Millions suffer with it. Anyone who has ever experienced back pain knows that it can keep you from doing even the simplest things. Standing, walking, sitting and sometimes even lying down can be unbearable. And forget about getting a good night's sleep!

If you have back pain, you are not alone. According to the American Chiropractic Association, back pain is the second most common reason people see a doctor. There are all kinds of back pain, both acute and chronic. Acute back pain is usually from an injury. You’re lifting a piece of furniture or a heavy box and “throw your back out.” There is a sudden sharp pain, often in the low back and wham!... you are out of commission! Or you make a sudden stop while driving and the car behind you hits your vehicle, jerking your neck and causing an injury known as whiplash. And it’s even possible that you did something as benign as turning your head too quickly. You feel a sharp pain as your neck muscles spasm.

But there are many people who have ongoing back pain from unknown causes. In some cases this chronic pain might be from an old injury, perhaps one that you can’t remember or that didn’t seem serious at the time. It may be that your back muscles are weak or atrophied from lack of physical exercise.

The pain may also be due to age. As we get older our backs get weaker for a couple of reasons: we may be more sedentary; and the natural process of aging weakens the bones, muscles and ligaments in the spine.  Pain can also be caused by anatomical conditions such as scoliosis, an "s" shaped curvature of the spine.

The spine is made up of bones called vertebrae. In the neck there are 7 cervical vertebrae, below them 12 thoracic vertebrae attach to the ribs, then 5 lumbar vertebrae in the low back. Below the lumbar spine are the sacrum and the coccyx (tailbone), and the vertebrae of these two bones are fused.  Interestingly, some people have one vertebra more or less, although rarely in the neck.

In between each vertebra are spongy pads called intervertebral discs. They are made of a tough fibrous substance, and in the center of each is a core called the nucleus pulposus which is filled with a gel-like material. The result is a structure that functions like a cushion, protecting the vertebrae and surrounding nerves.

The spine is connected to and surrounded by numerous muscles and ligaments which control bending, flexing, extending, twisting, and rotating of the spine.

From the spinal cord, which originates from below the brain stem and extends down through the center of the spine, there is a complex system of nerves. Depending on which section of the spinal cord they originate from, nerves are responsible for our many motor and sensory functions in different parts of the body. Each nerve has a “root” where it leaves the spine to extend out into the body along its specific pathway.

When the spine or its attached muscles and ligaments are injured, the body protects itself from further damage by rigidly contracting the surrounding muscles in what is called a spasm. As anyone who has ever experienced them knows, muscle spasms are extremely painful. Even the slightest movement can cause agony. With proper care, a muscle spasm will eventually relax and normal movement will be restored.

Another common cause of back pain, especially in the lumbar area, is injury to the disc. Remember the intervertebral disc? These little pads are like shock absorbers, protecting your spine as you walk, run, jump, bend, lift or do just about any physical activity. They are designed to bear our weight, but can become damaged when there is excess weight or obesity.

A common disc injury is herniation (also called a slipped, ruptured or bulging disc). This is when the disc becomes compressed squeezing its gel-like center, the nucleus pulposus, through the wall of the disc. The protruding nucleus pulposus can then come into contact with the nerve root causing pain (also known as a pinched nerve), as well as other sensations like numbness or tingling in the hands or feet. Sometimes this is not the result of an injury, but simply due to the normal wear and tear of aging. And too much sitting can also put a lot of pressure on the back, contributing to disc compression which could lead to eventual herniation.

Neck and upper back pain is another common complaint. Herniated neck, or cervical, discs can result in arm pain, weakness or numbness, as well as neck pain, spasm and difficult movement. As with lumbar discs, injury or age can be the cause. Working at a desk or computer for long periods of time can put stress on the upper back and neck leading to tight, painful muscles.

Many people with back pain, especially chronic back pain, become frustrated at the inability of conventional medicine to treat the problem. Treatment is usually physical therapy, pain medication, surgery, or any combination of the three. There are, however, alternative therapies which can help. Chiropractic, massage, yoga, and acupuncture can be very effective for both acute and chronic back pain.  And stress reduction techniques are a must for people with chronic back pain.

Acupuncture looks at the causes of back pain differently than conventional medicine. Chinese medicine recognizes “patterns” that relate to the kind of back pain a person is experiencing. For instance, chronic low back pain that is dull and feels better after resting is called a Deficiency pattern and is seen in middle aged and elderly people. A pattern of Blood Stagnation would be characterized by symptoms of sharp, stabbing pain. The muscles are stiff and tight, and feel worse after rest or inactivity. This can be compared to a diagnosis of acute sprain or strain. People with a pattern of obstruction due to Cold or Damp feel the pain is made worse when exposed to the cold or to damp, wet weather. In this case there may be numbness or swelling or even the sensation of heaviness. Pain is relieved by heat.

After talking with the person about his or her symptoms and diagnosing the pattern, the acupuncturist will design a treatment using needles, acupressure, massage, cupping, heat, or a combination of techniques.

Acupuncture involves the insertion of thin needles in specific points along energy pathways called channels or meridians. It works by helping to release tight, constricted back muscles and relieving the spasm. According to traditional Chinese medicine theory, the needles unblock stagnation in the channel, allowing the energy to flow smoothly. For people with back pain due to Cold or Damp, heat would be applied. For Deficiency, treatment would include acupuncture points to help build up a person’s energy and immunity. Treating a Blood Stagnation pattern would focus on breaking up the stagnation so that blood could flow smoothly, leading to pain relief and healing.

Cupping is a procedure whereby the acupuncturist uses glass globes (cups) to create suction on the painful areas, helping to release spasm and relax the muscles and ligaments. Using heat, a vaccum is created which adheres the cups firmly to the skin creating a negative pressure. The cups then either remain in place or can be slid around the problem area in a kind of massage. This increases circulation, improving blood flow to the area and promoting the healing process.

Worth noting is if you have any kind of back pain, you should be aware that it can be a symptom of a more serious condition. Don’t hesitate to seek immediate medical attention if the pain:

• wakes you up at night
• is accompanied by fever or weight loss
• is unrelated to movement
• is accompanied by blood in the urine or painful urination
• radiates to the chest
• is severe enough to cause you concern

However you choose to deal with your back pain, you will also need to incorporate stress reduction, daily exercise and proper nutrition into your treatment plan. When you don’t exercise (and especially if you aren’t eating right), muscles become weak and malnourished and don’t do an effective job of supporting your spine. Stretching and strengthening your back and abdominal muscles is key to avoiding a lifetime of chronic back pain.