14 Affordable Ways to Relieve Back Pain

Spinal fusion surgery for lower back pain can cost more than $100,000, according to Healthcare Bluebook. Many people might consider that a worthwhile price to pay for a pain-free life. But according to Johns Hopkins School of Medicine, only 5 percent of back pain patients are good candidates for surgery. And even among those who are, surgery doesn't always work.

Another approach to easing a chronically aching back is opioid painkillers. But they come with their own risks, namely, the chance that the patient becomes dependent on, and later addicted to them. Drug overdose is now the leading cause of accidental deaths for adults in America, with more than 20,000 people dying in 2015 alone from overdoses of prescription painkillers.

In her book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, investigative journalist Cathryn Jakobson Ramin chronicles her six-year investigation seeking answers for her persistent back pain. She started out believing she needed surgery, then ended up trying a controversial, heavily-advertised laser treatment, which didn't provide lasting relief.

Through her research, she learned that the patients who achieve the most relief are usually those who take an active part in their own recovery, easing pain through various exercise protocols or through rehab programs that combine psychological treatment with intensive exercise.

One surprising thing that Ramin learned is that it's often necessary to push through pain, ideally under the watchful eye of a qualified trainer or therapist. In fact, one cause of disability for many patients is not the pain itself, but the fear that too much movement will cause more pain, she learned. One renowned rehab expert, Ramin wrote, made his patients do "exercises that were performed under supervision, at a prescribed dose, without dwelling on associated discomfort."

Ramin isn't alone. Many medical authorities, alarmed by the opioid crisis and disheartened by the limits of invasive surgery, are recommending conservative treatments for lower back pain. Fortunately, many of these treatments are quite affordable, especially when compared to a $100,000 surgery.

1. A heating pad

This may seem old fashioned, but "superficial heat" is the first item on the American College of Physicians' (ACP) 2017 list of recommendations for treating low back pain. It's not that applying heat is expected to cure what's wrong with your back. It's that, as the guidelines state, "most patients with acute or subacute low back pain improve over time regardless of treatment."

Using a heating pad is mostly about feeling more comfortable while your body heals itself. For a one-time investment of just $10 to $50, it's worth a try.

2. Massage

Often back pain is caused by a muscle strain or muscle spasm, which may be eased by a visit to a massage therapist. At a cost of $50 to $150 a session, it's worth trying even if it doesn't work, because it usually feels good and helps you relax.

3. Acupuncture

Although the ACP calls the currently available evidence "low to moderate quality," according to National Center for Complementary and Integrative Health (NCCIH), results from a number of studies suggest that acupuncture may help ease chronic low-back pain. Routine visits cost $50 to $100, and Consumer Reports found that the average back pain patient spends $200 for a full course of treatment.

4. Chiropractic care

The most familiar chiropractic treatment is spinal manipulation. Although the ACP says the evidence that it works is "low quality," spinal manipulation is nevertheless among the top recommendations for back pain by the physicians' group.

However, one spine surgeon told me he recommends that instead of getting a spinal manipulation, you ask the chiropractor for soft tissue therapy such as active release — which is similar to a deep tissue massage.

Consumer Reports pegs the cost of seeing a chiropractor as similar to acupuncture — about $200 for a course of treatment. However, unlike acupuncture, many health plans cover a portion of the cost for chiropractic care.

5. Ibuprofen

The ACP recommends "nonsteroidal anti-inflammatory drugs" such as Advil. Doctors say it's important not to just pop an ibuprofen now and then, when the pain flares up, but to follow a regular regimen for the prescribed time, in order to quell the inflammation that may be causing the pain. At about $10 per bottle of 200 mg pills, this is a very affordable treatment.

6. Muscle relaxants

Some doctors prescribe a muscle relaxant for a short period, if your back pain is caused by muscle spasms. If so, the cost is generally limited to your insurance copay. If you have to pay full price, most prescriptions run from $10 to $200.

7. Rehabilitation programs

In Crooked, Ramin tried several programs that lasted for several weeks, with five sessions each week packed with supervised strengthening exercises, group therapy, and more. Working with highly trained professionals for weeks on end is not exactly cheap, though. The cost of a chronic pain rehab program can run you tens of thousands of dollars. But it costs significantly less than most back surgeries.

Unfortunately, it may be more difficult to get insurance companies to cover the full cost of the pain program than it would be to get them to cover surgery. And taking weeks off work to go through the program would be a financial strain for many people as well.

8. Tai chi

One study found that 75 percent of back pain patients showed improvement after a 10-week tai chi program. Considering that many tai chi groups are free to join, and that organized classes are available for as little as $10 a session, this is a very affordable treatment option.

9. Yoga

Not just any yoga class is recommended for back pain patients. In fact, some of the experts interviewed in Ramin's book warned that certain yoga positions can make back problems worse and should be avoided. She learned that Iyengar, a style that requires lengthy teacher training, has been shown to help people with back problems. Such yoga classes are advertised for as little as $14 a session, and yoga DVDs and online videos are also available. (See also: 8 Stress Relief Items You Need in Your Life That Are Under $20)

10. Osteopathy

Some patients report relief after visiting an osteopath, who performs manual adjustments similar to — but not identical to — what chiropractors do. One doctor of osteopathy explained to me that her discipline often blames an out-of-place or frozen sacrum (bottom vertebra) for back pain. She said she has been able to eliminate pain for most patients by gently repositioning this bone. Visits with an osteopath may be covered by insurance.

11. Exercise with a trainer

Of all the treatments she tried, the one Ramin found the most relief from was regular workouts with coaches recommended by back pain experts. A large portion of back pain is caused by weak muscles in the core area, such as abdominals and back muscles, and these trainers can help pinpoint which muscles need strengthening, and teach the exercises needed to get the job done.

Working with an expert trainer can help a patient maintain good form, because, Ramin learned, it's all too easy to let muscle groups that are already strong do the movement and let the weaker muscles continue to loaf. You might pay $100 or more an hour for an expert trainer, making it not exactly inexpensive — but many find the relief worth the cost.

12. Independent exercise

If you can't afford to work with an expert trainer, or you can only afford to work with one for a short period, you can find videos online to help you maintain those back-supporting muscles long-term. Ramin found a series of exercises known as the McGill Big Three so helpful that she links to them on her site and has taught them to strangers in airports. (See also: 10 Easy Back Exercises That Will Help Eliminate Pain)

13. Maintain a healthy weight

Ask any pregnant woman, and you'll learn that carrying extra weight in the midsection puts a strain on the lower back. It may not be easy, but doctors say that getting rid of belly fat is a reliable and affordable way to ease lower back pain. (See also: 5 Easy Ways to Take Better Care of Your Back)

14. Change positions often

Many of us realize that we are causing our own back pain by poor posture at work. An expensive approach to this problem is to buy specialized office equipment, such as standing desks and ergonomic chairs.

A cheaper approach is to avoid sitting at your desk for eight hours straight every day. Instead of texting or emailing a colleague, walk across the office to talk to them in person. Have walking meetings as if you're a character in an Aaron Sorkin drama. Stand up and stretch during boring conference calls. If you work from home (like I do), move to different furniture and positions throughout the day. And for goodness sake, just say no to extra hours as an everyday thing. Scoring points at work is not worth ruining your health.

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