BACK AND NECK PAIN
Up to 85 percent of Germans suffer from persistent back pain at least once in their life, and 34 percent of Germans complain about recurrent or chronic back pain. The numbers in the United States are not far off.17 In the Western world in general, millions of people visit a doctor every year because of back pain. In about 80 percent of the patients, the prescribed methods work initially, but very frequently the pain returns.18, 19
Treatment Approach of Conventional Medicine
For a long time now, the great number of back surgeries carried out in Germany has been criticized. For many years, the cause of chronic back pain was attributed to signs of wear and tear in the bones or disc protrusions, until studies were able to demonstrate that these medical findings, which almost every person shows after a certain age, are often not even the cause of the pain.20 That’s why a surgery is unable to produce relief in many cases. It’s only necessary in cases of a severe spinal disk herniation that disrupts bladder or bowel function or causes paralysis, and in cases of severe spinal stenosis (constriction of the vertebral canal), which causes great pain and can’t be improved through naturopathic treatments or physical therapy. Most patients receive medication or injections with pain-killing or muscle-relaxing agents; even antidepressants are prescribed. All of these medications have, when taken for a prolonged period of time, significant side effects.
Treatment Approach of Naturopathic Medicine
Most people suffer from “unspecific” back pain, for which naturopathic methods are highly recommended and scientifically funded. By now, the realization has prevailed that back pain shouldn’t immediately be treated with injections and medication, but rather with active measures that can be carried out by the patients themselves. Since pain causes a fear of movement (kinesophobia), the gentle and conscious movement methods of yoga or tai chi are particularly suitable. Many surgeries would become superfluous if naturopathic methods were applied consistently.
My Top Ten for Back and Neck Pain
Yoga: The exercises are very healing for back pain, and usually they are also better than any other therapies. Iyengar yoga and Vini yoga are particularly recommendable.
Physical therapy and physical activity: There are specially developed back training programs that combine muscle building and stretching. Get advice on this from your orthopedist. A good manual therapy, without the “cracking” and only using gentle techniques, can also be an effective supplementary treatment. Methods like the Alexander technique put special emphasis on conscious sequences of movements in the spine. Curative eurythmy from anthroposophical medicine combines movement and breathing with talking. In a forthcoming study conducted by our work group, eurythmy proved equal to intensive physical therapy and yoga.
Acupuncture and bed of nails: The effectiveness of acupuncture in treating back pain has been proven.21 It can provide a good bridge until an exercise program begins; additionally, it makes it possible to perform the exercises with less pain. At home, you can use the “bed of nails,” also called a “fakir mat” or an acupressure mat—a mat with small, pointy attachments that lowers the body’s sensitivity to pain. It’s easy to use: first, press your hands into it, then place it under the part of the back that causes pain, and remain lying on it for as long as it feels good.
Leech therapy: A recently concluded study by my group demonstrated the beneficial effect of a single treatment with leeches. In comparison to physical therapy, the pain receded significantly more after eight weeks.22 The long-term effect has not been sufficiently researched, but in otherwise treatment-resistant pain, I definitely recommend at least trying it.
Walking barefoot: Back pain is not only an issue of the back. The entire “motion apparatus” is interconnected. That’s why foot or knee problems can also cause back pain. Experienced physical therapists, manual therapists, and osteopaths know these connections. It’s recommendable to mobilize the fasciae from the sole of the foot using, for example, a spiky massage ball (but step on it forcefully, since it has to hurt a little . . .)
Standing: Avoid sitting for hours on end. Take walks whenever you can, and work at a standing desk or a vertically adjustable table.
Meditation: When stress is one of the causes of back pain—and it often is—mindfulness and mantra meditations (such as Jyoti) often help.
Heat therapy: Tense muscles can be loosened by using warmth, even at home. The simplest method is to take a hot bath. You can also buy heat packs at the pharmacy or online, e.g., peloid packs, beeswax packs, grain and ginger sacks. An alternative to a hot water bottle are heat plasters or capsaicin (Spanish pepper)—however, both irritate the skin and aren’t tolerated by everybody.
Cupping: In all its forms (wet, dry, or as a massage), cupping usually helps to treat back pain quite effectively. For household use, dry cupping and the cupping massage can be carried out by your partner.
Diet: Therapeutic fasting helps us lose superfluous weight, and to transition to a vegetarian diet. A base-rich diet (vegetables, fruit, sprouts) is advisable, since meat, fish, dairy products, and grains contain acid and can have a negative impact on the connective tissue. Eat less bread and drink mineral water that is rich in bicarbonate.
DIABETES
Diabetes is causing more and more concern for physicians and health officials. For years, the number of cases has been on the rise in Europe and the United States.23 While it was mainly the elderly who were affected before (“adult-onset diabetes”), type 2 diabetes patients are becoming younger year by year.24 Almost all scientists agree that malnutrition, overeating, and obesity are responsible for the epidemic, combined with a lack of physical activity (things are different for type 1 diabetes, where the insulin-producing cells are destroyed by the immune system). All attempts of prevention have been futile. According to recent reports, diabetes affects 9.4 percent of the population of the United States, or about 30.3 million people. Approximately 90 percent of all diabetes cases are type 2 diabetes. In addition, another 34 percent of American adults—84 million people—have prediabetes.25
Treatment Approach of Conventional Medicine
There are drugs that not only lower elevated blood sugar levels, but also significantly reduce the actual danger for diabetes patients (such as dying from heart attack, stroke, or kidney disease). Metformin is the drug used most frequently; it facilitates cells’ glucose absorption and thus lowers blood sugar levels. The next step is insulin therapy, which leads to weight gain, however, and often causes a vicious cycle: The patients move less, which further disrupts the metabolism and carries new health risks with it. New drugs like Empagliflozin and Liraglutide pursue different modes of action, such as the increased secretion of glucose via the urine. Further medications are in the pipeline. But as is so often the case, highly effective new drugs have two disadvantages: They cause side effects and they are expensive.
Treatment Approach of Naturopathic Medicine
Intensive lifestyle therapies and fasting try to normalize the insulin balance, to stabilize it, and to minimize the risk factors that are the result of the illness. A change in diet and exercise are important pillars. Bloodletting can be useful as a supplementary treatment.
My Top Ten for Diabetes
Oat days: Oatmeal lowers blood sugar levels. Eating nothing but oatmeal on certain days is a moderate form of fasting and brings relief to the metabolism.
Vegan diet: Studies show that the beneficial effect of a vegan diet is demonstrated clearly for diabetes mellitus.26
Nuts and olive oil: They should be consumed every day. They lower the risk of cardiovascular diseases by protecting the vessels.
Intermittent fasting and therapeutic fasting: One study was able to show that 16/8 fasting—i.e., a daily sixteen-hour abstention from food—improves blood values and even fatty livers within a few weeks.27 Prolonged th
erapeutic fasting of seven to ten days (twice a year) has even stronger effects.28 It’s best to combine both.
Bloodletting: It lowers blood pressure, intensifies insulin’s effect, and normalizes sugar metabolism by lowering ferritin levels. It’s particularly suited for patients with a fatty liver, which often develops in patients with diabetes.
Ayurveda: In India, multimodal therapy concepts (adjusted to the individual patient) are employed to remarkable success.
Ginseng: Traditional Chinese Medicine attributes a vital energy-maintaining power to this legendary medicinal plant. Its effects have best been proven in the treatment of diabetes mellitus. That’s why trying it can be recommended as a supplementary measure.
Vinegar: Consuming vinegar with a meal (i.e., in pickled vegetables or taken with a spoon) lowers the rise of blood sugar levels after eating.
Legumes: A daily ration of chickpeas, lentils, or beans leads to improved blood sugar regulation.
Avoid fattening chemicals (obesogens): Environmental toxins, such as the so-called persistent organic pollutants (POPs), are stored in the fat tissue. At the same time, they seem to cause weight gain, even though this has not yet been proven conclusively. Since they build up continuously along the food chain, they are contained to 90 percent in animal products, first and foremost in salmon and tuna.29 They are best avoided by switching to a vegan diet.
RHEUMATISM
Rheumatoid arthritis, formerly called polyarthritis, is accompanied by painful inflammations and swelling of the joints. It leads to severe damage of the joints if treated insufficiently.
Treatment Approach of Conventional Medicine
Up until a few decades ago, doctors were relatively powerless in the face of rheumatoid arthritis. Now, many new, effective drugs are available, the most famous among them is Methotrexate. Almost every year new biologicals (substances developed with the aid of biotechnology) come on the market, and they usually achieve a significant improvement, especially in combination with Methotrexate. Still, these medications don’t cure the disease. A lot of the time, cortisone has to be taken also—accompanied by the well-known side effects such as weight gain, increased blood pressure, a rise in blood sugar levels, etc.
Treatment Approach of Naturopathic Medicine
The treatment of rheumatism is a good example of an integrative medicine in which effective conventional medicine is combined with naturopathy. We cannot forgo modern antirheumatics and biologicals, since the effects of naturopathic methods are ultimately not strong enough. But they are appropriate supplements: They relieve symptoms and can facilitate a reduction of the dosage of medications. It’s important to start using them at the very beginning of the illness without delay. In my experience, stress plays a negative role in rheumatoid arthritis as well as in other autoimmune diseases.
My Top Ten for Rheumatism
Fasting: Numerous studies demonstrate the symptom-relieving effect of fasting.30 Every day at the Immanuel Hospital, the biggest rheumatology center in Berlin, we see good results from fasting.
Mediterranean and plant-based diet: It’s important to prolong the effect of fasting by adopting an anti-inflammatory diet for as long as possible afterward. Patients should refrain from eating meat and eggs completely, since they contain pro-inflammatory arachidonic acid. Dairy products should be consumed only in small quantities. Whether a strictly vegan diet provides further advantages is not scientifically resolved.
Elimination diet: Many patients have found that certain foods can cause a rheumatic episode. Often, these are meats or dairy products, but not exclusively. If a worsening of the condition has been noted multiple times after consuming certain foods, they should be avoided. However, this is subject to change, which is why it’s possible to test the suspected foods again after a while.
Mindfulness meditation: In three studies, regular mindfulness meditation led to a better mental state in patients with rheumatism. In one of the studies, inflammatory activity was also diminished. Meditation as a method of reducing stress is especially recommendable if the beginning of the disease was connected to an exhausting life phase or a difficult event.31
Cryotherapy: Cold chambers, localized ice packs, or cooling quark poultices relieve joint pain very well.
Medicinal herbs: Initial studies have shown that turmeric has an anti-inflammatory effect.32 I recommend turmeric in its natural form (put two teaspoons of it in your meal or a drink every day together with a pinch of black pepper, which improves absorption in the body). Extracts of stinging nettle, rampion, or incense have not been sufficiently examined by science to allow for them to be recommended as standard. If, however, there exists a resistance to therapy or if all other usual and newer antirheumatic drugs and biologicals cause particularly severe side effects, it’s advisable to give them a try. Particularly with incense, we keep seeing surprising successes over and over in our hospital.
Omega-3 fatty acids: They have an anti-inflammatory effect which can be used as a supplementary treatment in rheumatism. Plant-based sources that contain alpha-linolenic acid (flaxseed, flaxseed oil, canola oil, soy oil, walnuts, leafy greens, etc.), are recommendable. In principle, fatty saltwater fish are also a good source of omega-3 fatty acids, in this case for the long-chain fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). But since rheumatism is often accompanied by osteoporosis, and fish can foster osteoporosis because of its acidity and is often polluted with heavy metals, I recommend plant-based sources of omega-3 fatty acids.
Gamma-linolenic acid: It is found in borage seed, black caraway, or evening primrose oil and has an anti-inflammatory effect. Some smaller studies confirm this, but the effect is mild.33
Acupuncture: For rheumatism, this healing method is recommended as pain therapy.
Ayurveda: In India, rheumatism is often treated with Ayurvedic herbs. In an initial study, the Ayurvedic therapy was not inferior to Methotrexate.34 This is not enough to issue a general recommendation, but an attempt can be made if other therapies are unsatisfying.
GASTROINTESTINAL DISEASES
The digestive tract is, due to its nerve nets that span from the mouth to the anus, a sensitive area with many complex functions that react to both psychosomatic processes as well as serious metabolic disorders and infections. Common and not easily treatable diseases include esophagitis (reflux disease whose symptoms include acid reflux) and irritable bowel syndrome, which causes stomachaches and digestive problems with diarrhea, bloating, and indigestion without any abnormalities showing up during a colonoscopy.
Treatment Approach of Conventional Medicine
Antacids—proton pump inhibitors (PPIs)—and the antibiotic treatment of the stomach bacterium Helicobacter have been used in the therapy of gastric ulcers and severe esophagitis with great success. However, PPIs are among the medications prescribed too often nowadays. Around the world, they are recommended by physicians generously and for excessive lengths of time, probably in more than one in every two cases without proper indication being detected.35 This is not a trivial problem, since studies have shown that the prolonged intake of PPIs is linked to a series of serious risk increases, beginning with dementia, to cardiovascular diseases and osteoporosis.36, 37 It’s not rare that they also cause vitamin B12 deficiency, which, in turn, can result in nerve damage. Moreover, they impair the feeling of satiety while eating and can cause stomach pains, nausea, and diarrhea. Finally, the acid suppression can lead to undesirable bacteria settling in the gastrointestinal tract. Consequently, this can lead to unfavorable changes in the intestinal microbiome. That’s why PPIs shouldn’t be taken any longer than is necessary. A study was able to show that the body starts defending itself against the PPIs after only eight weeks: It reacts to the blocking of acids with an overproduction of the hormones facilitating acid production.38 In 40 percent of c
ases, the discontinuation of the drugs is accompanied by withdrawal symptoms.39 Previously nonexistent gastrointestinal problems develop. Thus, we see that PPIs can also be addictive.
Patients I see in consultations often report that they had been diagnosed with a diaphragmatic hernia—this is the medical term for a malfunctioning closing of the sphincter at the lower end of the esophagus where it meets the stomach. There are many people with this diagnosis, but it doesn’t necessarily mean that this results in a reflux disease, meaning the rise of the gastric juices. Therefore, you shouldn’t feel like you are suffering from an uncurable disease straight away. Contributing factors to the development of this hernia are obesity, stress, and lack of exercise and thus, there is the possibility for it to regress.
About 17 percent of the United States’s population suffers from irritable bowel syndrome.40 The exact cause for this is undetermined. But stress and excessive strain play a role in this, along with, probably, intestinal bacteria that contribute to a lowering of the pain threshold and to digestive problems when they settle incorrectly and even to natural intestinal movements causing problems. So far, there are no good, effective therapies that conventional medicine can offer, except for a FODMAP diet (Fermentable Oligo-, Di-, Mono-saccharides and Polyols), which avoids anything that causes flatulence and that is hard to digest.
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