The Use of Natural Health Products to Treat Chronic Low Back PainNatural health products (NHPs) are often used by patients with chronic low back pain (LBP). NHPs include herbal remedies, homeopathic medicines, vitamins and minerals. Probiotics, amino acids, and essential fatty acids are other NHPs used by many people.
Evidence for the therapeutic benefits of NHPs is limited. In this report, Dr. J. J. Gagnier, a naturopathic physician from the University of Toronto reviews and summarizes the results of NHPs in the treatment of chronic LBP.
He presents the history behind each category of NHPs. The mechanism of action (theory for how each one works), and the results of high-level studies are also discussed. Four systematic reviews provide the basis for the conclusions presented.
Herbal treatment contains active plant ingredients or plant materials. They come in many forms such as pills; topical creams, oils, or gels; or injection. Pain relief and improved function have been reported with Devil's claw, willow bark, and capsicum. Side effects (when they occur) are mild and include GI upset, headache, and sweating and flushing.
Vitamins and minerals come in many forms and are usually taken orally (pill by mouth). Vitamin B12 injections have been studied in the treatment of LBP. Pain and disability both improved with this particular treatment.
Homeopathy is based on the idea that giving low doses of remedies can cure these symptoms. Remedies are substances that are able to cause symptoms similar to those already present. Homeopathic remedies come in different forms such as liquids, gels, tablets, sprays, and creams. Research to support this treatment for LBP is lacking.
Studies of NHPs in the treatment of LBP are limited. But early reports look promising. If scientists are able to find one NHP or a combination of natural products that could successfully treat LBP, the cost of health care for this problem could be cut dramatically.
Future studies are still needed to verify findings about vitamin B12 injections. The safety of herbal, nutritional, and homeopathic supplements must be compared with standard treatment such as anti-inflammatory drugs used for most people with LBP. In general, more study is needed before NHPs can be routinely recommended for the treatment of LBP.
Joel J. Gagnier, ND, MSc, PhD. Evidence-Informed Management of Chronic Low Back Pain with Herbal, Vitamin, Mineral, and Homeopathic Supplements. In The Spine Journal. February 2008. Vol. 8. No. 1. Pp. 70-79.
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