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Have a Happier, Healthier Back by Friday

Pain doesn’t have to stand in the way of change. Here are five strategies for a healthier back, including exercise, meditation and stress relief.

by Sarah Mahoney

Well-Being
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If your back doesn't hurt today, just wait. Back pain affects about 80 percent of adults in the U.S. at some point. On any given day, one in five of us are walking around with some discomfort, says Dr. Jianguo Cheng, Ph.D., who heads up scientific affairs for the American Academy of Pain Medicine.

While most people think athletes and the elderly have it worst, it turns out that back pain peaks in midlife, between the ages of 45 and 64. Chronic pain—or even the fear of old pain returning—can hamper just about any life change, whether it’s as simple as rediscovering racquetball or as complex as changing careers.

See also: Is Back Pain Killing Your Chance for Life Change?

Most of the time, experts say, there’s no single magic solution to end pain forever. But if you move “deal with back pain” higher on your to-do list, instead of just gritting your teeth and popping another handful of pain relievers, you can take charge in a new way, learning effective strategies to minimize pain.

“People need coping strategies to effectively self-manage chronic back pain,” says Murray McAllister, Ph.D., founder of the Institute for Chronic Pain in Minneapolis, who says challenging some of your fundamental beliefs about pain can be very helpful. Often, people are unaware of how much they’ve let back pain influence their lives, he says. “It’s important to recognize choices we’ve made. When did the story of back pain become a central narrative in our lives? When did we decide to make pain reduction a primary value? Has having back pain made our lives small?”

It’s important to recognize choices we’ve made. When did back pain become a central narrative in our lives? Has back pain made our lives small?

To back-burner your back pain, try our five-day challenge:

Monday: Rethink your (self) diagnosis. Lower back pain is one of the most common reasons patients see doctors, but many people treat persistent pain themselves, assuming a doctor’s visit will result in an expensive imaging test like an MRI. They may dread a scolding, or anticipate being told to lose weight or exercise more.

That’s a mistake. Cheng says it’s essential to get the right diagnosis, “since treatment for one type of problem can be very different from another.”

“Most acute pain goes away,” he says, “and about 75 percent of people with back pain will see their symptoms resolve in six to eight weeks.” If yours doesn’t, if your back episodes are frequent, or if there are red flags—the pain is unbearable or there is loss of bowel or bladder control, for example—seek treatment right away.

Head for your physician knowing that a pricey MRI isn’t inevitable. “Sometimes they are part of a diagnosis,” he says, “but most of the time, imaging studies aren’t very helpful in treating back pain.”

Tuesday: Rethink exercise. When it hurts just to move, any exercise can sound like a bad idea. But it’s not. “When people lie in bed with back pain, that leads to deconditioning,” says Cheng. “You’re not damaging yourself by moving.” Exercise, even just walking, gentle stretches and physical therapy all help. Tai chi and swimming are especially helpful for some conditions.

Look for mild exercise that you can do consistently, says McAllister. “With pain, the nervous system has become highly reactive, so it doesn't take much stimuli to trigger more pain. Regular exercise makes us less reactive.”

Wednesday: Rethink meditation. If you’re like many people, suggesting that meditation can soothe physical pain is a little insulting, implying that the problem is in your head, not your back. Consider this: Research shows that meditation, particularly the types of mindfulness meditation designed to reduce stress, results in less back pain than other types of care. After a two-month course, “the benefits in terms of disability or pain bothersomeness held pretty constant at twelve months,” says meditation researcher Dr. Madhav Goyal, an assistant professor of medicine at Johns Hopkins University. “This is a long time to have continued pain relief after only a two-month course.”

When a patient bristles at the suggestion, “I tell them that mindfulness has been scientifically studied in randomized clinical trials the same way that drugs have been, and that it showed significant benefits without all the side effects.”

And while meditation is not for everybody, be sure you don’t give up too soon. “Meditation is a path, and the more one practices, one may find that it starts producing benefits for them,” Goyal says.

Thursday: Rethink medication. For many people, reaching for an over-the-counter pain reliever now and then is fine. But experts say plenty of people with chronic back (pain lasting longer than three months) routinely exceed recommended doses, putting themselves at risk for side effects, some severe.

Others need more medication, including muscle relaxants or heavier-duty narcotics. Talk to your doctor. If you’re at midlife, pay close attention to the latest dependency statistics: While every age, race and ethnic group has seen death rates decline, middle age white Americans are dying more often, and experts say opioid addiction is part of the problem.

See also: Why You Should Try Yoga For Pain Relief

Plus, evidence is mounting that opioids are not effective. The U.S. Centers for Disease Control and Prevention issued new guidelines, suggesting doctors not prescribe opioids for chronic pain, saying the risks outweigh the benefits.

Friday: Rethink your future. McAllister says one of the trickiest parts of treating pain patients is getting them to the point of acceptance and the realization that while there are strategies to modify pain, it may not go away, despite your best efforts at stress relief, mindfulness and exercise.

“Pain isn’t an all or nothing thing, and that’s not a mindset we’re comfortable with. We want to fix it and move on with our lives,” he says. “By learning to cope with pain, and strategies to keep it under control—whether it’s yoga, mindfulness, better time-management skills or cognitive behavioral therapy—we can change our relationship with pain and move on with our lives.”