Comprehensive medical treatments for patients with chronic back pain are frequently indicated. Increasingly, alternative medical methods are being employed. Fifty percent (50%) of all patients in the United States use alternative medicine (survey, Archives of Family Medicine). Annually, US visits to alternative medical providers are 425 million compared to 338 million visits to primary care physicians (N.E. Journal of Medicine, David Eisenberg, MD). Acupuncture and herbal treatments are some of the most popular and effective methods used. Several of these are discussed here.

Acupuncture
Acupuncture is a method of pain relief using the insertion of small needles at precise points on the body. In medical acupuncture, points are chosen that frequently correspond to standard medical/anatomical locations. Highly skilled medical acupuncturists use locations to treat nerve roots in the cervical and lumbar spine in a manner similar to an epidural injection. One advantage of this technique includes no side effects from medication, as no medication is used. The needles are of a much finer gauge and therefore less traumatic than standard epidural injection needles.

Herbs and Supplements
Herbal medicine is used by 80% of the world's population. People in the US are increasingly accepting it. In fact, it is now a 3.87 billion dollar industry in this country. It is growing at the rate of 25-50% each year. In Germany, since 1974, Commission E, a division of the German Federal Health Agency, has had the responsibility of reviewing herbal medicines including chemical analysis, traditional usage and scientific studies of toxicology, pharmacology and epidemiology.

In many countries, even where rigorously tested pharmaceuticals are available, the costs of such medicines are too prohibitive for many patients. Therefore, the worldwide use of herbal medicines and vitamins and supplements is not only commonplace, but continues to increase. Listed here are a few herbs and supplements, which are indicated for back and spinal problems.

Capsaicin (Cayenne pepper)
Research studies have indicated that topical application of this herb will decrease the pain associated with peripheral neuropathy and low backache. Neuropathy is a degenerative condition affecting nerves that branch into the body's extremities such as the hands and feet. Spinal nerve injury can be one of the causes of this disorder. Capsaicin is believed to act by depleting substance "P" which is involved in the pain response. Initial application may cause an increase in burning for several days. It must be applied 4-5 times a day. It can take several weeks to gain the full effect.

Glucosamine-Chondroitin Sulfates
These two substances have become very popular in the treatment of degenerative arthritis. When the articular cartilage of the joints of the body breaks down, we begin to experience aching, cracking sounds and pain. Glucosamine and chondroitin occur naturally healthy cartilage. Veterinarians have successfully used these substances for years in the treatment of horses and dogs.

Glucosamine and chondroitin are natural food supplements. Toxicologists have determined them to be safe. Studies have shown that the combination of 1000-2000 mg of glucosamine per day plus 800-1600 mg of chondroitin per day, along with proper diet and regular exercise can be generally effective in controlling the symptoms of arthritis. Fifteen European and Asian studies have shown this treatment to be effective. These studies were double-blinded and placebo controlled. American medical journals have published and referenced this research.