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According to the National Institutes of Health, back pain is the most common cause of job-related disability in the United States, costing us about $50 billion a year in treatments.

I guess the other $5 billion spent (mentioned in the previous two articles) must be unrelated to our work. Close to 80 percent of us will experience some form of back pain in our lives and most cases aren’t attributed to a specific incident.

“It’s a huge problem that we have for both conventional and alternative techniques for treating back pain,” says Daniel C. Cherkin, PhD, a senior investigator at the Group Health Cooperative’s Center for Health Studies in Seattle.

“With this huge category of people who have what’s referred to as non-specific back pain, you can’t trace it to a particular cause.”

This puzzling dilemma induces many back pain sufferers to seek alternative treatments such as massage, acupuncture, mind-body therapies, and exercise programs like yoga, and Tai chi. Cherkin mentioned that studies show that back pain accounts for 20 percent of massage therapist visits and 14 percent of trips to acupuncturists. But do they work?

No surprise, the scientific community is in a quandary. However, Cherkin’s results from dozens of studies involving massage, acupuncture, and spinal manipulation (chiropractic) as low back pain treatments revealed some evidence as to the effectiveness of massage and spinal manipulation, but less is known regarding acupuncture.

“The studies we reviewed found massage to be effective for relieving symptoms and increasing function among people with persistent back pain,” Cherkin states. “Spinal manipulation shows small clinical benefits for back pain — about the same as conventional medical treatments such as over-the-counter pain relievers and various types of physical therapy.”

Acupuncture’s effectiveness is presently unclear based on existing studies, but a new, large project by the Group Health Cooperative should provide answers in four years. The study consists of 700 back pain sufferers for the purpose of comparing acupuncture to conventional care.

Cherkin mentions that the choice of alternative back pain treatment is an individual thing.

“I don’t think any of these approaches have been shown to be dangerous for low back pain,” he says.

“So it really comes down to what works for an individual patient and what’s worth trying. It’s clear that there’s no single treatment that’s effective for everybody.”

The mind-body approach to treat back pain has been successful for Andrew Block, PhD, a clinical assistant professor of psychiatry and the director of the Well-Being Group, a spine center in Plano, Texas.

“The major approaches are what we call ‘self-regulation strategies’: hypnosis, biofeedback, and relaxation exercises. They’re designed to promote muscle relaxation and pain control, reducing the amount of energy used for keeping muscles tight and giving the patient a sense of control over the situation — something you feel like you’ve lost with chronic pain.”

Block likes to use the image of electricity to help control pain. Imagine pain signals going up the spine like electrical wires. When pain is felt, the wires glow. He continues, “As they get into a relaxed, hypnotic state, they’ll see the glow decrease, visualize it not flowing as intensely or rapidly, and that enables them to mute the pain.”

However, sometimes the issue is managing pain instead of relieving it. The psychological approach is called ‘cognitive behavioral intervention.’ The idea is to take the thoughts associated with back pain and change the way a patient views his particular situation.

Block concludes, “The main thing I advise people to do is to move from seeing the pain as a condition that can be cured to a condition of living that requires them to adapt and function as best they can. It’s important to use your own strength to overcome what this does to your life.”

Next time: Core stabilization and back exercises.

Kay Sager is a certified fitness and aquatic specialist living at Port of the Islands. She is a personal trainer using land and water fitness and teaches swimming. She also has written articles for Physician and Sports Medicine among other publications. Kay can be reached by e-mail: kswimfit@aol.com.