a
About 80 percent of all Americans will suffer from low back pain at some point in their lives. Backache becomes more common between the ages of thirty and fifty as the intervertebral disks lose some of their ability to absorb shock and backs become more unstable from inactivity and prolonged sitting. According to the National Center for Health Statistics, back pain is the fourth most common chronic ailment, the sixth most common reason for visiting an emergency room, and accounts for 13 million visits to primary care physicians’ offices each year, making it one of the most common reasons for seeing a doctor. Back pain is responsible for 60 million lost working days each year, which in turn costs the economy $5.2 billion.
Although we often think of the back as a single entity, it is actually a complex connection of bones, nerves, muscles, and ligaments with multiple functions. Together, all these parts of the back allow us to do a variety of activities, to comfortably remain in one position, to balance ourselves, and to perform very complex movements. The nervous system also helps coordinate various motions so that the different muscles and joints in particular areas work together to allow for seamless movements and actions.
Backache is the term used to describe a variety of conditions. Since X-rays usually reveal no abnormality, your symptoms and a physical exam are the major components in establishing a diagnosis. However, up to 85 percent of patients with low back pain cannot be given a definitive diagnosis. The most common types of backache are:
1. Sprain and strain—often used interchangeably, the most prevalent forms of low back pain. A strain is usually an overstretched muscle, and a sprain a partially torn ligament, but in most cases of backache it isn’t clear which one is the cause.
2. Muscle spasm—a painful, sustained, and involuntary contraction of muscles in the back.
3. Disc problem (a slipped disc)—accounts for only 2 to 4 percent of backaches. In actuality, the disc herniates or bulges from between two vertebrae and may eventually rupture. This bulging disc may push against a spinal nerve, causing shooting pains, tingling, or numbness to extend into the leg. Most often the affected spinal nerve is the sciatic, the largest one, and when that occurs the condition is called sciatica.
MRI (magnetic resonance imaging), considered the most high-tech diagnostic tool, is known to be inaccurate 10 to 20 percent of the time with backache. Yet thousands of painful and expensive surgical procedures are performed every year based on the results of MRIs that show slipped or herniated discs. This practice has continued despite a study published in the New England Journal of Medicine that found no correlation between structural abnormalities (e.g., herniated disc) revealed on MRIs and back pain.
Low back pain from all causes is the most common reason for using medical marijuana. People suffering with low back pain comprise a third of my MMJ patient population. The vast majority of these patients use MMJ on a daily basis, usually late afternoon, shortly after finishing their workday. They either vaporize or smoke an indica strain or ingest an indica edible. Remember that indica usually contains higher amounts of CBD (and lower THC content than sativa strains), which is not only a strong analgesic but reduces anxiety and is also an excellent muscle relaxant. The overall effect (with inhalation) is almost immediate pain relief and relaxation, just what most of us could use for an aching back following a stressful day at work.
Other effective MMJ options for backache:
• Topicals—localized (apply directly to painful area); this is especially helpful during work hours; not psychoactive and an effective analgesic for two to three hours
• Topicals—generalized (apply to wrist or ankle for rapid absorption)—transdermal patches, especially 1:1/CBD:THC and CBN (best used in the evening for pain and sleep)
• Vaporizing high-CBD strains of flower—especially Harlequin (a 50:50/S:I hybrid), Lucy (a 70:30/I:S indica), Cannatonic (a 50:50 hybrid); or other hybrids (either 50:50 or 60:40/S:I or 60:40/I:S)
• High-CBD tinctures—1:1, 2:1, 3:1, 6:1, or 20:1/CBD:THC
• High-CBD hash oil—3:1, 6:1, 12:1, or 20:1/CBD:THC
• Indica strains of flower, with I:S of 70:30 or above
• Indica and hybrid edibles—gluten-free, without sugar or dairy
If sciatica accompanies the backache, it is often a more severe pain and requires the strongest MMJ analgesic products, such as Harlequin, vaporized or in a tincture. THCa, a potent anti-inflammatory, is also helpful for sciatica, in either a tincture (preferred) or a transdermal patch. It can be used in conjunction with other MMJ products.
• Lifting heavy objects improperly—e.g., moving too quickly or awkwardly, or bending from the waist
• Poorly conditioned muscles (both back and abdominal) due to lack of exercise and flexibility and excessive exercise
• Posture problems and leg length discrepancy
• Prolonged standing, insufficient arch support, and inappropriate footwear, such as high heels
• Obesity and pregnancy
• Inadequate support from a soft mattress
• Uncomfortable workstations, such as chairs with improper support or working under an automobile or with heavy equipment
• Nutritional deficiencies, especially low protein, manganese, and magnesium intake (diuretics used to treat high blood pressure can lower magnesium), and constipation
From my own experience and that of several of my holistic medical colleagues, I believe that yoga may not only be the most therapeutic exercise, but is probably the single best self-care therapy for treating chronic low back pain. I’ve also been impressed by the survey results from the book Backache Relief, by Arthur Klein and Dava Sobel. Published in 1985, the survey asked people (they had 492 respondents) who had been treated for backache to evaluate their practitioners based on the extent of the relief they experienced following their treatment. Yoga instructors fared best, with 96 percent of the respondents experiencing moderate-to-dramatic relief from back pain after practicing the yoga positions they’d been taught. The complete results of the survey are as follows:
Practitioner |
Moderate-to-Dramatic Temporary Relief (%) |
Moderate-to-Dramatic Long-Term Relief (%) |
Yoga Instructors |
96 |
4 |
Physiatrists/Physical Medicine & Rehabilitation (PM&R) |
86 |
0 |
Physical Therapists |
65 |
8 |
Acupuncturists |
36 |
32 |
Chiropractors |
28 |
28 |
Osteopathic Physicians |
28 |
15 |
Neurosurgeons |
26 |
8 |
Orthopedists |
23 |
9 |
Family Practitioners |
20 |
14 |
Massage Therapists |
10 |
63 |
Neurologists |
4 |
4 |
Yoga (a Sanskrit word meaning union) is a Hindu spiritual and ascetic discipline. It refers to a balanced practice of physical exercise, breathing, and meditation to unify body, mind, and spirit, making yoga one of the most effective and ancient forms of holistic self-care. The benefits of this five-thousand-year-old system of mind-body training to improve flexibility, strength, and concentration are well documented. The basis of yoga is the breath, a variant of abdominal or belly breathing. There are a number of yogic systems. Hatha yoga is the best known in the West. Hatha yoga postures, or asanas, affect specific muscle groups and organs to impart physical strength and flexibility, as well as emotional and mental peace of mind.
There are a variety of hatha yoga forms available. Initially it is preferable to receive instruction for the first two or three months, due to the subtleties involved in yoga practice that are not apparent without firsthand experience of its practice under the guidance of a qualified yoga instructor.
While writing the book Backache Survival in 2002, I consulted with five yoga instructors and asked each of them, “What are your top three yoga asanas that you would recommend to someone with low back pain from any cause?” Wherever they overlapped, I added that pose to my list, and was able to compile my own list of what I consider the top ten yoga poses for treating low back pain. Each one is a relatively simple stretch that can be performed on a yoga mat or on a carpeted floor. In yoga there is no such thing as perfection or competition. It is not a goal-oriented practice, nor is there the belief “no pain, no gain.” In fact, the beauty of yoga is that there should be no pain.
You should begin yoga or a daily stretching regimen only after you have given your back a chance to rest and heal following an injury or an acute flare-up of back pain. If you’re someone with backache, the practice of yoga is too valuable for you not to at least give it a try. If practiced on a consistent basis, I’ve found it to be the most effective therapy for long-term relief of low back pain.
With all of the following poses listen to your body and stretch gently to the point of pain and then back off just enough so that you experience no pain. As you practice them daily, your flexibility will gradually increase, and you’ll be able to stretch a bit farther without any pain. By trying to achieve too much too quickly you can slow your progress and possibly injure yourself. Hold each pose for five breaths or approximately thirty to sixty seconds while breathing abdominally and if possible through your nose. Unless specified otherwise, repeat each position twice. If a particular stretch is meant to be done on both sides of your body (e.g., the Knee-to-Chest should be done for both the left and right knee), then do each side twice. Commit to spending at least fifteen to twenty minutes daily practicing the following ten yoga poses. Remember to breathe. With some, you’ll be instructed to coordinate your breath with the stretch (e.g., Cat-Cow). Yoga can be very relaxing as well as remarkably helpful for your aching back. Enjoy the process!
YOGA POSES FOR LOW BACK PAIN
Knee-to-Chest: This position gently stretches the muscles in the hips, buttocks, knees, hamstrings, and lower spine, and strengthens core abdominal muscles, while keeping the spine in a protected position. There are two options for performing this stretch. They both begin the same way. Lying on your back, slowly bring one knee up to your chest, or as high as you can without experiencing pain. You can keep your opposite knee bent or straight, whichever feels better (with back pain, it’s usually more comfortable bent). In position a, clasp your hands on your shin between your knee and your ankle. In position b, clasp your hands on your lower thigh just above the back of the knee. In both positions, on every exhalation, gently pull or squeeze your knee closer to your chest. On every inhalation, relax. Keep the knee flexed with both the pulling/squeezing and releasing. Continue this slow rhythmical breathing, while squeezing and relaxing. Feel the stretching in your hip joint, knee, and lower back. Repeat the same sequence with the opposite knee.
a
b
Supine Pelvic Tilt: Lie on your back with your arms to your sides and palms down. Bend both knees, keeping your feet flat on the floor. With each inhalation, arch your low back while keeping your hips on the floor (a). This will create a space between your low back and the floor. Exhale and press your low back into the floor (b). Repeat this movement of tilting your pelvis back and forth at least ten to twelve times.
a
b
Cat-Cow: Turn over and place your hands directly under your shoulder joints, your knees under your hip joints, thighs and shins forming right angles. Your feet are in alignment with your knees. Toes point straight, and soles of feet face upward. Your spine has the same curves as it did when you were lying on your back in position b above, but now you are turned over, and with this movement your spine will flex and extend as you tilt your pelvis back and forth. Another benefit of this position is that because you are on your hands and knees, all of the weight is off your back, allowing for a greater capacity to stretch and heighten mobility of the spine.
For the Cat Pose (a), tuck your pelvis, drop your head, and round your back like an angry cat. Your hips (pelvis) are tucking and your spine is bending (flexing). This movement presses the air out of you, just like a bellows (exhale as you do it). You are also relaxing all the muscles in your head, neck, and shoulders as you do this stretch.
For the Cow Pose (b), tuck your pelvis as you inhale slowly, lift your head, look up, and gently release the arch from your thoracic spine (mid-back), forming a concave curve.
With both poses, move and breathe in a harmonious and relaxing rhythm while doing ten cycles initially and gradually working up to twenty-five cycles.
a
b
Chair Forward Bend: Sit in a chair with your knees wide apart, and your heels placed under your knees and your toes pointed slightly inward. Use a chair with a firm seat that allows your feet to be placed flat on the floor, or place books under your feet. Be sure your legs are parallel to each other, so that your shinbones provide support and you don’t twist your knees. To begin, slide your buttocks to the back of the chair and tilt your trunk (from your waist up) forward to lean your elbows on your knees. Let your head hang forward so the back of your neck is stretched. If this position is too uncomfortable or if you have high blood pressure, glaucoma, or a detached retina, then maintain this pose for a few slow abdominal breaths and go no further. If none of these precautions apply to you, then tilt your trunk fully forward, letting your head and arms hang between your legs. If your hands don’t touch the floor, then place them on books. Remain in this position and relax into it by tucking your chin slightly to stretch the back of your neck and soften the front of your neck as well. Hold this position for at least twenty to thirty seconds as long as you’re not feeling pain. To come out of it, do not use your back muscles. Press your hands into the floor and begin moving up until your elbows rest on your knees, and then pause for several breaths. Then place your hands on your knees or on the seat of the chair, pushing your trunk upward while your head is still hanging forward. Straighten your head last, and then sit and breathe for another ten to twenty seconds without moving.
Cobra: Lie facedown on your belly. Place the palms of your hands on the floor in line with your chest and your fingertips in line with your shoulders, with your elbows close to your body, your feet together, and your forehead on the floor. Slowly extend your head so that your chin first touches the floor. Continue extending and lifting your head off the floor while raising your upper body. Use only your upper back muscles to lift (not your hands). Look up as you extend your head and neck as far as you can without straining, while feeling a backward bending in your spine. Come up only as high as is comfortable for you. Inhale as you do each progressive extension and raise your upper body. To lower, reverse the order, lowering your chest, then your chin, and then your forehead to the floor. Repeat this cycle five times. Remember to breathe and keep only light pressure on your palms so that your back muscles are doing the work. Try to relax the muscles in your buttocks as you maintain this position for as long as you can without forcing or straining. After completing at least five cycles, turn your head to one side, close your eyes, straighten and lower your arms to the floor, breathe, and relax. In addition to stretching and strengthening the muscles that extend your spine as well as your abdominal muscles, this stretch also helps to open up the disc spaces.
Desk Pose or Bridge: This pose is the counter pose of Cobra. Lie on your back and align your body as in the Supine Pelvic Tilt. This movement is very similar to the Cobra, except that now instead of your abdomen, your upper back becomes the base. Begin by exhaling and lifting your hips just an inch off the floor while keeping your waistline on the floor. If it’s not uncomfortable for you to do so, with each subsequent exhalation you can raise your pelvis higher, but do so very slowly (about an inch with each out breath). As you raise your pelvis, press down on your arms, hands, and the inside edges of the feet. Keep your knees and feet in alignment with the hip joints. Continue lifting up until you feel your lumbar spine (low back) beginning to arch.
Hamstring Stretch: There are several methods for effectively stretching the hamstrings. Located in the back of the thigh, they are among the most powerful muscles in the body. Every yoga instructor with whom I consulted emphasized the importance of stretching the hamstrings in healing low back pain. (Surprisingly, it was the only one of these ten stretches selected as one of the top three by all five teachers.) I was given three hamstring options, which I’ll present here.
(a) Lying on your back, bend one knee and bring it to your chest by clasping your hands behind your lower thigh just above the back of the knee. Then slowly straighten your leg at the knee joint, holding it in a vertical position, as close to ninety degrees as you can without forcing or straining. Hold the stretch for thirty to sixty seconds. It may be more comfortable to do this stretch if you bend the other knee while keeping that foot flat on the floor. To release this stretch you can slowly lower your leg to the floor, feeling its full weight as you lower it. Or if that’s too uncomfortable, you can simply reverse the above stretch and bend your leg at the knee as you lower the leg and rest your foot on the floor. Repeat this stretch for the other leg.
(b) Begin this stretch just as you did in step a. However, instead of clasping your hands behind your thigh, place the center of a strap or belt on the ball of your foot before you gradually straighten your leg. Wrap the ends of the strap around your hands (ideally the strap should be six to eight feet in length) and hold for thirty to sixty seconds. The rest of this stretch is the same as step a.
(c) This hamstring stretch uses a doorway or a wall to support your leg, keeping your knee straight and stretching the hamstring. It’s very similar to a and b, but with this one you can rest your arms on the floor. I find it a little easier to do than the other two and I’m able to hold the stretch much longer (two to three minutes). With all three of these options, remember to stretch both legs.
a
b
c
Forward Bend: Stand with your feet parallel, about hip width apart. Inhale while raising your arms up over your head with your palms facing each other. As you exhale, bend forward at the hips and gradually lower your hands toward the floor while slightly bending the knees (do not lock knees). Bend forward until you feel a gentle stretch in your hamstrings. Hold this position while breathing for thirty to sixty seconds.
Easy Back Twist: Lie on your back with arms outstretched to the sides in a “T” position, with palms facing down. Bend your right knee and place your right foot on top of the left knee. Grasp your right knee with the left hand and gently draw the knee toward the floor on the left side of your body. Keep the right shoulder pressed to the floor, turn your head to the far right and gaze at your right hand. Hold for thirty to sixty seconds or five breaths. Release the knee and extend the leg and place it on the floor. Repeat the same sequence on the left side.
Relaxation Pose (Shivasana): This should be the final position of your yoga session. It will help you to become more fully relaxed, yet still conscious. It trains the body in stillness, the mind in alert quietness, and teaches systematic release of tension throughout the entire body. With each inhalation imagine that the breath is filling your chest, abdomen, back, and pelvis with cleansing or purifying air. With each exhalation, imagine that the breath is taking with it tension and toxins. Each in-breath can radiate in and illuminate every part of your body that it enters. It is helpful and can be especially healing to see a bright white light filling your low back with each breath. You should be very comfortable and warm in this pose, lying on a thick mat, a blanket (or under a blanket), or folded towels.
Begin by sitting on the floor with your knees bent and the soles of your feet on the floor. Place your hands behind your hips, palms down, with your fingers under your buttocks. Lean back on your elbows, your chin in, chest expanded, and shoulders away from your ears. Rest the back of your pelvis on your hands. Press your feet to the floor and gently push your body backward, hips sliding over hands, until your whole back, pelvis to shoulders, rests on the floor. Your head then comes to the floor with the chin tucked and neck elongated. Slide your hands out from under your hips and turn palms up. Extend your arms outward about fifteen degrees from your sides. Press your whole body downward into the floor—your feet, lower back, and the back of your neck and head. Feel your spine elongating. Exhale and relax. Extend first your right leg out on the floor, and then the left. Your feet, knees, and thighs turn outward. Now turn your attention to yourself, while trying to detach from any noise, activity, and your thoughts. You are aware of all of them but choosing not to give them any of your attention. Try to focus on your breath as it flows in and out, and feel the tension leave your body, from the crown of your head to the soles of your feet. Relax your tongue and your jaw muscles as your mouth opens slightly. Your arms and legs feel soft and heavy. Your hands and feet melt into the floor. Become very still and listen to the internal sounds of your body—the rhythmical beat of your heart, the breath flowing in and out. Use the imagery described above and rest in this relaxed state for about five minutes before you slowly come out of the pose. Begin to stretch your fingers and toes wide apart. Roll onto your side, knees to chest, hands cushioning your head. After a few breaths, come up to a sitting position. Sit for a few minutes with legs and ankles crossed, spine straight, head centered, and hands on knees. Feel gratitude for the healing gift you’ve just given yourself. In addition to the therapeutic benefit to your back, the consistent practice of yoga, even for just twenty minutes a day, is one of the most beneficial health practices I’ve ever experienced—for body, mind, and soul.
Maintaining the structural alignment of the muscles, tendons, joints, bones, and fascia (the lining of muscle) is an essential component of the holistic treatment for chronic low back pain. Several treatments by an osteopathic physician, chiropractor, or other trained or certified practitioner may be needed. Lasting benefit is most likely to be obtained with the more indirect types of treatments, such as myofascial release or craniosacral osteopathy. The more direct or high-velocity thrusting techniques, which force areas that are out of alignment back into alignment, are usually more helpful with acute injuries than with chronic back pain. However, other forms of osteopathic or chiropractic treatments, which usually consist of gentler techniques, can be helpful in some cases of chronic pain. But if these modalities or any other forms of therapy do not offer noticeable improvement after three to six treatments, it is important to evaluate whether to continue.
Physical therapy performed by a highly skilled therapist using a variety of modalities, such as heat, ice, ultrasound, and electrical stimulation, is often helpful. However, these are adjunct therapies and are not substitutes for structural treatment. They are unlikely to provide lasting relief with chronic pain when used alone. Standard physical therapy often utilizes strengthening exercises to overcome areas of weakness or misalignment. A holistic treatment program is designed to help the body to realign itself, thus healing the weakness and directly treating the cause of the problem.
There are several other forms of bodywork or body movement therapies that may be helpful in treating chronic low back pain. These therapies utilize methods to retrain the nervous system to improve posture, alignment, balance, coordination, and self-awareness. They can help you to move more efficiently and to be more aware of your body and how it works. Some of the more common body-based therapies include Pilates, Feldenkrais, Rolfing, and Alexander Technique. The Lauren Berry Method of bodywork is not as well known, but is also highly effective. These approaches often involve both hands-on treatments and instruction from the practitioner for exercises to be done by the patient at home. These exercises can directly address the cause of the back pain by helping the body to integrate its functions and resolve areas of dysfunction.
With any of these therapies for treating chronic back pain, you need to continually evaluate their benefit. If you are receiving the same treatment repeatedly without lasting results, the therapy is probably not addressing the underlying cause. Not only can continuing such a course of treatment become expensive, but it can also create a dependence on the practitioner. Holistic medicine attempts to address causes while empowering patients to learn to heal themselves.
Yoga is the most effective exercise for both treating and preventing chronic low back pain. Remember—DON’T PUSH YOURSELF. If you keep it slow and steady, practicing every day, you might very well end up with a healthier back than you had prior to the onset of your back pain.
If you do not practice yoga, you should at least do several stretching exercises every day. A physical therapist can teach you, or you can refer to the book Stretching by Bob Anderson.
Brisk walking, swimming, or any other gentle form of aerobic exercise is recommended for treatment and prevention of chronic backache.
Acupuncture may be helpful for both acute and chronic back pain. It may offer substantial and long-lasting relief, and it often works well in combination with structural approaches. The sooner the problem is addressed with acupuncture, the better the chance that it will work.
Be sure your bed provides good support. Waterbeds and soft mattresses should be avoided.
Being overweight is a significant risk factor for chronic low back pain. If this applies to you, then I’d suggest following the candida-control, anti-inflammatory, hypoallergenic diet presented in Chapter 5. It’s a highly nutritious, low carbohydrate diet that nearly always results in significant weight loss.
Energy medicine, using Healing Touch or Reiki, can be helpful in treating chronic low back pain. They work similarly to acupuncture, but instead of the specific meridians used by acupuncturists, these modalities should be applied directly to the low back. Using imagery while being treated by a practitioner of energy medicine will often enhance the effectiveness of the treatment.
Fear is the underlying emotion contributing to backache. Louise Hay, in her classic book You Can Heal Your Life, writes that a fear of money and lack of financial support may contribute to backache. People with low back pain also tend to have a need for control, so part of their stress may be a fear of being out of control or losing control.
Sciatica is often associated with concerns about financial security.
Caroline Myss, in Anatomy of the Spirit, believes the mental/emotional issues that may be associated with low back pain are those of the first and second chakras (the energy centers described in Ayurveda, the traditional medicine of India). These issues in the tissues of the low back are:
• Family relationships and group safety and security
• Ability to provide for life’s necessities
• Ability to stand up for self
• Comfortably occupying one’s home
• Social and familial law and order
• Blame and guilt
• Money and sex
• Power and control
• Creativity
• Ethics and honor in relationships
Louise Hay believes that backs represent the support of life and suggests the following affirmation for preventing back pain: I know that life always supports me. Specifically for low back pain, she suggests: “I trust the process of life. All I need is always taken care of. I am safe.”
Just as with any other malfunctioning part of the body, there are a wide variety of affirmations that you can create that will represent a healthy back to you. Some examples might be: My back is strong and flexible. I am sitting, standing, bending, and lifting normally. My back is now completely healed. I am stretching every day and my back continues to heal.
Relaxation techniques and biofeedback work well for backache related to muscle spasm and muscle tightness—the variety of backache often related to chronic stress.
Visualizations that represent healing are very powerful. Whatever your understanding of the cause of your back pain, it can be used to create a healing image. If the cause of your pain is unknown, then just ask for a healing image to come to you and use it every day while doing a breathing exercise. You could imagine each breath filling your abdomen and low back with light and energy, or a laser beam of light zeroing in on any abnormal tissue or contracted muscle. The light could either heal the tissue or relax the muscle enough to allow for a realignment of the spine to take place. Since the regular practice of visualization has been known to successfully dissolve cancerous tumors, it can certainly help to relax tight muscles and move bones.
Counseling can also be helpful in treating chronic low back pain.
The following story is a dramatic but typical account of the many positive treatment outcomes I’ve seen using medical marijuana for chronic low back pain.
Bruce S. is a forty-three-year-old computer programmer in Boulder, married, and the father of two, with a passion for the outdoors. A day after he slipped and fell on a rock while hiking with his family, he awoke with back pain so severe that he was unable to get out of bed. Muscle spasms seized his back with the slightest movement. A searing sciatic pain, radiating down to his knee, left him almost totally incapacitated.
Bruce’s physician referred him to an orthopedic doctor, who, following an MRI revealing a partially ruptured disc in his lumbar spine, immediately recommended surgery. Bruce and his wife did some quick research and found that back surgery generally has a low success rate, so they decided to explore other treatment options. He visited a chiropractor, physical therapist, massage therapist, and an acupuncturist, but their treatment provided only minimal, temporary pain relief. His doctor prescribed various narcotics, primarily oxycodone, which masked the pain for a few hours, but he hated the side effects: drowsiness, constipation, and nausea.
After a few weeks, Bruce couldn’t live with the pain any longer, so he decided on surgery. His fears were confirmed: the surgery didn’t work. There was minimal improvement for the first few weeks, but he still continued with daily doses of oxycodone just to function. After several months he saw a pain medicine specialist who told Bruce that he should consider another surgery. More drugs, including antidepressants and muscle relaxants, were prescribed. Now a chronic condition, Bruce’s back pain was straining his marriage; he could no longer sit on the floor with his baby daughter or lift his toddler son.
After more than a year of dead-end treatments, Bruce limped into my office in Boulder. Not only was his back pain excruciating, but also the ordeal had left him suffering severe bouts of anxiety and depression. Bruce felt hopeless and desperate. He admitted to being addicted to oxycodone.
“I have no life,” Bruce said. “I can’t even play with my kids. I’m not sleeping, and I’m concerned about losing my job.”
Bruce was an ideal candidate for medical marijuana—specifically the indica strains that are typically high in CBD. In addition to marijuana, I suggested a regimen for gradually tapering off oxycodone. I also recommended daily yoga and gentle stretching, as well as a program of mindfulness and self-reflection.
After six weeks of daily doses of medical marijuana, Bruce returned to my office a different person, physically and emotionally. He had reduced by half his daily dosage of the narcotic pain relievers. After three months, he had stopped the drugs completely, relying solely on medical marijuana for pain relief, and continued with the holistic program of yoga and meditation. He and his wife were getting along better, his boss was pleased with Bruce at work, he was sleeping through the night, and he was lifting and playing with his children.