HARTFORD -- In a very general sense, the catch-22 of chronic lower back pain is, any treatment that provides a lot of relief can only be used for a short amount of time, and any treatment you can use for a long stretch of time, doesn't provide a lot of relief.
Dr. Michael White from the UConn School of Pharmacy, talked about a recent study of back pain treatments by the Agency for Health Care Research, and here are some of the bullet points he highlighted:
- Opioids and Muscle Relaxers provide the strongest relief, but can only be used for a short period because of their tremendous potential for abuse, and because they lose their effectiveness over time anyway, as the body builds up a tolerance.
- Ibuprofen and other NSAIDS can be taken for longer stretches, and provide moderate relief, but NSAIDS do seem to elevate the risk for heart attack and stroke.
- Tylenol and other acetaminophen products weren't found to be effective for chronic lower back pain.
- Certain topical treatments like heat, menthol rubs, lidocaine patches and capsaicin creams all had moderate effectiveness, but can be taken for long stretches.
- Capsaicin cream, which has the same active ingredient that makes chili peppers hot, uses an interesting mechanism. It's mild burning sensation, in a way, exhausts the body's chemical that it uses to transmit pain, Substance P. However, the creams would need to be taken for several days to have this effect, and you should be careful when mixing with heat therapy, because of the body's diminished ability to feel that kind of pain.
- These moderate, topical treatments are best combined with other movement-based treatments. Physical therapy had a lot of evidence to suggest its effectiveness, and certain exercises like yoga and Tai Chi, which can also decompress the spine and promote core strength, had some evidence to suggest they are effective as well.