Chronic back pain can be increadibly frustrating Acute back pain is difficult enough to deal with, but at least you probably know the cause. You take painkillers, and it subsides over the next week or so. But with chronic back pain or chronic neck pain, the misery goes on and on. You try everything: painkillers, muscle relaxants, hot and cold compresses, chiropractor visits, yoga, and assorted relaxation techniques.
The pain may diminish or disappear for a time. But then one day you’re hoisting a bag of groceries out of the trunk of your car, or you slip in the shower and catch yourself, and ouch! There’s that pain again, in full force. Or sometimes the pain returns again and again for no known reason, a mystery pain that is all too often hard to diagnose. In some cases, people suffer for years without doctors being able to pinpoint the exact cause.
Episodes of back pain are one of the most common reasons that people visit their doctors. An estimated 8 out of 10 Americans will experience back pain at some time during their lives.
If you look at the anatomy of the back and neck, it’s easy to see why. You have 24 vertebrae—individual back bones—each with a different angular shape. Each is cushioned by a disk, attached to assorted ligaments and tendons, and threaded through with some of the most crucial nerves in the body. Except for the nerves in the head, all of the body’s other nerves are wired through the back and neck. And the whole structure has to bend and twist every which way as you go about your daily life.
It’s all so anatomical—ligaments and tendons and nerves. It’s hard to believe that nutrients might prove helpful. But there are a couple of them that sometimes bring significant relief. While they aren’t exactly on the top of the list for back pain treatment, they fall into the category of complementary remedies that are safe and worth a try.
A 2006 study done at the University of Pittsburgh found that fish oil, which contains high amounts of the omega-3 fatty acids EPA and DHA, reduces both pain and the need for pain medications in people with chronic back and neck pain. In this study, 250 people with either chronic back or neck pain who had been taking non-steroidal anti-inflammatory drugs (NSAIDS) took fish oil supplements as a therapy for their pain. They were not asked to discontinue their NSAIDs.
For the first 2 weeks, study participants took fish oil supplements that provided 2,400 milligrams of the essential fatty acids EPA and DHA. After 2 weeks, they were asked to reduce their dose to 1,200 milligrams.
After approximately 75 days, study participants were asked to fill out questionnaires. Of the 125 who completed the questionnaire, a full 80 percent reported that they were satisfied with the amount of improvement in their pain symptoms. And 59 percent reported that they were actually able to discontinue their NSAIDs. Long-term use of NSAIDs is associated with a number of side effects, including ulcers and stomach bleeding.
“It is important for patients to understand that safer, less-toxic alternatives to anti-inflammatories are available,” says study author Joseph Maroon, MD. “A fish oil supplement containing omega-3 essential fatty acids is a natural alternative treatment that reduces the inflammatory process and thereby reduces pain, with fewer side effects.”
A number of studies have shown that high doses of vitamin D often bring significant relief from back pain, especially in those who are deficient. In 2008, Stewart B. Leavitt, PhD, published an online review of 22 clinical investigations of people with chronic musculoskeletal pain. The combined studies, which looked at a total of 3,670 people, found that anywhere from 48 to 100 percent (depending on the study) were deficient in vitamin D. When these people took high doses of vitamin D supplements, pain relief was, in most cases, substantial.
Dr. Leavitt’s report calls for supplements in the range of 2,400 to 2,800 IU. This is considerably higher than most doctors and nutritionists are willing to endorse. If you’d like to give vitamin D therapy a try, discuss it with your doctor and encourage him or her to read Dr. Leavitt’s report. And be aware that vitamin D supplementation, according to the report, does not provide instant relief. It can take several months for the therapeutic effects to kick in.
Dr. Leavitt’s report looked at musculoskeletal pain in general. That kind of pain, of course, includes back pain. But has anyone looked at vitamin D specifically for back pain relief? Actually, yes. There have been a couple of studies showing positive results.
In 2003, the scientific journal Spine published a Saudi Arabian study that looked at 360 people who visited clinics for chronic back pain. The study found that 83 percent had an “abnormally low” level of vitamin D. After treatment with vitamin D supplements, all of those who originally showed abnormally low levels experienced measurable improvement in their back pain symptoms. And 95 percent of study participants—including those who were not abnormally low in vitamin D—experienced improvement.
In another study, conducted in 2008, Gregory Hicks, PhD, assistant professor in the physical therapy department at the University of Delaware, and colleagues found that moderate to severe back pain in women 65 and above is often associated with vitamin D deficiency. He recommended that older women with back pain always have their vitamin D level tested.
Also note: If your back or neck pain is caused by the disk degeneration that sometimes accompanies osteoporosis, there are some other supplements that may prove helpful.
“Vitamin D—A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain: An Evidence-Based Review and Clinical Practice Guidance” by Stewart B. Leavitt, PhD, published online in June 2008, at Pain-Topics.org
If you are experiencing chronic episodes of back pain or neck pain, make sure you see your doctor for evaluation and treatment.
Omega-3 Fatty Acids |
2,400 milligrams EPA and DHA from fish oil for 2 weeks, then 1,200 milligrams of EPA and DHA* |
Vitamin D† |
2,400 to 2,800 IU |
*The amount of EPA and DHA in fish oil can vary from product to product. Read labels to determine the amounts in your product so you can take enough to achieve the recommended levels. And do make sure you are taking pharmaceutical grade fish oil. Fish oil has a blood-thinning effect. If you’re taking any kind of blood-thinning drug, talk to your doctor before taking fish oil supplements.
† These are high levels of vitamin D. Do not take this amount on your own. Ask your doctor to test your levels of vitamin D and to recommend an appropriate amount for you. Your doctor may have you take a considerably higher amount for a short period of time.