By Ray


This is one of a number of Medical Checkpoints giving information about common conditions and what you can do about it. Your opinion and reaction to these Medical Checkpoints would be valued and appreciated. Medical Checkpoints are published periodically by STARTHealthcare and are provided as a free service.





I have a theory why the United States is experiencing an epidemic of back pain that costs us - you and me - $50 to $100 billion a year. My theory is that it is the same reasons we in the United States are having an epidemic of heart attacks and strokes. I believe that arteriosclerosis is the basic cause of these epidemics. I believe that the cause of arteriosclerosis (hardening and clogging up of the arteries) is related to lack of exercise and eating a refined diet. This I believe is the root cause of most if not all of our degenerative diseases that are epidemic in the Western world. Whatever will increase our blood flow and get our arteries supple and pliable again and back in shape will largely cure back pain, heart attacks, strokes, and arthritis. This is the basic philosophy behind the recommendations made for the care of your back.




There are other causes of back pain. Some of them very nasty. I am making certain assumptions about your back pain. If my assumptions are wrong, then there are some other things you should do before you follow this advice. The reason for telling you my assumptions is so you will know what they are and do something about it if my assumptions do not fit your case.


1. You have back pain that has been completely diagnosed and treated by your doctor.

2. That you are taking the responsibility for getting your back pain better.

3. That you have done or are doing all your doctor has recommended, and in addition, you have decided to do for yourself what is here recommended.




These seven suggestions for your back are divided into two groups:

A) Suggestions for help with acute flare-up of chronic back pain or acute back pain of recent onset - three weeks or less.

B) Suggestions for chronic "incurable" back pain of longer than three months' duration.


A) Acute Back Pain Management.


Acute means that there is inflammation of repair caused by stretched muscles, ligaments, or tendons that are acutely painful. There are two objectives of treatment in the acute stage of back pain: a) decrease the inflammation which will decrease the pain, and

b) assist the repair process which is the object of the inflammation.



1. Rest Without Being in Bed. The reason your back muscles go into spasm is to rest your back with muscle splinting. A back brace or corset may be helpful in this stage by letting your muscles rest while the splint or brace keeps your back supported and rested. Bed rest is not recommended because it is not necessary in most cases and has many disadvantages including disuse atrophy and weakness of the muscles. So for a few days try a back splint or brace and do whatever does not increase the back pain; and stay out of bed except for sleeping your usual amount.


Bed boards are important to use with a person who has back ache. Best is to have a new firm mattress and bed boards both. Bed boards are a piece of 3/4 inch plywood (or similar material) that is as wide as your bed and as long as your bed. Place the bed board under your firm mattress and on top of your box springs. (The mattress needs to be firm. A 3" or 4" new foam rubber will work well for a mattress.) Actually the box springs is not essential. Nor is the bed board necessary if you put your firm mattress on the floor or other rigid surface. The reason a firm surface is best to sleep on is that your spine is supported and not stretched or strained depending on how you lie during sleep.


2. Local Hot and Cold Anti-inflammatory Hydrotherapy.

Local hot and cold will do three things simultaneously:

a) ease the pain and muscle tension,

b) increase the local blood flow which will wash out the pain chemicals that result from the inflammation and speed up the healing process by bringing in nutrients, and

c) directly by the action of both heat and cold ease the pain, making you feel better immediately.


There are two ways to give hot and cold hydrotherapy:

i. In a shower and by use of hot and cold fomentations. The easiest is in a shower because you do not need help and can do this treatment on your own. But a shower is needed for this treatment. Simply get in the shower and let worm or hot water run on your back for 3 minutes and then suddenly change it to cold for 30 seconds and then back to hot for a second three minutes. Start with the hot, give three changes and end with the cold. Hot-cold; hot-cold; hot-cold and get out of the shower or repeat a few more times, but end with cold. People instinctively give themselves heat or cold because either feels good. But the best is the combination of both as outlined above. This stimulates the local circulation and has the wonderful, beneficial effects stated above. This treatment is best given at the end of the day and then go to bed and sleep.


ii. The other way to give hot and cold hydrotherapy treatments is with towels or wool cloths of three or four thicknesses. These fomentation cloths should be dampened with water (not soppy or dripping, but enough to feel wet, like a wrung out dish rag) folded into a large bath towel or cloth, and then put in a plastic bag to keep in the moisture. Place the fomentation pack into a microwave for five minutes on high heat. These hot towels or cloths are placed on top of another towel (or 2 or 3 thicknesses, depending on how hot it is) next to the skin to keep the skin from being burned. This is changed when the fomentation loses its heat, and the next one applied, which has been heating in the microwave. Between changes the skin should be rubbed with ice or a wash cloth dipped in ice water. Do three changes and end with the ice water rub. Three changes is the most efficient benefit to time ratio and given just before retiring for sleep is the optimal time do give this treatment.


3. Muscle stretching and strengthening Exercises. This is the secret - or one of the secrets of success of chiropractic treatments and why chiropractic works so well with so many back aches. While a skillful chiropractor has much experience with this treatment and initially could do better on your back than whoever else you get to help you, it is the treatment and the range of motion and the stretching of muscles and ligaments that does the good. There are four directions that you want to stretch your back. You can do this to some extent yourself. If you have a spouse or friend or family member help you that may be an additional benefit. The four directions you want to stretch your back muscles are flexion, extension, and twist in one direction and then in the other direction. Flexing your back is arching your back like a mad cat. Extension is curving your back in the opposite direction. Then twisting as far as you can go without undue pain one direction and then in the other direction completes the four directions for stretching your back. These stretching exercises need to be done once a day every day for best results indefinitely for the rest of your life. It is particularly useful if someone else can help you with the twisting motion to gain a little bit further stretching than you can do on your own. Sometimes a pop can be heard similar to popping your knuckles. It is better not to cause the popping regularly, but sometimes great relief can be experienced with the popping sensation.  Another excellent stretching exercise (perhaps the best) is to stand against a wall with you head touching the wall as well as your heels with feet apart about the same distance as your shoulders - directly under your shoulders- and lean one way keeping your back and shoulders against the wall as far as you can and hold it for four deep breaths.  Then with your body in the same position stand up straight and bend the opposite direction again keeping your back, shoulders and heels against the wall.  Hold the position for four deep breaths.  Repeat each direction four time, once a day.


It cannot be stressed too much that your back will recover sooner and do better the more active you are within the limits of what does not cause too much pain with an acute back sprain or strain.


B) Chronic Back Pain Management


By chronic back pain is meant pain in the back that has been present for over three months. It is very important that you have had a complete diagnosis and treatment program followed as recommended by your doctor.


4. Back Exercises. The reason back exercises are so important is because of the strength given to your muscles by the exercises and the increase in blood flow in your back that results from the back exercises. The best back exercises are walking, swimming, and cycling. These exercises are characterized by little exertions often repeated. With the little exertion the blood is pressed out of the back by the muscle contraction. With the rest between the muscle contractions, blood is brought into the back again. Repeating this cycle over and over again with each step in walking or stroke in swimming or cycling, the blood flow is improved while the muscles are being strengthened.


Specific back exercises that are needed for some people include extension exercises - arching your back deliberately ten times two or three times a day as often as you think about it - in the opposite direction from a mad cat's arched back. This arching strengthening your back muscles. The second specific back exercise is to strengthen your abdominal muscles. Your abdominal muscles are at a great advantage to influence your back because they operate at a distance giving them a leverage effect. The simplest back exercise to strengthen your abdominal muscles (apart from walking, swimming, and cycling - which are all more fun!) is to lie on your back - flatten out your back while bending your knees and then lift one leg at a time up as far as you can - straightening out your leg while you do it and point and flatten your foot stretching your hamstring muscles and then place your foot on the floor with your knees bent. It is important to start and end the "kick-up" with your knee bend. If you do a straight leg raising you may increase your back pain because of the pull of your psoas muscle on your back. This is the reason for keeping your knees bend. That relaxes your psoas muscles. When it is easy to do one leg at a time, do both legs at the same time. You will feel a definite pull on your abdominal muscles. The slower you do this exercise, the longer your abdominal muscles will be contracting and the better the effect of strengthening your abdominal muscles. Do ten "kick-ups" a day five days a week for three or four months - or at least one month after your back pain is gone.


One other "back exercise" that will be good for your abdominal muscles is to learn to breath using your abdominal muscles. To do this breathe in with a deep breath letting your belly push out. Then contract your abdominal muscles to push the big breath of air out through your nose. Practice this often enough so it becomes a habitual way of breathing. Sit or stand straight (or walk straight) while practicing this abdominal breathing.


5. Drink 6 or 8 glasses of water a day. This is a positive way to get the fluid you need to give your blood the fluid it needs to keep your blood volume adequate. Dehydration (not enough water in your body) causes thicker blood that does not flow as well. Adequate hydration causes the blood to have the correct fluidity and aids in good blood flow. Avoid sugar in the water (as in most artificial or real fruit juices or "pop" drinks) and other chemicals like caffeine or the other alkaloids in tea or coffee. Sugar and alcohol causes the red cells in the blood to clump. The technical name for this clumping is "rouloux" formation. This clumping of the red cells makes it impossible for the blood to circulate through the smallest blood vessels called capillaries. High fat does the same thing. Icecream or milkshake makes rouloux formation of the red cells because of the high sugar and because of the high fat content of icecream and milkshakes. The alkaloids cause the vessels to constrict and decrease the circulation and raise the blood pressure for that reason. Water is the best liquid and the most needed liquid in the body. Water is just what the doctor ordered!


6. Eat Unrefined Food. Whole wheat or whole grain bread is the best because of the fiber, vitamins and minerals in the whole grain. Avoid flesh food of any kind - including fish and chicken because these foods have no fiber and are have high concentrations of cholesterol that is the most important determinant of promoting atherosclerosis leading to diminished blood flow to all the organs of the body including the sex organs and brain and heart. This is one of the most important steps that you can do to get rid of low back pain - to change your diet to eliminate the refined foods of all kinds including flesh foods and switch to unrefined foods of plant origin. There is no possibility of not getting enough protein as long as you take sufficient calories from unrefined plant sources. All animals you may want to eat got their protein from plant sources. Plants are the only primary source of protein. Not only will you do your back a favor to eat unrefined plant-based food, but your kidneys will also thank you. On the typical meat-rich diet of most Americans, the kidneys are overworked due to consumption of many times the body-daily-requirement of protein that must be eliminated from the body by the kidneys. In order to eliminate excess protein from the body the calcium stores are depleted causing osteoporosis in individuals who eat more protein than their body requires. Osteoporosis is not a calcium deficiency disease as much as it is a protein excess disease. A unrefined plant-based diet will greatly improve your blood flow to all of your organs and be one of the most important things you can do to improve a chronic back pain.


7. Understand the Nature of Chronic Pain. Chronic and acute pain are two entirely different "animals". Acute pain is caused by pain chemicals stimulating the local nerves as a result of the inflammation of repair caused by tissue damage from strain or sprain of joint capsules, ligaments or muscle fibers. The three acute back pain treatments are most effective for controlling and diminishing this kind of pain. Chronic pain is not caused by pain chemicals released in the inflammatory process. Chronic pain can be likened to an echo effect that a loud noise caused. Not only does the body register acute pain but it keeps a memory file of the acute pain. If the pain lasts as long as three months, then the body does not need the original nerve stimulus in order to experience the pain. Something trivial can trigger the memory patterns of the pain to fire off and the full blown pain is experienced without the original cause being operative at all. This sequence seems to be most enhanced by emotional factors that were associated with the original tissue damage. The most frequent emotions that have this capacity are resentment and bitterness and anger. If a person is angry in connection with an injury there is the most potential for that pain cause by that injury to become chronic. This is not to suggest that the pain is any the less real. Understanding the difference in mechanism between these two types of pain is important to know how to deal with the chronic pain which is entirely different from acute pain. Acute pain is dealt with by washing out the pain chemicals and promoting the resolution of the inflammation of the tissue damage and healing the tissue damage. In chronic pain there is no tissue damage. The tissue damage heals within a few weeks regardless of the pain symptoms. Chronic pain is not influenced much by those modalities that are so effect for acute pain management. The main factors that are effective with chronic pain management is to deal with the emotions of anger, hostility, revenge and bitterness when they are present. These emotions are effectively dealt with by replacing them with forgiveness, thankfulness and gratitude. The healing power of a conscience void of offense is very great. The best way to clear the conscience is through forgiveness obtained by granting forgiveness to those who have harmed you and asking those whom you have harmed for forgiveness for Jesus' sake and through His name. Once the conscience is cleared by forgiveness the way is opened for gratitude and thankfulness to take the place of anger, bitterness, fear and distrust. When these emotions are healed in this way and at the same time a high fiber, unrefined diet is eaten and exercises are done especially outside when weather permits, chronic pain begins little by little to fall away as new memory patterns replace the old pain memory patterns. The longer the pain has been present, the longer it takes to replace those memory patterns with new emotional patterns. But the effort of this healing is worth it and it works every time!


What about drugs? Drugs work primarily at the level of the brain and brain pain centers and on the mind. Pain medication works like putting a bandaid over a red light on the dash of your car. It removes the red light from being seen but it does not deal with the problem. The seven remedies here suggested for back pain deal with the problem where it exists and aids the body in healing the damage.


Want hands-on Help for your Back Pain?

Visit Black Hills Health and Education Centeronline at or

Phone 1 (800) 658-5433