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CAM Treatments for Back Pain

Complementary and alternative medicine (CAM) includes any medical treatment that is not currently considered to be part of conventional medicine. Complementary medicine is used in conjunction with conventional medicine; alternative medicine is used in place of conventional medicine.

Conventional medicine is evidence-based medicine - proven through scientific research and large, carefully controlled clinical trials. A CAM treatment may be adopted into mainstream medicine if good evidence emerges for the safely and efficiency of such treatment for a particular condition.

Acupuncture, chiropractic, massage therapy and biofeedback are often covered by health insurance plans for the treatment of back pain; however, many CAM treatments are not covered by health insurance due to insufficient scientific evidence as to the effectiveness for the condition being treated.

Large clinical trials are costly. While large pharmaceutical companies routinely fund clinical trials for new medications it is usually more difficult to obtain funding for clinical trials involving complementary and alternative treatments. NCCAM (National Center for Complementary and Alternative Medicine) funds many studies on complementary and alternative medicine.

Evidence for CAM

Some CAM therapies have more evidence than others of effectiveness and safety for the condition being treated. Most M.D.s will only recommend a treatment if there is good scientific evidence of its efficiency.

Why do many Doctors ignore Personal testimonials and Anecdotal Reports? It is believed that roughly a third of people receiving any treatment will experience the placebo effect. Both patient and doctor may be influenced by personal biases when observing and reporting results of a treatment. Also some conditions are self-limiting and some conditions have periods of flare-ups and remissions. As a result, personal testimonials and anecdotal reports do not carry much weight.

Double-Blind Studies are considered The Most Reliable.

In a double-blind, placebo controlled study neither patients nor researchers know who is receiving the real treatment or the placebo (sham treatment). Roughly a third of patients receiving the placebo will experience the placebo effect (beneficial effect from receiving sham treatment). Only if real treatment provides significantly greater results than the placebo can there be any proof the treatment really works.

Placebos can produce either positive or negative effects. When a person experiences undesirable side effects from a placebo, it is often referred to as the nocebo effect.

While a large, properly designed double-blind, placebo-controlled study is considered the most reliable, some double-blind studies are difficult to perform. Chiropractors, massage therapists, and acupuncturists know whether or not they are performing real treatment. In this case, a single-blind study may be used (only the patients do not know if they are receiving the real treatment or not). In some studies, a treatment is compared to an accepted proven treatment.

Even when testing a medication where a sham pill looks identical to the real medication, people receiving the real medication may clue in if there are significant side effects.

Only a Placebo Effect?

The placebo effect demonstrates the powerful connection between mind and body. It is believed that the placebo effect may be caused (at least in part) by the brains production of endorphins (natural painkillers) when a person receives a treatment that they believe will help them. The mind-body connection is significant. Many people take advantage of this mind-body connection with the use of biofeedback, meditation, etc.

Conventional treatments and CAM treatments may carry Risks.

Safely issues: Many CAM treatments are believed to be safer and to have less side effects than conventional treatments, especially pharmaceutical treatments. But side effects are often only discovered after very large extensive studies have been done or even after they have gone to market. A CAM treatment may have not been studied extensively enough to uncover potential safely issues.

PROS AND CONS of Unproven CAM Treatments

A treatment that may work well may take so long to be accepted and recommended by medical doctors, that many may be missing out on a treatment that may benefit them now.

However, some CAM treatments are eventually found to be no more effective than a placebo, so engaging in unproven therapies may result in wasted time and money. Some treatments may also pose health risks. Of course, many conventional treatments have significant side effects and risks.

CAM treatment providers of alternative therapies may use the lack of studies to their benefit. Though there may not be real evidence a treatment works, there is also not evidence that is doesn't work. Additionally, without large clinical studies, safety issues may not be uncovered.

Be skeptical of claims that appear 'too good to be true.' These inflated claims are often based on anecdotal evidence and patient testimonials rather than large, controlled clinical trials. It is likely that only positive personal testimonials will be published.

Some alternative treatments become 'fads.' Do your research before jumping on the bandwagon.

Discuss all CAM treatments you are considering trying with your regular doctor. If your doctor advises against it, ask why. Is it because he or she considers it unsafe or unproven? If the treatment appears relatively safe, are you willing to take a chance on it.

List of CAM treatments for Back Pain

Acupuncture may stimulate the production of the body's own pain-relief substances. Though there are a variety of acupuncture techniques, a commonly used method involves inserting very fine needles into specific points in the body. Stimulating specific points of the body is believed to stimulate healing. Most studies have had positive results.

Chiropractic Treatment
Chiropractors treat back pain by manipulating the spine to help restore normal range of motion in the spinal joints, taking stress off surrounding soft tissues (muscles, ligaments, fascia).

Inversion Tables
The Inversion Table stretches the spine and relieves back pain.

Spinal Traction
Spinal traction stretches muscles and ligaments and increases the space between the vertebrae. A constant or intermittent pulling force is applied to the spine to gradually stretch the spine. There are different techniques used in spinal traction, both mechanical and manual.

Spinal Decompression Therapy
Spinal Decompression Therapy is also called Vertebral Axial Decompression or VAX-D. It is a form of mechanical lumbar traction.

Massage Therapy
A professional massage therapist can relieve back pain by manipulating the soft tissues (muscles, tendons, fascia) to help relax tense muscles, increase circulation to the muscles and accelerate healing. Back pain and neck pain are the most common reasons people seek massage therapy.

Low-Level Laser Therapy is the application of visible red or near-infrared light emitted from a low power laser, believed to speed healing and reduce pain and inflammation. This treatment is also known as cold laser, non-thermal laser, soft laser, biostimulation laser, etc.

This treatment is used for the treatment of chronic back pain that may be caused by damaged, weak, or lax ligaments.

Supplements for Osteoarthritis
Supplements that appear to be effective in relieving pain and improving function in those with osteoarthritis.

Warm water therapy, a form of hydrotherapy, reduces pain, stiffness, and stress.

Stress and Back Pain

The muscles of the back and neck are commonly affected by stress. Stress alone can cause back pain. Stress causes tensing of muscles which restricts blood flow (oxygen) to the tissues in the tensed area and stress hormones intensify the perception of pain. Stress can also intensify back pain for which there is a clear physical cause. By causing the back muscles to tighten up, stress also leaves the back vulnerable to injury. Like keeping physically fit through exercise, stress management is an ongoing process