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Physical, Environmental, Psychological: The Three-Pronged Approach To Treating Lower Back Pain

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Too often, lower back pain is treated through medication alone. But there are serious problems with this approach to pain management. It is easy for medication to become a crutch or, in the case of prescription opioids like oxycodone, even a dangerous addiction. And on their own, these pills only treat the symptoms of lower back pain.

That's why treating back pain from multiple angles is gaining popularity. Lower back pain often has more than one cause, so it only makes sense to use more than one treatment. Generally, these treatments are broken into three categories: physical, environmental, and psychological.


These include the problems that show up on x-rays or MRIs. Slipped discs, scoliosis, or trauma to the back, for example, are clear physical causes, and thus these causes can be treated. But surprisingly few cases of lower back pain have such clear physical causes. Muscle strain, for instance, is also a physical problem – but the question is, where did the muscle strain come from?

Physical pain relief is an important part of treating the lower back. This can mean medication – preferably over-the-counter NSAIDS like ibuprofen. It can also mean traditional pain-relief and muscle-relaxation techniques like massage, meditative yoga, or acupuncture.


Environmental factors for back pain include things like mattresses with poor back support, work that causes strain on back muscles, and even poor posture. The answers are generally straightforward. If you wake in the morning feeling strain in your back muscles, purchasing a better mattress can help. If your work puts a lot of strain on your back, you may need to discuss with your boss how your duties could be changed.

However, it's also possible to help fight environmental causes by strengthening your back muscles. The stronger and more flexible those muscles are, the better your back holds up to things like physical labor, and the better your posture will be. Ask your doctor about exercises designed specifically for back muscles; yoga is also an excellent workout for strength and flexibility.


Some people hear "psychological" and think it means the pain is all in their head – that's not true. For back pain, the number one psychological cause is high stress. Stress has many negative effects on the body, and many of them can affect the back. Poor sleep, increased muscle tension, and even increased sensitivity to pain – all of these feed into back pain, making it worse.

Some people with stressful lives find that cognitive-behavioral therapy helps them find better ways to deal with and release stress. Yoga also teaches meditative techniques that can be used to lower stress. And acupuncture is an excellent treatment for stress as well; a press release from Georgetown University Medical Center describes a study that found acupuncture can lower stress hormones in the blood. While the study was on rats, the scientists believe it also shows why acupuncture has been successful at lowering stress and reducing pain for so many people.