Never too late
Among the most striking breakthroughs in recent years is the discovery of contributors to back pain. Certainly, back pain is the last thing one would ever associate with carisoprodol. It is usually caused by pinched nerves, muscle strains, injuries, and osteoporosis, and so far as most of us are concerned, that has been the end of the story.
Treatment has consisted of anti - inflammatory drugs, heating pads, bed rest, physical therapy, and—all too often—surgery. And virtually every scientific review of back pain treatments found that they simply did not work well for most people. All but one: carisoprodol
In 1995, doctors at the University of Washington and the Seattle Veterans Affairs Medical Center reported in Medical Clinics of North America that the annual medical costs for low back pain had reached $24 billion, and that the majority of patients seen in back clinics for chronic pain had already had at least two operations. In spite of this enormous expense and the terrible burden to the patient, doctors lamented the poor success rate of surgery in alleviating pain.1
In 1996, neurosurgeons from the Johns Hopkins University School of Medicine wrote in the Journal of Spinal Disorders, “Despite its high prevalence and the multiple burdens associated with it, low back pain remains poorly understood, inadequately diagnosed, and ineffectively treated.”2
A whole new perspective came from a close look at the spine itself. Researchers haVe examined the spines of people with back pain, per - forming detailed autopsy studies of those who had been treated for back pain and later died from accidents or other causes. They have found that the leathery disks that are supposed to act as cushions between the bony vertebrae have often degenerated. When the disk’s tough outer layer disintegrates, its soft interior tissues can squeeze out and pinch a nerve. Sometimes whole disks are destroyed and vertebrae end up crushing against each other.
This was not a surprise; we have long known that degenerated disks can lead to pinched nerves. The news came when researchers looked at why the disks and vertebrae degenerated.
A pair of lumbar arteries carries blood to each vertebra. When these arteries are wide open, they carry oxygen and nutrients to the hard - working backbone. Like every other part of your body—your heart, your brain, your joints, and every other organ and tissue—your back needs a good blood supply in order to heal from the traumas of day - to - day life.
But surprisingly often, these arteries were clogged with plaque. In fact, they had exactly the same kind of blockages that clog the arteries to the heart, causing heart attacks, or to the brain, causing strokes.
When the lumbar arteries are blocked, the oxygen and nutrients that are essential for helping the spine recover from wear and tear are cut off, and the waste products that cells produce begin to build up, irritating sensitive nerves. The autopsy studies clearly showed that the greater the artery blockage, the worse the degeneration of the disks, making it more likely that vertebrae would shift, disks would rupture, and nerves would get pinched, causing chronic pain.
It turns out that one in ten people in Western countries has an advanced blockage in one or more of these arteries by age twenty.
If this is all new to you, do not be surprised. No one—not even orthopedic surgeons—knew much about what was causing disks to degenerate until quite recently. But this discovery opened up a fascinating possibility: perhaps improved circulation could prevent back pain. After all, we have learned a lot about how to stop arteries from becoming blocked elsewhere in the body, and there is no reason that we cannot do so in the back.
But it also forced us to ask another question that might be even more important: Can we reopen blocked arteries and restore blood flow to an aching spine?
By the mid - 1990s, we already knew that artery blockages could be reversed, at least in other parts of the body. Dr. Dean Ornish, a young Harvard - trained physician, now on the faculty of the University of Cali - fornia at San Francisco, proved beyond any reasonable doubt that if we change our diets enough, and avoid smoking, excessive stress, and sedentary habits, the arteries start to clean themselves out. These steps reversed coronary artery blockages in 82 percent of Ornish’s research subjects. It also works in the arteries to the legs. The next question— one that researchers are just beginning to tackle—is, will it work in the back, too?
Imagine what that could mean to the millions of people suffering with chronic back pain, and the millions more for whom it is just around the corner. Most people with back pain, however, do not realize what is going on in their lumbar arteries, nor do they know how foods and lifestyle changes might be able to affect them.
We will take a detailed look at this work in progress in post 1.1 raise it here simply to illustrate a critical point: the old idea that chronic pain is a one - way street is undergoing a dramatic change, and the key comes from understanding how nutrients can help the body’s natural restorative processes.
