs, drugs. It's a sign that something good might be happening out there. Doctor Land is waking up.

Stop with the drugs, the ACP is telling doctors and the 100 million Americans who suffer from chronic low back pain (to the tune of $600 billion a year in medical treatments). Not only are prescription drugs for treating back pain not effective; the most popular ones are addictive and have led to an out-of-control opioid epidemic that is killing Americans at an astonishing rate.

So if prescription drugs aren't the answer, according to the new guidelines, what is?

"Treatment recommendations," it says front and center on the ACP website, "include massage, acupuncture, spinal manipulation, tai chi and yoga."

Yes! Finally! Non-drug therapies! Massage, body work, yoga and acupuncture are getting the evidence-based respect and attention they deserve, and the same-old, same-old drug-based therapies are being called out as being ineffective and even dangerous.

"Physicians should reassure their patients that acute and sub acute low pain usually improves over time regardless of treatment," ACP President Nitin Damle, M.D., says. "Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially narcotics, for these patients."

I don't expect an overnight turnaround, but it's two giant steps forward in the right direction, toward wellness, away from wackiness. Slowly, word is getting out, even from mainstream doctors, about what helps you prevent and recover from low back pain, and what doesn't. Gentle movement -- especially in a therapeutic yoga class, going slowly, with awareness -- does help. Steroids do not.

What else helps, you might ask?

Now we're talking. When it comes to reducing low back pain, working at a stand-up desk is one of the great health care discoveries of the modern sedentary era. So is something that may be new to you called dynamic sitting.

"For sitting to be healthy, it needs to be what I call dynamic sitting," says NeuroMovement specialist Anat Baniel. "It's not about doing large movements or stretching; it's about creating a fuller map of the body in the brain while in a sitting position."

You can read lots more about the benefits of stand-up desks and dynamic sitting in the February 2017 "End Back Pain Forever" issue of What Doctors Don't Tell You magazine. It includes specific big and little exercises you can do -- in your office or at home -- to wake up and strengthen and lengthen your spine enough to fulfill the promise on the cover.

It takes some study and effort, but so does resisting drugs. And no one ever died from an overdose of yin yoga.

Marilynn Preston's weekly column, "Energy Express," can be found at

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