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Western medicine has made many great advances in health technology, but its emphasis on drugs and invasive procedures are enough to send some people looking for other means of treatment. For 95% of lower back pain patients, surgery is not recommended. Surgery is a last resort that many dread. Pain medications are doled out easily to those with painful conditions, but this method of treatment alone fails to resolve the cause of pain. If you are searching for a way to avoid surgery and drugs, consider complementary and alternative medicine (CAM).
The designation "CAM" encompasses a wide variety of treatment methods that either serve as a complement or an alternative to modern Western methods. Western medicine is often accused of emphasizing the reduction of unpleasant symptoms as opposed to the identification of the real cause thereof. For those whom Western medicine has doomed to surgery, or those wishing to avoid the drugs of modern medicine, a CAM approach to treatment may serve as a viable yet previously unconsidered alternative.
Types of CAM
One category of CAM is body manipulation. Massage therapy and chiropractic care fall into this category.
Massage therapy is a versatile terrain; while all practitioners work with muscles and other tissues of the body, they use different techniques to achieve an array of results. Massage involves the use of applied pressure to muscles and other tissues to relieve tension. A massage may aim to loosen a particular tight muscle or set of muscles, target the connective tissue surrounding muscles (called myofascia), disperse dense knots called trigger points that refer pain to other areas, or increase flexibility within the tendons and ligaments. It is a hands-on approach to restoring health to bodily tissues, and, since muscles are responsible for many instances of lower back pain, can be particularly helpful to those wishing to avoid back surgery.
Chiropractic care is a technique that strives to restore range of motion to joints, realign the spine and support neurological function. By applying force, called manipulation, and mobilizing the treated area, chiropractors can, over time, change the alignment of vertebrae in the spine and relieve pressure from nerves exiting the spinal column. Moving vertebrae also means changing the relationship between the bones and muscles, ligaments and tendons around them. By so doing, chiropractic care can help to stretch out tense tissues surrounding and pulling on the spine.
CAM also includes movement techniques, which use the body as its own medicine. Movement techniques involve mental and emotional as well as physical benefits. There are a vast number of such techniques; we will address only a few here.
Pilates is becoming more popular in the U.S.; it is an exercise and stretching program that emphasizes core strength and stability. Pilates requires a body-mind connection. The body performs the exercises while the mind must focus on the particulars of the movement and be aware of how the muscles work together. This attention to detail can often help an individual identify postural dysfunctions or muscle compensation that was previously unnoticed. Since postural dysfunction and muscle imbalances are common causes of chronic lower back pain, the emphasis Pilates puts on both strengthening the core and revamping the mindset that allowed that dysfunction in the first place could greatly benefit those who have had no luck with other treatment methods.
A movement technique called Rolfing, developed by Dr. Ida Rolf over 50 years ago, focuses on the web of connective tissue called fascia that runs throughout the body. Fascia surrounds and supports all of the tissues in the body - muscles, ligaments, tendons, bones and organs. Rolfing is similar to certain kinds of massage, but its emphasis all on fascia, not just myofascia, allows it to claim the distinction of significantly straightening posture and allowing the body to operate more efficiently.
The Alexander technique has been sought by some with back pain to identify and modify behaviors that create postural dysfunction. An Alexander assessment may involve a practitioner asking you to pick up an object on a nearby table. The practitioner may then stop you and note all of the muscles that your body has employed in this action. Usually, we use much more energy than we need to and end up straining our muscles in the process. The Alexander technique aims to increase awareness of movement and posture while increasing the efficiency with which our body operates.
Still another category of CAM is energy technique. This includes rather obscure forms, such as light and magnet therapies, and more familiar ones, such as Reiki.
Each of these techniques operates on the premise that energy fields in the body can be manipulated to allow for a more balanced flow and, therefore, increased health. Reiki practitioners seek to transfer their energy to those who are being treated. Their hands hover over the recipient's body, while attention is focused on the energy transfer.
Qi gong is an energy technique that involves movement. The movements of this form of exercise are slow and gentle. They are designed to allow energy to flow through the body. Qi gong is said to increase strength and improve mood by its practitioners.
CAM also includes what are called "whole medical systems." These include Traditional Chinese Medicine (TCM) and the Indian Ayurvedic medicine systems. Bother systems emphasize the balance of energy. Acupuncture, massage, qi gong and herbal remedies are all common within TCM. Ayurvedic medicine uses plants for herbal remedies and tonics that detoxify the body, promote vitality and reduce pain. It also includes yoga, exercise and dietary restrictions.
Why CAM?
The overall costs of experimenting with CAMs is likely far less than the costs of surgery. Beyond the medical expenses, surgery costs you time. Recovery times can be months long from spinal surgery, with some people still in severe pain after years. Fusion and discectomy operations, the most popular surgeries performed on the back, take time to heal and affect the stability and flexibility of the spine. Physical therapy and pain medications will likely be necessary post-op to get you through the pain and to retrain your back's movements.
Reported success rates for spinal surgeries vary widely depending on who is doing the reporting, so it is nearly impossible to say for sure how successful they are. If you ask surgeons, they often report 98% success rates. A quick look at any other source will leave you skeptical of those results, since some report numbers lower as 40%.
The truth is probably somewhere in the middle. One way to get a reliable effectiveness rate is to look at reviews by people who have received the treatment. Spinal fusion, the most popular type of back surgery, received a 64% success rating from people who received it for non-scoliotic back pain. Read their reviews at http://www.dailystrength.org/treatments/Spinal_Fusion.
Given the possibility that surgery may not adequately address lower back pain, plus the cost of time spent rehabilitating post-op, CAM is an attractive resource. Though many of its methods have not been scientifically tested, many have the evidence of history behind them. Massage, yoga, and herbal remedies have existed for thousands of years as revered healing practices.
Above all, CAM addressed an essential component of healing that modern Western medicine for the most part neglects: the mind. Hippocrates recognized the importance of the mind in healing, and it has been coupled with the body in both TCM and Ayuredic medicine for thousands of years. Awareness and focus are needed to create long-lasting behaviors that promote healthy movement, which in turn is needed to prevent lower back pain. The holistic approach of all CAM techniques may set them above the more narrow and invasive forms of Western medicine.
Involving the mind, CAM can go beyond treating physical disorders to provide psychological benefits as well. Focus and awareness encourage calmness; the techniques learned throughout the process of a CAM may lend themselves to other situations in life. Also, relieving bodily pain can improve mood. A study conducted by the Touch Research Institutes and summarized on the National Institute for Biotechnology Information (NCBI) website showed that cortisol levels decrease and serotonin and dopamine levels increase after a massage. Just as the mind's awareness can assist the body, the body's relaxation can assist the mind.
Since CAM treatments are not well studied by the scientific community, possible harms of practice are not known. As with any substance, herbal remedies may interact with other medications or any allergies you may have. Most CAM treatments are gentle and non-invasive, which limits the amount of harm you can do. Tell your doctor of any CAMs you are seeking out and make sure you are physically able to participate. As part of ensuring safe treatment, make sure to research practitioner's training and experience. Since the fields encompassed by CAMs are often obscure in the West, it is necessary to guard against those who would play off your desire to heal by providing uneducated treatment.
When deciding on back surgery, ask yourself if you have tried every viable alternative. Though some of the premises upon which CAM treatment is based may seem strange to the minds of Westerners, it would be much more strange to allow yourself to be cut open and put at risk due to an unwillingness to try a new, more holistic approach to healing. CAMs have earned their claim to legitimacy through history and a body-mind foundation. For more information on CAM, see the National Center for Complementary and Alternative Medicine's page at http://nccam.nih.gov/health/whatiscam/#manipulative.
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