If you’re struggling with back pain, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), low back pain is the most common pain reported to doctors and the most common cause of disability in the United States. (2) Some estimates show that upwards of 84% of the adult population worldwide will experience back pain in their lifetime, with 23% experiencing chronic (long-term) low back pain. (1)
Types of back pain
To understand the types of back pain, a reminder of the functions of the spine can be helpful. The purpose of the spine, a bony structure that extends from the head to the pelvis, includes:
- Protecting the spinal cord, which is the nerve supply that connects the brain to the entire body
- Providing postural control and stability, as well as force transmission between the legs and arms, via its connection to the muscles and ligaments of the trunk
- Supporting the body and allowing it to be mobile and flexible (4)
All along the bony vertebrae and intervertebral discs that are connected to the muscles and ligaments of the back, painful issues can arise. The spine is made up of different regions, and the location of pain can help determine the diagnosis and the treatment. These regions, from top to bottom, include:
- Cervical: the neck, from the base of your skull to the top of your shoulders
- Thoracic: the upper back, mostly around the ribcage area
- Lumbar: the lower back, continuing down from the thoracic and ending at the top of the hips
- Sacral/coccyx area: the region from your hips to your tailbone, which also falls in the category of the lower back area (4)
Back pain is also characterized by the length of time pain is experienced. Low back pain can be classified into these three categories:
- Acute: lasting less than four weeks
- Subacute: lasting four to 12 weeks
- Chronic: lasting more than 12 weeks (2)
Back pain relief
Both non-surgical (e.g. steroid injections) and surgical (e.g. disc replacement or fusion) treatments are commonly used in conventional medicine to ease back pain, specifically low back pain. (7) In addition, pain medications, including opioids are often prescribed.
Did you know? Over the past 18 years, drug overdose deaths due to opioids (e.g., morphine, codeine, hydrocodone) have more than tripled in the United States. (13) According to the CDC, despite a lack of evidence to support efficacy, opioid medications continue to be prescribed for acute low back pain. (2)
Fortunately, an integrative approach to back pain has much to offer, beginning with chiropractic medicine and acupuncture.
The American College of Physicians recommends spinal manipulation as an effective non-invasive treatment for low back and neck pain, and it’s estimated that more than 50% of adults in the United States seek care from chiropractors for their back pain. (5) One reason chiropractic is so popular is that it is effective in significantly improving pain associated with neck and low back pain, as well as enhancing the overall quality of life. (6)
Acupuncture is another proven integrative treatment for back pain. Many studies involving large numbers of participants have shown that acupuncture is safe and effective for the treatment of low back pain, with one meta-analysis involving nearly 18,000 patients demonstrating that the beneficial effects were sustained one year later. (8)
Vitamin supplements for low back pain can also be effective and can help complement chiropractic and/or acupuncture.
Supplements for back pain
While there are many supplements for pain available, here we will focus on dietary supplements specifically for low back pain, the most common form of back pain. (11) Let’s begin with the topical application of capsaicin from cayenne pepper.
Topical capsaicin, an active component of chili peppers, has been widely used for joint and muscle pain for years. Emerging research is showing that multiple applications of the creams or the use of the patches can help reduce pain and inflammation in the low back and neck area. Be careful not touch sensitive areas such as the eyes after applying capsaicin topically. (12)
Curcumin is another herb that has been commonly used to help ease joint and muscle pain; however, research shows that when taken orally it may also help with back pain. The benefits of curcumin for lower back pain from degenerative disk disease is likely attributed to its role in reducing inflammatory markers. (14) One 2015 case-control series involving four patients with scoliosis, a degenerative spine condition, did show that taking curcumin supplements for six months resulted in significant improvements in pain. (9) While research has demonstrated the general analgesic (pain-relieving) effects of curcumin, further human clinical trials specific to back pain are needed to confirm this effect. (11)
Devil’s claw is also an herb that can help with low back pain. Studies indicate that 50 to 100 mg of a standardized dose daily of devil’s claw was more effective for low back pain than a placebo and just as effective as Vioxx, a COX-2 selective nonsteroidal anti-inflammatory prescription drug that was taken off the market due to safety issues. (10)
Willow bark is often referred to as nature’s aspirin because it contains salicin, which is converted to salicylic acid, the active compound in aspirin. Although salicin from willow bark is considered a milder form of salicylic acid, studies show that it may be just as effective as Vioxx (3) and more effective than a placebo when it comes to relieving low back pain. (10)
The bottom line
There’s no question that back pain can significantly impact your quality of life. Utilizing an integrative approach may offer relief to those experiencing back pain. In addition to chiropractic treatment and acupuncture, certain dietary supplements may help address acute back pain before it becomes a chronic concern.
If you are experiencing back pain and looking for natural alternatives to provide relief, consider consulting with your integrative practitioner for guidance.
- Casiano, V. E., Dydyk, A. M., & Varacallo, M. (2021, July 12). Back pain. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538173/
- Centers for Disease Control and Prevention. (2020, May 11). Acute low back pain. https://www.cdc.gov/acute-pain/low-back-pain/index.html
- Chrubasik, S., Künzel, O., Model, A., Conradt, C., & Black, A. (2001). Treatment of low back pain with an herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology, 40(12):1388-93. https://pubmed.ncbi.nlm.nih.gov/11752510/
- Frost, B. A., Camarero-Espinosa, S., & Foster, E. J. (2019). Materials for the spine: anatomy, problems, and solutions. Materials, 12(2), 253. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6356370/
- Hays, R. D., Sherbourne, C. D., Spritzer, K. L., Hilton, L. G., Ryan, G. W., Coulter, I. D., & Herman, P. M. (2020). Experiences with chiropractic care for patients with low back or neck pain. Journal of Patient Experience, 7(3), 357-364. https://journals.sagepub.com/doi/full/10.1177/2374373519846022
- Hays, R. D., Spritzer, K. L., Sherbourne, C. D., Ryan, G. W., & Coulter, I. D. (2019). Group and individual-level change on health-related quality of life in chiropractic patients with chronic low back or neck pain. Spine, 44(9), 647-651. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459736/
- Knezevic, N. N., Candido, K. D., Vlaeyen, J., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00733-9/fulltext
- Mao, J. J., Davis, R. T., Coeytaux, R., Hullender-Rubin, L., Kong, J., MacPherson, H., Napadow, V., Schnyer, R., Wayne, P. M., Witt, C., & Harris, R. (2019). Acupuncture for chronic low back pain: recommendations to Medicare/Medicaid, from the Society for Acupuncture Research. The Journal of Alternative and Complementary Medicine, 25(4), 367-369. https://www.liebertpub.com/doi/full/10.1089/acm.2019.29067.jjm
- Morningstar, M. W., Strauchman, M., & Fleischmann, G. (2015). Controlled Release Curcumin for the Treatment of Pain Related to Adult Degenerative Scoliosis: A Retrospective, Open-Label, Case-Controlled Series. J Pain Relief 4:192. https://www.omicsonline.org/open-access/controlledrelease-curcumin-for-the-treatment-of-pain-related-to-adult-degenerative-scoliosis-a-retrospective-openlabel-casecontrolled-series-2167-0846-1000192.php?aid=57737
- Oltean, H., Robbins, C., van Tulder, M. W., Berman, B. M., Bombardier, C., & Gagnier, J. J. (2014). Herbal medicine for low back pain. Cochrane Database of Systematic Reviews, 12. https://www.cochrane.org/CD004504/BACK_herbal-medicine-for-low-back-pain
- Sahebkar, A., & Henrotin, Y. (2016). Analgesic efficacy and safety of curcuminoids in clinical practice: a systematic review and meta-analysis of randomized controlled trials. Pain Med, 17(6), 1192-202. https://pubmed.ncbi.nlm.nih.gov/26814259/
- Sarabon, N., Lofler, S., Cvecka, J., Hubl, W., & Zampieri, S. (2018). Acute effect of different concentrations of cayenne pepper cataplasm on sensory-motor functions and serum levels of inflammation-related biomarkers in healthy subjects. Eur J Transl Myol, 28(1), 105-116. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895990/
- Singh, G. K., Kim, I. E., Girmay, M., Perry, C., Daus, G. P., Vedamuthu, I. P., De Los Reyes, A. A., Ramey, C. T., Martin, E. K., & Allender, M. (2019). Opioid epidemic in the United States: empirical trends, and a literature review of social determinants and epidemiological, pain management, and treatment patterns. Int J MCH AIDS, 8(2), 89-100. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804319
- Webb, M. (2015). Curcumin reduces degenerative disc disease pain. Natural Medicine Journal, 7(6). https://www.naturalmedicinejournal.com/journal/2015-06/curcumin-reduces-degenerative-disc-disease-pain