I been having back pain off and on for years, and lately it seems to be getting worse. My doctor prescribed a pain killer that just makes me feel loopy. What else can I do to relieve the pain? Does yoga really help?

Answer: Human beings have probably been having problems with our backs ever since we first stood up on two legs a few million years ago. Chronic back pain is one of our most common health problems, resulting in substantial physical, emotional, and financial distress. The costs associated with acute low back injuries have been estimated at over 50 billion dollars annually when you add up the expenses of diagnosis, treatment, and missed work.

Although there are specific indications for surgical treatment, most back pain is best managed conservatively. Improved muscle strength and flexibility are the keys to a healthy back. At the Chopra Center, we have had great success with yoga therapy. Using a consciousness-based program designed to enhance mind-body integration, many of our patients with chronic pain experience increased flexibility and comfort. A recent study from the University of Washington found that yoga was more effective than conventional therapeutic exercises and standard back care procedures in reducing back pain (Annals Internal Medicine 143:849-56, 2005). I would strongly encourage you to find an experienced yoga instructor in your area and take a few private sessions to see if your pain can be lessened. Also, finding a physical therapists who can help you with exercises to isolate and strengthen spine supporting muscles (multifidus, longissimus, spinalis) can reduce the strain on joints and discs.

Chiropractic care is the most frequently used alternative treatment for chronic back pain. In addition, acupuncture treatments for chronic pain are now approved by the National Institutes of Health. Although the pain-relieving mechanisms behind this ancient system of medicine are not fully understood from a Western perspective, acupuncture can be effective in some people. A recent report found that acupuncture that used electrostimulation may be more effective than acupuncture alone.

There has been recent interest in the anti-arthritic potential of “chondroprotective” substances such as glucosamine sulfate and chondroitin sulfate. These agents may support the development of healthier joints and are worth trying when facing a degenerative spine condition. A recent report could not demonstrate overall value in people with chronic knee pain, but suggested that the combination may improve symptoms in those with moderate to severe pain. The usual daily dose is 1,000 to 1,500 milligrams for glucosamine, and 800 to 1200 milligrams a day for chondroitin sulfate divided into two to four doses during the day.

It’s often the simple things that can provide the greatest relief. Find a good chair that provides back support while you are working. Get a lumbar support pillow to use in the car. Make certain that you have a good mattress. The small additional cost of buying ergonomic furniture will save you money and suffering in the long run. Techniques such as Feldenkreis and Alexander that focus on improving posture can also be of value.

Finally, whenever there is chronic physical pain, there is emotional pain. [Learn a simple meditation technique to relieve stress, develop healthy relationships, and create a future for yourself that inspires you.

With love,
David