The Lower Back—Complex and Easily Damaged
When your patients think of their back, they probably think of the spine—the centerpiece of the entire structure. But of course, there’s much more to it than that. The back comprises all of the muscles, ribs, nerve endings, cartilage, and blood vessels that work in unison to carry us through the day.

The spine’s stack of 30 vertebrae extend from the base of the skull. The spinal cord contains a bundle of nerves that run from the brain to nearly all other parts of the body. Between the vertebrae are discs made of cushioning cartilage that keep us flexible and absorb shocks. The ligaments and tendons along the spinal column attach muscles to the spine and hold the vertebrae in their proper positions. When these cushioning disks rupture or move out of place due to lower back injury or strain, pain—sometimes extreme—is the result.

The resulting scar tissue from torn or injured muscles or discs is never quite as strong or mobile as the original healthy tissue, and that can set up more back injuries to follow.

The problem with conventional treatments for lower back pain (outside of the obvious complications of surgery for severe cases) is that over-the-counter and prescription pain medications cause a number of risky side effects, including severe damage to the stomach lining, liver, kidneys, and heart. Fortunately, there are safe and effective ingredients that stop pain and inflammatory damage, and help rebuild the cushioning cartilage of the spine.

Curcumin from turmeric (Curcuma longa) excels at relieving pain and inflammation. One of the challenges though, is that even as a purified 95% extract, curcumin can be difficult for the body to absorb. It generally needs some help.

A clinically studied curcumin that can overcome these challenges is blended with turmeric oils (which has its own anti-inflammatory abilities) for enhanced absorption. The oils mimic the way that someone would get curcumin in their food, except that the levels of curcumin are much higher in this extract, so it concentrates the effect that would normally take years into easy-compliance dosage levels. The compounds in the turmeric oil—especially turmerones—enhance curcumin’s medicinal power.

Boswellia (Boswellia serrata) is a specific inhibitor of 5-LOX, an enzyme that activates inflammation-inducing leukotrienes—an ability that can’t be matched by synthetic drugs. The most active and beneficial of the boswellic acids in the extract is known as AKBA (Acetyl-11-keto-B-boswellic acid).

While boswellia is relatively popular in health food stores, not all boswellia extracts are equally beneficial. For example, in unstandardized boswellia products, the AKBA levels can be very low—sometimes as little as 1%. A effective boswellia extract will be standardized to contain at least 10% AKBA. Conversely, products with extremely high levels of AKBA are almost certainly spiked to the point where they bear very little resemblance to any naturally occurring ratio of compounds.

Plus, while boswellia is generally a very helpful herbal ingredient, it can contain a compound that can actually cause inflammation — beta-boswellic acid.  Boswellia is most effective when the beta-boswellic acid is screened out—rendering any remaining amount harmless. That’s a big difference compared to unstandardized boswellia, which can be all over the board in terms of content.

A study comparing a combination of these forms of curcumin and boswellia to the generic celecoxib found that they relieved osteoarthritis pain for 64% of participants versus only 29% in the drug group.

Additionally, more people in the herb group could walk without pain compared to the drug group. While this study focused primarily on the function of the knees, the real message here is that curcumin and boswellia reduce pain and the tissue-damaging inflammation that causes pain. When your patients use them, they’re not just “covering up” pain signals — they are helping their body to heal.

Devil’s Claw (Harpagophytum procumbens, Harpagophytum zeyheri) has powerful anti-inflammatory benefits for relieving back pain. Aside from stopping pain and strengthening the lower back, it can help stop the deterioration of the joints seen in those with rheumatoid and osteoarthritis. In one study, devil’s claw relieved the pain of osteoarthritis by 35% by the end of the 8-week trial.

Other research shows that devil’s claw is equal in pain-relieving ability to rofecoxib, often known to pain sufferers as Vioxx, a prescription non-steroidal anti-inflammatory drug (NSAID) that has since been pulled from the market because of its side effects.

Devil’s claw reduces inflammation by inhibiting the cyclooxygenase-2 (better known as “COX-2”) pathway. A scientific study measuring COX-2 inhibition found it was reduced by 31%. By affecting this enzyme specifically, devil’s claw provides a much more targeted approach to inflammation compared to many over-the-counter and prescription pain medicines. Many devil’s claw extracts are only standardized to 2% harpagosides, the plant’s key compound. However, a more potent devil’s claw extract is standardized to a minimum of 20% harpagosides.

Back pain is extremely difficult to live with. It can effect everything in your patients’ lives, preventing them from work and enjoying simple tasks like taking a walk, working in the garden, and getting a good night’s sleep. These ingredients can stop the pain and help build the strength of the back to prevent future injuries. Best of all, they are an option without the risks of over-the-counter and prescription medications.

To stop the pain and help build the strength of the back, a combination of curcumin, boswellia, and devil’s claw can be taken daily under the guidance of a practitioner.