(The Denver Post)

Your back hurts. Is it because of tightened muscles, thickened connective tissue or blocked energy? Depends on whom you ask, but if you seek out alternatives to traditional Western medical treatment, you will be in good company. About four in 10 adults (and one in nine children) use some form of what the government calls complementary and alternative medicine (CAM).

Through its Center for Complementary and Alternative Medicine, the National Institutes of Health studies a wide variety of nontraditional and non-Western treatments, including herbs and supplements, energy medicine, massage and other manipulative, body-based practices.

The center has found that American adults are most likely to seek out alternative treatments for musculoskeletal problems such as back, neck or joint pain. For detailed information on hundreds of treatments and topics, go to nccam.nih.gov. Here’s a sampling of hands-on treatments in Denver:

Massage

An experienced certified massage therapist is trained to deal with muscle and tissue dysfunction through hands-on soft-tissue manipulation that both relaxes and improves blood flow to the affected area and the body as a whole.

Massage can be effective preventive medicine, say therapists. Tess Gallegos, a Denver massage and skin-care specialist, says massage also improves posture and body mechanics.

“The goal of a massage therapist is for the client to leave with an understanding of back pain and to feel more in control,” says Gallegos. “Massage is not just relaxing, it can actually change the structure of the body and get to the bottom of the cause of the pain.”

Swedish massage specialist Stefan Paulsson explains that tight muscles pull on the skeleton where the muscle is attached. The body then compensates for the short, tight muscle in another part of the body, causing pain.

“A contracted muscle has poor blood flow; relaxing it improves blood flow,” says Paulsson, who owns Back In Shape in the Commons Park neighborhood downtown. “Keep soft tissue soft, relaxed and with good blood flow, and fewer problems arise.”

Rolfing.

Developed by Ph.D. biochemist Ida P. Rolf more than 60 years ago, Rolfing is the process of examining and reorganizing the connective tissues that envelop the entire body. “Connective tissue provides support for the entire body,” says Marekah Stewart, a certified advanced Rolfer. “It encases all of the body’s systems — muscle, organs, bones — all of them.”

When you combine gravity with any illness or trauma (physical or emotional) the connective tissue thickens, shortens and becomes “stuck,” and we begin to compensate, says Stewart.

The head may pull forward, the shoulders may become rounded, and imbalances in the hips and pelvic girdle may occur. Because of its plasticity, connective tissue responds to warmth and pressure, so Rolfers manually free up the connective tissue over a series of 10 sessions.

“If one area is affected, others are impacted, the ultimate goal being to bring the head, shoulders, thorax, pelvis and legs back to a more vertical alignment,” says Stewart. “Rolfing can provide more freedom of movement, function, flexibility, and the sense of being integrated, giving one more energy and balance.”

Acupuncture

Practiced in China and throughout Asia for thousands of years, acupuncture stimulates specific points on the body, most commonly through thin metal needles inserted into the skin. The acupuncture points are on pathways, called meridians, along which the life force (qi) flows, and stimulating them is thought to remove blockages in the flow of qi.

While the National Institutes of Health places it in the complementary and alternative medicine category, acupuncture is one of the most-studied alternative practices. The American Pain Society and the American College of Physicians say doctors should consider acupuncture, among other complementary and alternative therapies, for patients with chronic low-back pain that does not respond to conventional treatment.

A clinical trial reported in May 2009 that actual acupuncture and simulated acupuncture were equally effective — and both were more effective than conventional treatment — for relieving chronic low-back pain, says the National Center for Complementary and Alternative Medicine.

Patty Wang and Henry Cao have been practicing acupuncture in Colorado for 15 years, since they moved here from China, where Wang practiced acupuncture and Cao was an orthopedic surgeon. In their Denver practice, Wang does most of the acupuncture, and her husband, Cao, works with herbs and uses his surgical knowledge to diagnose and prescribe exercises.

“Acupuncture can help relax soft tissue from a muscle spasm, muscle imbalance, arthritis, or herniated disk, but cannot restore the lost cartilage due to arthritis or repair a herniated disk,” says Cao.

Reiki

Based on the idea of a universal energy that can support the body’s healing abilities, Reiki is a Japanese practice that gained popularity in the United States in the 1930s. Pronounced RAY-kee, the word comes from the Japanese words rei, or universal, and ki, life energy. Practitioners place their hands lightly on or above the client’s body, in order to channel that energy and facilitate healing.

The National Institutes of Health includes Reiki in the complementary and alternative medicine category, and is funding studies on its usefulness in treating symptoms of advanced AIDS, prostate cancer, and nerve pain and cardiovascular risk in people with Type 2 diabetes. A study published in 2008 found that neither direct nor distant Reiki affected the pain of fibromyalgia.

Although not licensed or regulated, Reiki training has three levels, taught by a master, a practitioner who has reached the highest level.

Reiki master Regan Peschel says in the case of back pain, energy blockages could contribute to the injury, she says.

“With physical pain, half the time is spent sending healing energy to that spot,” says Peschel, who believes we all have the ability to connect with healing energy and to self-heal.

Yoga

“There is a misconception that ‘yoga’ only means get on a mat and be a pretzel,” says Lisa Eller Davis, a Denver yoga teacher and Reiki master. People in pain are often afraid, she says, and stress from that pain makes the pain worse.

“First I use breathing and mind/body awareness to calm the fear,” says Eller Davis. “Breathing oxygenates the body and relieves tension.” Gentle yoga postures and movements — some as simple as changing the position of the head and neck — open the mind and calm the body, she says.

Then, people can begin coordinating body postures with breathing techniques. “Body follows mind, and mind follows breath,” says Eller Davis.

In addition to breathing and relaxation techniques, yoga can be practiced seated, standing and reclining.

“There is a yoga for any body,” Eller Davis says. “With some back injuries, physical yoga movements are not the best place to start; the person should be evaluated by a physician before beginning any yoga program.”

Yoga can adapt, align, strengthen and stretch limbs, and release tension in the head, neck and shoulders, all of which help in the healing process.

Exercise/strength training with Pilates

Personal trainer David Bartlett asks clients to perform exercises like rollups and un-weighted squats. He watches for moves that cause the pain to kick in.

By using strength-training techniques, while challenging balance on a wobble board, FitBall, BOSU, or Coreboard, Bartlett’s clients have reduced or even eliminated pain, he says.

“The goal is the fluid integration of range of motion, speed, length of lever and proper breathing,” Bartlett says. “When people can do this with reduced or no pain, their confidence, co-ordination, and balance all improve as well.”

He says there’s more to developing back strength than “core work” — the pelvic floor muscles, back and abdominals must be strengthened without stressing the area of the back that is under duress.

“I get the best results when strength or resistance training is combined with Pilates, using primarily Polestar Pilates principles and Balanced Body equipment,” he explains. “Pilates strengthens, tones, elongates, and stretches all the muscles in the body — some all at the same time.”