Healthnotes Newswire — If you have experienced low back pain (LBP) then you are among the 80% of American adults who suffer from this condition sometime during their life.1 And in half this population, the problems will reoccur. Factors that could lead to backache in your future include standing or sitting for extended periods, wearing high heels, lifting improperly, and being sedentary or obese. Pregnancy and long hours spent driving are additional predisposing factors that can add up to a tweaked back.
Ease Inflammation with Enzymes
Proteolytic enzymes, including bromelain, trypsin, and chymotrypsin, may be helpful in healing minor injuries because they have anti-inflammatory activity. Several preliminary trials have reported either reduced pain and swelling, faster healing, or all three, in people with a variety of conditions who use either bromelain or papain.2 3 4
Three double-blind trials have investigated the effects of supplementing a combination of trypsin andchymotrypsin for seven to ten days on severe low back pain with or without accompanying leg pain. Eight tablets per day were given initially in all trials, but in two trials the number of pills was reduced to four per day after two to three days. One of these trials reported small, though statistically significant, improvements for some measures in people with degenerative arthritis of the lower spine.5 People with sciatica-type leg pain had significant improvement in several measures in one trial,6 while another found the enzymes were not much more effective than a placebo.7 These trials included chronic low back conditions, so their relevance to acute LBP alone may be limited.
B-Vitamin Combo Brings Reprieve
A combination of vitamin B1, vitamin B6, and vitamin B12 has proved useful for preventing a relapse of a common type of back pain linked to vertebral syndromes,8 as well as reducing the amount of anti-inflammatory medications needed to control back pain, according to double-blind trials.9 Typical amounts used have been 50–100 mg each of vitamins B1 and B6, and 250–500 mcg of vitamin B12, all taken three times per day. Note: Such high amounts of vitamin B6 require supervision by a doctor.
First Aid with a Unique Amino Acid
Several animal studies and some research involving humans suggest that a synthetic version of the natural amino acid L-phenylalanine called D-phenylalanine (DPA), reduces pain by decreasing the enzyme that breaks down endorphins.10 It is less clear whether DPA can help individuals with LBP, though there are a small number of reports to that effect,11 including one uncontrolled report of 27 of 37 people with LBP experiencing “good to excellent relief.”12
Back to Basics
In a double-blind trial, University of Texas researchers found that 250 mg of DPA four times per day for four weeks was no more effective than placebo for 30 people with various types of chronic pain; 13 of these individuals had low back pain.13 In a Japanese clinical trial, 4 grams of DPA per day was given to people with chronic low back pain half an hour before they received acupuncture.14 Although not statistically significant, the results were good or excellent for 18 of the 30. The most common supplemental form of phenylalanine is D,L-phenylalanine (DLPA). Doctors typically recommend 1,500–2,500 mg per day of DLPA.
Heat Up Your Healing
Topical cayenne pepper has been used for centuries to reduce pain. More recently, a special extract of cayenne called capsaicin has been found to diminish localized pain for a number of conditions, including chronic pain, although low back pain has not been specifically investigated.15 16 Capsaicin creams typically contain 0.025–0.075% of capsaicin.17
While capsaicin cream causes a burning sensation the first few times used, this decreases with each application. Pain relief is also enhanced with use as substance P, the compound that induces pain, is depleted.18 To avoid contamination of the mouth, nose, or eyes, hands should be thoroughly washed after use or gloves worn. Capsaicin cream should not be applied to broken skin.
Willow bark is traditionally used for pain and conditions of inflammation. According to one double-blind trial, use of high doses of willow bark extract may help persons with low back pain. One trial found 240 mg of salicin from a willow extract to be more effective than 120 mg of salicin or placebo for treating exacerbations of low back pain.19
Don’t forget about the basics when it comes to caring for your ailing back. General recommendations for people recuperating from low back pain include wearing low-heeled comfortable shoes, sitting in chairs with good lower back support, using work surfaces that are a comfortable height, resting one foot on a low stool if standing for long periods, and supporting the low back with a pillow during long drives.
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3. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647–52.
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6. Gaspardy G, Balint G, Mitsuova M, et al. Treatment of sciatica due to intervertebral disc herniation with Chymoral tablets. Rheum Phys Med 1971;11:14–9.
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8. Schwieger G, Karl H, Schonhaber E. Relapse prevention of painful vertebral syndromes in follow-up treatment with a combination of vitamins B1, B6, and B12. Ann NY Acad Sci 1990;585:54–62.
9. Kuhlwein A, Meyer HJ, Koehler CO. Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes. Klin Wochenschr 1990;68:107–15 [in German].
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11. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Advances in Pain Research and Therapy, Vol 5. JJ Bonica, JC Liebsekind, DG Albe-Fessard, eds. New York: Raven Press, 1983; 289–93.
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13. Walsh NE, Ramamurthy S, Schoenfeld L, Hoffman J. Analgesic effectiveness of d-phenylalanine in chronic pain patients. Arch Phys Med Rehabil 1986;67:436–9.
14. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (2nd report)—schedule of administration and clinical effects in low back pain and tooth extraction. Acupunct Electrother Res 1990;15:121–35.
15. Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909–14 [review].
16. Schnitzer TJ. Non-NSAID pharmacologic treatment options for the management of chronic pain. Am J Med 1998;105:45S–52S [review].
17. Siften DW (ed). Physicians’ Desk Reference for Nonprescription Drugs. Montvale, NJ: Medical Economics, 1998, 790–1.
18. Rumsfield JA, West DP. Topical capsaicin in dermatologic and peripheral pain disorders. DICP 1991;25:381–7 [review].
19. Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: A randomized double-blind study. Am J Med 2000;109:9–14. This article is provided by Healthnotes for theBetterHealthStore. Copyright © 2001 Healthnotes, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.