by Dr. Wei Hung
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Posted on 16-09-2020 10:48 PM
Acupuncture for back pain is a pain relief treatment being used by more and more poeple. The National Institutes of Health reports that approximately 80 percent of the basic population in the United States suffers or will experience an episode of lower pain in the back.
That implies 4 out of 5 grownups are most likely to have lower neck and back pain at some time in life, making it among the most typical neurological conditions, 2nd just to headache.
Is back pain interfering with your daily life? if you’ve tried every trick in the book and still haven’t made much progress, it may be time for something a little out of the ordinary.
Acupuncture and acupressure points designed to stimulate energy flow and ease the pain in the back could be the solution you’ve been looking for! it is both safe and effective and has been known to deliver results. But how does it work and where on your body can you find these pressure points? here are some answers.
There are numerous treatments and solutions readily available for individuals who experience this condition. And while there is no conclusive treatment, using acupuncture for back pain has actually experienced a remarkable boost over the past couple of years.
A variety of placebo-controlled studies have actually developed and verified acupuncture for lower neck and back pain as a trusted method for pain relief. The "Annals of Internal Medicine" has actually released a meta-analysis on acupuncture for lower back pain revealing how amongst the 2 lots formerly released studies on back pain treatments, acupuncture is "considerably more efficient" than sham acupuncture or no treatment.
The British Acupuncture Council, the UK’s largest professional body for the practice of acupuncture, fully supports the National Institute For Health and Clinical Excellence decision that acupuncture be made available on the NHS for chronic lower back pain.
Back pain affects more than 1.1 million people in the UK with 95% of patients suffering from lower back pain problems. Recent research has shown that acupuncture treatment can be effective in treating back pain and introducing acupuncture treatment on the nhs can be very beneficial for patients who are suffering from the one of the nation’s main reasons for work-related sickness absence. It is essential for patients to choose an acupuncturist who is registered with a professional body.
British Acupuncture Council members have extensive undergraduate degree level training in acupuncture and biomedical sciences appropriate to the practice of acupuncture in the uk. They are bound by strict codes of ethics, and safe practice and professional conduct. Traditional acupuncture has been used for over 2,000 years to alleviate back pain and British Acupuncture Council members have for many many years been successfully treating patients for this condition either in private practice or working within the NHS. In effect, therefore, these new guidelines are a rubber stamp of the positive work already being undertaken as well as an endorsement of the wealth of research evidence now available in this area.
Nearly 8 out of every 10 people will have low back pain at some point in life. Back pain is one of the top reasons people seek medical treatment. It is also the number one reported reason for seeking acupuncture. The good news is chronic low back pain is one of the conditions that research suggests acupuncture may be an effective tool for treating.
One recent review of 22 acupuncture studies showed that it provided short-term relief from chronic back pain. It also showed there was greater improvement in pain for people who got acupuncture compared to those who received a “sham” treatment. Other studies have found, though, that sham acupuncture can be as effective as actual acupuncture. Those studies also found that, compared to standard treatment, both actual acupuncture and sham acupuncture are more effective.
In Canada over 80% of individuals experience pain in their spine at some point in their lives. Back pain remains one of the most common reasons to visit the doctor, acupuncturist, chiropractor or physiotherapist. In Canada, medical expenditures with respect to low back pain are estimated between $6 and $12 billion annually. Low back pain and related ailments have a significant economic impact on society due to the loss in worker productivity, resultant time off work, and the associated disability payments.
Acupuncture is a holistic treatment that's a branch of Traditional Chinese Medicine, or "TCM". Acupuncture uses fine needles to activate pressure points along specific energy meridians in the body, which stimulates your central nervous system to promote overall healing. Acupuncture began in China more than 2,500 years ago. It involves inserting thin needles at certain points on the body.
According to Traditional Chinese Medicine, the body has more than 2,000 of these points. They are connected by pathways or meridians, which create a flow of energy called qi (pronounced “chee”). Stimulating these points is said to correct the imbalance of qi and improve the flow of energy. Practitioners believe that this helps relieve pain and improve health. It's thought the effects come from stimulating the central nervous system. This may trigger the release of chemicals into the muscles, spinal cord, and brain. These chemicals either alter the experience of pain or produce bodily changes that promote a sense of well-being.
Acupuncture is a substantial element of Traditional Chinese Medicine. It has actually been utilized to deal with a variety of health problems for centuries in China and most Asian countries. Standard acupuncture is rather various than Western therapies. It is a procedure that works to bring back general muscle balance to the body by promoting the "chi". As Chinese practitioners understand, the body is fundamentally configured for balance and balance.
The findings of various studies show that it's not needed to in fact pierce the skin in order for acupuncture to offer pain in the back relief; it could be that acupressure is just as efficient. A few of the researchers feel that a "physiological chain of occasions" takes place when the skin is ostensibly promoted.
The treatment is based upon a theory that the body is comprised of channels or meridians where the "vital force" or qi streams through. If these meridians are blocked off because of stress or any variety of reasons for disease, it would jeopardize the health of the person. The goal of acupuncture, for that reason, is to unclog the blocked meridians and enable the qi to again circulation easily throughout the body. This is done by sticking needles unto the impacted meridians to launch the qi.
Acupuncture works by placing extremely thin needles with particular depths into specific points of your body. Placing needles into your body is thought about as a method to stabilize the circulation of energy in your body. In dealing with pain in the back, the needles are frequently placed to numerous points outside the location where signs happen. For an example, acupuncturists may place needles to a number of points of your feet or ears to recover the pain.
The points picked for needle insertion are called the meridians. The Chinese think about that the meridians are carefully related to the organ systems of body, so acupuncturists place needles on particular meridians that related to the pain being suffered by patients. Among numerous aspects that make acupuncture so distinct is that the organ systems specified by the Chinese is various with the meaning of organ systems by the western doctors. Acupuncturists identify patient's issue by feeling pulses on each wrist. This medical diagnosis method likewise allows acupuncturists to understand which meridians require to be dealt with and which do not.
Acupuncture has some risks and side effects, which we’ve outlined here for you. These may include pain, bruising, soreness, or bleeding. Any type of treatment, including acupuncture, has risks for side effects. However, according to the "American Family Physician", 12 prospective studies of more than 1 million acupuncture treatments showed the risk of a serious adverse event to be 0.05 per 10,000 treatments. As long as acupuncture is performed by trained and qualified practitioners, evidence supports it as a safe treatment for back pain.
Some treatments for back pain come with risks or side effects. If you have back pain and are in relatively good health, you are probably a candidate for acupuncture. While relatively few adverse effects have been reported, it is possible to suffer injury from improper delivery of needles or non-sterile equipment. By choosing a reputable acupuncturist certified by the "National Certification Commission for Acupuncture and Oriental Medicine" (NCCAOM), you can ensure that you are receiving safe, hygienic therapy.
The risk of complications during acupuncture increases if you have a bleeding disorder or are taking blood thinners. If you have a pacemaker, avoid treatments that apply electrical pulses to the needles. This can interfere with your device’s operation. Finally, talk to your ob/gyn if you are pregnant. Your doctor will most likely recommend that you reserve acupuncture for the pre-labor stage of delivery when you are almost ready to have your baby.
Acupuncture pain in the back therapy is one method that offers a good deal of relief to individuals who suffer chronic pain. Utilizing the info supplied above, it can likewise be presumed that anything which promotes the proper pressure points along the neck, back, and spinal column would likewise be advantageous. Therefore, a Posture Shirt with its acupressure capability likewise supplies relief.
Acupuncturists declare that their treatments do more than simply ease neck and back pain however work rather to bring back the body's balance therefore work constantly to enhance total health. The exact same holds true when an individual is re-trained to remain in appropriate posture; it keeps the body in balance and assists all of the organs and systems operate efficiently.
Acupuncture pain in the back is a genuinely effective type of therapy with tested outcomes. It deals with similar concepts as appropriate posture in regards to stabilizing the body and all of its systems. In between acupuncture and posture correction, those who experience lower neck and back pain make sure to discover relief.
Acupuncture treatments intend to deal with the underlying causes, however not in the method individuals usually consider when neck and back pain relief enters your mind. The Chinese thought that the basic circulation of an individual's underlying vital force could be improved and permitted to move more easily through the precise positioning of small needles at various locations of the body, and simply under an individual's skin. Whether you believe in the presence of this intrinsic field of life energy, the stress-relieving capacity of using acupuncture for neck and back pain treatments is indisputable. All that's required to be able to take pleasure in the benefits is an open mind, and a determination to attempt options that are off the beaten path. Everything depends upon how prepared you are to eliminate your chronic pain in the back.
The procedure resolves a healing result in order to eliminate pain and sometimes, totally recovers it. Acupuncture treatment typically lasts for fifteen to twenty minutes. It is practical in alleviating pain for intense and chronic conditions, reducing stress and stress and anxiety, speeding up the recovery procedure, helping in cigarette smoking cessation and other treatments for internal conditions. Acupuncture does not need making use of any sort of medication in the treatment procedure. Entirely based upon natural care, an acupuncture treatment can assist you to prevent making use of pain relief medications that may have some severe adverse effects in time.
There are few things in day to day life that are worse than living with back pain. Because acupuncture for back pain has been clinically proven to be an effective therapy, it’s become a popular way for people with sporadic and chronic discomfort to find lasting relief. Dozens of clinical studies have shown that acupuncture has a demonstrable benefit when it comes to treating a range of musculoskeletal conditions and related issues – which also include neck and joint pain as well as migraine and headaches.
Acupuncture is really about positioning great needles in particular and tactical points or locations in the body to make a healing result. When it concerns pain in the back, the procedure does not alter. The back is pierced by extremely great needles so regarding set up the motion of energy in the back therefore reducing and in some circumstances, even dealing with neck and back pain completely.
Many individuals do not like the part where needles are permeating their bodies. In this case, they go to sham acupuncture sessions rather. Sham acupuncture utilizes toothpicks instead of needles to put pressure to the exact same tactical points in the body. The concept is the tactical points will get the very same quantity of stress that a needle offers without needing to permeate your body with using toothpicks.
This pressure point located on the foot can help ease lower back pain, stress, and aches related to menstrual cramps. Lv3 stimulation also helps with anxiety and insomnia as well as high blood pressure. Look for the spot two finger widths from where the skin between the second toe and the big toe meet. You can find it by sliding your finger down along the space between both the toes until you feel the tip of the joint. The pressure point is in the depression that you feel just before your finger makes contact with the bone of your metatarsal joint.
Acupuncture for pain in the back is shown to be an efficient therapy when carried out by knowledgeable acupuncturists. Lots of studies have actually revealed that acupuncture can minimize chronic back pain and improve wellness in general. The studies likewise reveal that acupuncture methods supply much better lead to alleviating pain in the back than physical therapies and medications.
The reduction in pain reported by the patient, achieved with a combination of master tung points, myofascial needle manipulation, and qi puncture–style acupuncture, demonstrates the efficacy of managing the symptoms that had previously adversely affected the patient’s quality of life. Thus, it is an option worth offering to patients with chronic low back who have not found relief with other therapeutic methods. At end of treatment, the patient reported pain of 0 to 2 out of 10 on the 10-point numeric pain rating scale, he will continue to receive acupuncture treatment to manage any future low back pain. The patient’s prognosis is good and considered improving based on the reduction of pain symptoms.
That sudden, scary sensation of pulling in your lower back that lets you know you’re in for more pain later. The nagging, daily ache that develops over time. Lower back pain can really feel like a burden, holding you back from enjoying your life. If you are searching for how to reduce low back pain, acupuncture and tcm can provide real relief. Pain in the lower back is one of the most common complaints heard by healthcare practitioners. The vast majority (80%) of adults experience at least one episode of low back pain at some point in their lives. For some people, lower back pain becomes a chronic condition. It is the second most common cause of disability among adults in the United States.
If you experience lower back pain, you are not alone. Eighty percent of adults experience low back pain at some point during their lifetime. The good news is that acupuncture can be an effective treatment. In 2017, the American Academy of Family Physicians recommended acupuncture as a first-line therapy for chronic back pain. The process involves inserting fine needles along energetic channels called meridians, that follow along and affect the areas in the back that are causing pain. The acupuncture points may be found on the feet, legs and arms, in addition to the back.
When you bring your backache to your doctor, you likely expect, and hopefully get, an explanation as to why it’s hurting and what you should do to make it stop. Maybe you have pain, numbness, weakness, and/or electrical sensations that travel down one leg or arm. This is called radiculopathy. Or maybe you’re stiff, and you wonder why.
When an acupuncturist stimulates these points, the release of endorphins activates the body’s own opiate receptors, causing an analgesic effect. In other words, acupuncture helps to relieve pain.
How often should you receive acupuncture for back pain? Acupuncture treatment can be scheduled twice weekly for several weeks, and then once a week as the back pain improves. The benefits of treatment build over the first 24 to 48 hours, with therapeutic benefits lasting about a week. Patients may feel relief after the first acupuncture session and resolve completely after several treatments, depending on the severity of the back pain and how long it has been present.
Chronic, but low grade, back pain is notoriously difficult to treat effectively through conventional clinical services that are routinely available through the NHS. Often patients experiencing this type of ongoing discomfort are either treated through near-permanent analgesia (painkillers) or, in extreme cases, invasive surgery that isn’t guaranteed to be successful. There is now substantial evidence to show that acupuncture, which uses slender needles to painlessly stimulate the body’s natural healing processes and promote renewed wellbeing, in this case reducing pain or, in many cases, eradicating it altogether.
Guidelines from the "American Pain Society" and "American College of Physicians" say doctors should consider acupuncture as an alternative therapy for patients with chronic low-back pain that's not helped by conventional treatment.
Chronic back pain is something that afflicts countless Americans every day, and a great deal of otherwise healthy individuals typically find themselves questioning why they need to harm a lot all the time. While the private reasons for pain and pain in the back can be rather diverse, it typically breaks down to either a posture problem that triggers unneeded stress in the muscles of the back, or an imbalance in an individual's capability to handle their stress. While avoiding the causes prior to beginning is typically not a possibility, because they're a fundamental part of daily living, one method for dealing with the signs that a great deal of folks have actually started to turn to is Chinese acupuncture. Pain in the back, if left unattended, can end up being devastating as time goes on.
This acupuncture point is effective against back pain linked to cervical spondylosis, a condition that causes pain from wear and tear of your bone and cartilage in the cervical spine or neck region. It can be used to alleviate shoulder pain and back pain as well. Meridian point Si15 is located in the middle shoulder area and will have to be stimulated by a therapist as it is located on the back.
For many people, the average cost of acupuncture is more affordable than allopathic medicine and provides a better solution for long-term pain relief with almost no risk of side effects. For example, those undergoing cancer treatments like chemotherapy have numerous side effects like nausea, extreme fatigue, body aches and migraines that don't always go away with OTC pills. However, considering that acupuncture can help relieve these symptoms without interfering with other medications, the typical cost of each session is more than worth it.
Contrary to what many people believe, medicare does not cover everything you need. That often leaves you to pay for alternative and complementary treatments, like acupuncture, out of your own pocket. With the rise of the opioid epidemic, however, the "Centers for Medicare and Medicaid Services" (CMS) is looking to find new ways to treat chronic pain syndromes. To that end, medicare is now looking to add acupuncture as a covered benefit.
Medicare aims to cover treatments that are medically necessary, and acupuncture remains a controversial procedure. Acupuncture is an ancient Chinese practice where small needles are inserted into the skin to stimulate responses in certain areas of the body. The exact mechanism for how it works is unknown, though it is theorized that neurohormonal pathways may play a part. to date, acupuncture has been used to treat a number of conditions including allergic rhinitis, depression, fibromyalgia, headache, hypertension, migraine headaches, nausea, and numerous pain syndromes ranging from low back pain to rheumatoid arthritis.
In a current study released in the Clinical Journal of Pain, Dr. Christer Carlsson and his coworker Dr. Bengt Sjlund of the Lund University Hospital in Sweden had the ability to show the security of using acupuncture for lower neck and back pain.
Hiring 50 patients (consisted of 33 women and 17 men) all of whom have actually been suffering chronic low pain in the back for a minimum of 6 months, the researchers arbitrarily designated one group out of 3 to go through sessions of acupuncture for lower pain in the back. The other 2 groups went through electro-acupuncture and placebo, respectively.
After 4 sessions plus a follow up treatment 2 months later on, "considerable" modifications were observed in the group that went through acupuncture for lower pain in the back. Based upon these outcomes, the researchers concluded that "there is now affordable proof that acupuncture has a scientifically pertinent pain-relieving result on particular kinds of chronic pain."
Numerous more studies were carried out examining the results of Atlanta acupuncture for lower neck and back pain. While the concern of effectiveness stays extensively contested, an excellent variety of the European medical neighborhood are embracing acupuncture for lower neck and back pain as a legitimate treatment method.
When done by an experienced, trained acupuncturist, the procedure is generally safe. Serious side effects, such as infections or punctured organs, are rare. Also, acupuncture has fewer adverse side effects than many of the standard treatments for back pain.
Pregnancy pain (pelvic girdle) a series of acupuncture visits is usually needed to receive real relief. Sometimes, insurance companies may cover the cost of acupuncture therapy, but every plan is different, so it's important to check before making an appointment. As with any treatment, acupuncture has its benefits and drawbacks. Acupuncture pros: many people with pain find relief from acupuncture when they couldn't find relief from other sources. When a qualified practitioner is performing acupuncture with sterile, nontoxic needles, the risks are very rare.
Many people who have chronic low back pain have found acupuncture to be helpful. But the scientific evidence to support these claims has been mixed, partly because it can be difficult to devise a good form of sham acupuncture for comparison. Acupuncture for back pain involves inserting very thin needles to various depths into strategic points on your body. Scientific studies have indicated that sham acupuncture works just as well as real acupuncture for back pain. A key point, though, is that in several studies, both sham acupuncture and real acupuncture relieved low back pain better than having no treatment at all.
Regardless of the intensity of your back pain, you could find some respite with acupressure and acupuncture. Pressure points like the lv3 (tai chong), ub62 (shen mai), and b49 (yi she) help with lumbar/lower back pain and even alleviate sciatica. Te3 (zhong zhu), si15 (jian zhong shu), and gv14 (dazhui) can ease upper back pain and stiffness.
Acupuncture is a safe method which has actually revealed favorable outcomes for a variety of conditions that you might experience consisting of neck and back pain. It can assist you to eliminate the pain brought on by extreme neck and back pain. You can observe the distinction not long after the very first see to the acupuncture center and after a series of routine sees you will discover that the pain has actually been totally lessened.
“Is acupuncture effective to help reduce back pain, and is it safe?” is a question some people with back pain ask. Acupuncture is indeed an effective and safe way to help relieve your back pain—when the treatment is administered by a trained and licensed acupuncturist. It is worth talking to your doctor about trying it for your particular back pain-related symptoms. Acupuncture has been an integral part of Chinese medicine for over 4,000 years, although the benefits were slowly discovered in the western world.
One session with an acupuncture professional is inadequate to recover the pain. Various type of sharp pain need you to go through a number of sessions at the center. The terrific benefit of acupuncture treatment for your neck and back pain is that it can assist even years after the initial concern or problem established. Acupuncture treatment can reinforce your muscles and assist you increase your series of motions by assisting you to control your pain.
How long does it take to treat back pain with acupuncture? Chronic conditions may require 10 or 12 treatments and possibly recur at a reduced level of pain. If increasing pain returns in the future, regular acupuncture can be helpful. Acupuncture and traditional Asian medicine have been used for thousands of years and have been very effective in treating pain and other health conditions. Given the concerns about strong and potentially habit-forming medications being used to mask pain, acupuncture stands out as a safe and nonaddicting alternative.
Acupuncture, how it works and its effectiveness in treating back pain and other causes of body pain have been studied rather extensively by researchers in China, the United States and other countries. Acupuncture unblocks and moves the body’s energy (called qi [chee]) through the body’s functional systems—such as, the nervous, respiratory, circulatory, muscular, and digestive systems. According to the "National Center for Complementary and Integrative Health" (NCCIH), “Results from a number of studies suggest that acupuncture may help ease chronic low back pain, neck pain, and osteoarthritis knee pain. It also may help reduce the frequency of tension headaches and prevent migraine headaches."
In general, the majority of people who struggle with neck and back pain require as much as 12 acupuncture treatments to recuperate from their pain in the back. The treatments can be one or two times weekly depending upon the tip from the acupuncturist. If you never ever take this Chinese recovery strategy, you may question whether the treatment hurts or not. You will feel a sharp feeling for a flash when the acupuncturist inserts the needles into the targeted points. The needles will stay in place around 5 to 20 minutes, and you are not permitted to move when the treatment is being carried out. One treatment area normally lasts for about 30 minutes.
Neck and back pain is typically triggered since muscles that are not regularly worked out and extended are unexpectedly put to extreme usage. Muscle spasms prevail in such cases and lead to the specific sensation aching, stiff and a dull pains in the back. Patients struggling with sciatica might even feel a tingling experience or feeling numb. This is normally due to the constricting of the disc area or a disc protrusion in the lumbar region.
Acupuncture is utilized to enhance blood flow to the whole lumbar region and spine. It unwinds paraspinal muscles and offers remedy for muscle spasms. The increased blood circulation supplies higher nutrition to the discs and increases the flexibility and reinforces the spine. Therefore, acupuncture can be very efficient in minimizing back pain signs. It is essential to keep in mind that various patients react in a different way to acupuncture sessions and it can take anywhere in between 4-12 sessions to actually feel the distinction.
During phase 1 treatment, pain in the patient’s lower back, left buttocks, and posterior thigh, on average, decreased from 7 to 2 on a 10-point numerical pain scale. The patient reported that the treatment both with and without electrostimulation was more effective than the previous physical therapy and spinal injections that he had received. The patient stopped treatment in may 2015 and resumed acupuncture in september 2015, continuing for 1 year.
Upon initiating phase 2 acupuncture, the patient reported continued pain in his left lower back and upper buttocks with left lateral upper thigh pain, especially when bending forward. The pain was 5 out of 10 on the numerical pain scale. Acupuncture treatment in this phase emphasized fascial manipulation and the use of master tung points to address the pain in the left buttocks and hamstring muscles. This treatment reduced the patient’s pain to approximately 0 to 2 on the 10-point numeric pain scale between treatment periods, during which the patient admitted sitting in a slouched position both with and without his feet elevated.
I want to focus on the treatment of lower back pain with acupuncture and moxibustion. This condition is incredibly common. I would have to say that 30-40% of the acupuncture patients i see have some aspect of this condition. In some cases, it is full-blown lower back pain with chronic sciatica that can be caused by degeneration of the verterbrae. Other times, it may be a collapsed disc, muscular spasm or scar tissue from an injury. There are also patients who have been victims of terrible accidents and who have bolts and metal plates in their back.
Lumbar muscle strains and sprains are the most common causes of low back pain. Many “weekend warriors” experience injuries and pain from trying to tackle large home projects, such as painting the exterior of their home or doing their own landscaping. The low back is susceptible to strain because of its weight-bearing function and connection in movements, such as twisting and bending. Muscle strain is caused when muscle fibers are over-stretched or torn. Inflammation is common at the site of injury, usually accompanied by pain with movement. Muscle cramping or spasms can occur, as well as decreased function and/or range of motion.
Acupuncture has been an integral part of Chinese medicine for over 4,000 years, although the benefits were slowly discovered in the western world. Today, as people are becoming more aware of alternative treatments—and seeking pain relief options that do not include medication—acupuncture seems to have jumped to the top of many people’s radar. Still, I find it interesting when people who have suffered from a certain condition long term consider acupuncture a “last resort” option.
Unfortunately, many turn to acupuncture as a last resort for spinal stenosis treatment when all other options have been exhausted, making the assessment of the therapy’s benefits difficult in most circumstances. However, some research has been conducted in recent years showing that alterations in blood pressure and blood flow can occur with acupuncture treatment leading to clinically significant responses in those with lumbar spinal stenosis.
Sciatic nerve blood flow appears to be affected by acupuncture, with an animal study finding that pudendal nerve stimulation and sciatic nerve stimulation through electroacupuncture increased sciatic nerve blood flow by 100% in both cases, compared to a 56.9% increase in those models undergoing lumbar muscle stimulation. Inoue’s 2005 study observed alterations in vasodilator and vasoconstrictor nerve activity which affected the experience of intermittent claudication in those subjects with cauda equina syndrome.
In the quest to relieve chronic pain, having tiny needles inserted into your skin may not initially sound like a great idea. But the millions of Americans who try acupuncture every year might disagree. The alternative therapy is gaining traction with both patients and doctors, and research suggests it may be an effective treatment for chronic headaches and knee osteoarthritis as well as neck and lower back pain. Many physicians use acupuncture to support conventional treatments like medication, physical therapy and lifestyle changes.
While over-the-counter or prescription pain medications may offer some relief, the relief is temporary and does not treat the underlying issue(s) or cause of the pain. Medication may mask the pain to the point that a person continues to do a certain activity that may worsen their physical situation.