Bottom Line has been saying it for years, and mainstream medicine has finally woken up. If you have back pain—and nearly two-thirds of Americans do at some point in their lives—don’t reach first for drugs. That’s good advice whether you’re suffering an occasional “back attack” or you’ve got chronic back pain, and it’s now the advice in new guidelines from the American College of Physicians.

Why are doctors moving away from drugs for back pain? Simple. Most back pain gets better on its own, and while you’re healing, natural remedies and mind-body techniques are just as effective at relieving pain—without the serious side effects of many medications.

So before you reach for the drugs, try some of these 15 safe, natural and effective treatments. Bonus: Many of these techniques stretch your spine, relax your muscles and improve posture in ways that may prevent future back injuries. Some of them will surprise you…

1. Stretch Gently.

To give the muscles around your spinal column a gentle stretch, try this short stretch routine. It’ll loosen you up while increasing blood flow to the muscles that are often the culprits in back pain. The improved blood flow may reduce painful muscle spasms, too.

2. Get Nice and Comfrey.

Comfrey has been a controversial herbal remedy because it can contain dangerous levels of pyrrolizidine alkaloids (PAs), which cause liver damage. So when safety warnings appeared, comfrey creams disappeared from shelves. But now a German company has developed a technique to remove PAs. Studies show that comfrey cream can reduce pain and inflammation better than prescription topical pain medication. Just be sure that you use a PA-free comfrey product.

3. Cool Down Your Diet.

A bad diet promotes chronic inflammation, and that can lead to irritated muscles, nerves, tendons and ligaments. Plus, food sensitivities can set off a chain reaction that often ends with back pain. Optimize your diet to reduce back pain with these guidelines.

4. Get Inverted.

You don’t need to hang upside down from your feet to feel the benefits of gravity. Relaxing at a small incline while lying on a special inversion table or sitting on an inversion chair can remove pressure on your spinal column and release painful muscle spasms. (Don’t do this if you have high blood pressure, heart disease or certain eye conditions.) Find out more in the Bottom Line article, “To Ease Back Pain, Lean Back.

5. Apply Pressure…to Your Thumb.

Reflexology takes advantage of the “spine reflex,” an area on the outer edge of your thumb that corresponds to the spine. Pressing on this sweet spot in the right way can relieve a tense, aching back.

6. Do These Yoga Poses.

Yoga is beneficial for many facets of your life—including easing low-back pain. These seven simple poses that you can learn to do at home (without expensive equipment, props or gear) can get you through the day with less pain.

7. Use Your Mind.

Learning how to remain perfectly aware of your thoughts and physical sensations—while changing how you view them—can affect the way your body and mind respond to pain. It’s called mindfulness-based stress reduction (MBSR), and studies show that it’s very effective. Plus, you can learn it at home.

8. Wear This Under Your Clothes.

If you’ve ever had physical therapy, chances are you’ve experienced transcutaneous electrical nerve stimulation, aka TENS. A device gives you a mild tingling sensation…while your brain releases very welcome pain-blocking chemicals. Now there’s a TENs device you can buy and use yourself. It reduces pain in 80% of people who use it.

9. Roll Away the Pain.

Professional sports trainers have long used foam rollers to help athletes recover from muscle strains and tight ligaments that can contribute to back pain. Now it’s our turn—they’re readily available in sporting goods stores or online. Here’s how to use them to get rid of back pain.

10. Walk It Off—Uphill.

Staying active is the best thing you can do for a sore back. Gentle walking is an excellent exercise, but even better is walking up a slight incline. When you walk uphill, you lift your feet more than you do when walking on a flat surface, so the muscles along your spine get a better stretch and workout. Get the specifics plus four more DIY remedies for back pain.

11. Flow with Tai Chi.

The slow and graceful movements of tai chi are deceiving. Beneath the coordinated, fluid motion is an aerobic workout that increases muscle strength, improves posture and breathing, reduces blood pressure and reduces back pain. Like yoga, tai chi has so many upsides that there is almost no reason not to try it.

12. Move Your Blood Around.

This ancient healing technique rooted in traditional Chinese medicine gets “stagnant blood” moving again. It involves an accupuncturist but no needles. It can leave a temporary mark, but the pain relief is worth the temporary rashlike appearance. It’s called gua sha.

13. Reframe Your Pain.

People with pain who are hypnotized feel less pain and need less pain medication, research shows. How does it work? Like mindfulness, hypnosis allows you to reframe the pain, which makes it far less bothersome.

14. Squeeze the Pillow.

No, simply squeezing a pillow won’t get rid of nagging back pain. But done a certain way, an exercise that involves lying on your back with a pillow between your knees can help realign your body and ease low-back pain.

15. Be Kind—To Yourself, Too.

Pain and anger can go hand-in-hand. Learning to be more compassionate—to yourself, to friends, even to strangers—can actually reduce your pain. It really works.

The nation’s physicians are finally getting behind the no-drug approach to easing back pain—but if you know about all of the approaches above, you are way ahead of them! Experiment with different combinations, and don’t be afraid to layer treatments. Example: A morning stretch routine, midafternoon tai chi and an evening stroll might do the trick over a few days.

WHEN TO SEE A DOCTOR

Do drugs ever have a place for back pain? According to the American College of Physicians, nondrug approaches should be your first steps, but if they aren’t enough, ask your doctor about nonsteroidal anti-inflammatories such as ibuprofen or naproxen, or muscle relaxants—either over-the-counter or by prescription. In some situations, other medications may have a place. Opioids? Only as a very last resort, when all else fails.

Caution: Get checked out by a health-care professional if your back pain is accompanied by fever, tingling or numbness in your arms or legs…you have new bladder or bowel control problems…you’ve had some sort of trauma (a fall, for example)…your pain is severe…you have pain that lasts for more than a week despite your trying natural approaches for relief.

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