Low-level laser therapy (LLLT) is a noninvasive light source treatment that generates a single wavelength of light without generating heat, sound, or vibration. Also called photobiology or biostimulation, LLLT may accelerate connective tissue repair and serve as an anti-inflammatory agent. Wavelengths from 632 to 904 nm are used in the treatment of musculoskeletal disorders. A Cochrane review of 7 small studies with a total of 384 patients with nonspecific low back pain of varying durations found insufficient data to either support or refute the effectiveness of LLLT for the treatment of low back pain. Because of the varied length of treatment, LLLT dose, application techniques, and different populations, it was not possible to determine optimal administration of LLLT.71 No side effects were reported.
Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the leg, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
Get some exercise. You may be tempted to stay in bed when your back acts up, but exercise and activity can actually help you heal faster and reduce pain. A study of 240 men and women found that regular exercise reduced pain by 28 percent and disability by 36 percent. Low impact, moderate intensity exercise is the safest option. Avoid movements that trigger pain or require excessive jumping or squatting, which can exacerbate injuries. Take two to three minutes at the end of your workout to stretch your back thoroughly. Lie flat on your back and hug your knees to release any tension that developed during your workout.
In a 2011 research review published in the British Journal of Anaesthesia, investigators looked at the available research on the use of topically applied capsaicin in the treatment of several types of chronic pain. This included two clinical trials examining back pain, both of which found that capsaicin helped reduce low back pain without causing notable side effects.
It may sound funny to massage your own back, but it is easy to have someone massage your back for you. In fact, having a loved one or friend use Ben Gay to massage the cream into your back is a great way to naturally help your back pain. Don’t massage directly over the spine, as this can cause harm to that delicate collection of anatomical structures. Long, smooth strokes over the entirety of the back are the best. These are called gliding movements, and they help to relax the muscles under the skin. Work the muscles up and down the back to either side of the spine, allowing the hands to glide over the problem area and work the cream into the muscle to provide maximum, natural healing. Next, find out the 15 everyday habits that are causing back pain and damaging your spine. 
Congenital bone conditions: Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit by support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.
Long periods of inactivity in bed are no longer recommended, as this treatment may actually slow recovery. Spinal manipulation for periods of up to one month has been found to be helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.
A diagnosis of sciatica is usually made during a history and physical examination. Your doctor will ask you about your pain. During the physical exam, you may be asked to lift your leg while lying on your back — shooting pain down the back of your leg while in this position is a common sign of sciatica. Your doctor will also check the strength and reflexes in your leg.
Nerve blocks, epidural steroid injections, nerve ablations and other types of injection-based procedures are available for chronic back pain. They are used when the source of the pain is known and can sometimes help rule out certain causes if the treatment doesn’t work. Injections may stop or lessen pain for a certain period of time, but are not intended as long-term solutions and shouldn’t be used in isolation.
Pain is a leading cause of insomnia—difficulty with falling asleep and/or staying asleep. Approximately two-thirds of people with chronic back pain suffer from some type of sleep disorder. Paradoxically, inadequate sleep can make your back pain worse. This vicious cycle makes it ineffective to treat just the pain. If you have sleep problems, you need to get the sleep problems addressed too.
Chronic back pain is straining both physically and emotionally. To manage the frustration, irritability, depression and other psychological aspects of dealing with chronic pain, you may get referred to a rehabilitation psychologist. This specialist may recommend meditation, yoga, tai chi and other cognitive and relaxation strategies to keep your mind from focusing on pain.
You don’t need to take my word for anything — you can just take the word of the many low back pain medical experts that I quote,12 and the hard evidence that their opinions are based on. At the same time, I am realistic about the limits of the science, much of which is pretty junky.13 My own credentials are somewhat beside the point. My decade of professional experience as a Registered Massage Therapist does help me understand and write about low back pain, but what really matters is that I refer to and explain recent scientific evidence, but without blindly trusting it.
An accurate history and physical examination are essential for evaluating acute low back pain. Often, patients awaken with morning pain or develop pain after minor forward bending, twisting, or lifting. It is also important to note whether it is a first episode or a recurrent episode. Recurrent episodes usually are more painful with increased symptoms. Red flags are often used to distinguish a common, benign episode from a more significant problem that requires urgent workup and treatment (Table 2).5,6,8 A recent study shows that some red flags are more important than others, and that red flags overall are poor at ruling in more serious causes of low back pain.8 Patients with back pain in the primary care setting (80 percent) tend to have one or more red flags, but rarely have a serious condition.8  However, physicians should be aware of the signs and symptoms of cauda equina syndrome, major intra-abdominal pathology, infections, malignancy, and fractures (Tables 15,6  and 25,6,8). Cauda equina syndrome and infections require immediate referral. Family physicians should rely on a comprehensive clinical approach rather than solely on a checklist of red flags.
Sometimes, however, the conditions that cause acute back pain can lead to more chronic and serious problems. Clues to a different and more serious cause include: persistent pain, pain and numbness that radiate down both the legs, bothersome pain at night plus fever, weight loss and swelling of the joints. If you experience any of these, it's important you consult a doctor who can examine you carefully, X-ray your back and perform some lab tests. Possible causes of pain in these cases could include ankylosing spondylitis or an infection or tumor of the spine.
To avoid unwanted weight gain, consuming inflammatory ingredients or complications due to nutrient deficiencies, reduce or eliminate the following foods: added sugar, sweetened beverages or snacks, refined vegetable oils, refined grain products, too much alcohol and tobacco products (smoking impairs blood flow and adds to nutrient deprivation to spinal tissues).
Clearly, stretching works as an effective back pain treatment (and offers a more natural pain relief solution than other common pain interventions, like prescription painkillers or surgery). But why is stretching so effective? Which back pain stretches should you be doing to maximize results? And what are the best ways to incorporate back pain exercises into your daily routine to strengthen your core and keep pain at bay?
Some exercises can aggravate back pain and should be avoided when you have acute low back pain. Partial crunches can help strengthen your back and stomach muscles. Lie with knees bent and feet flat on the floor. Cross arms over your chest or put hands behind your neck. Tighten stomach muscles and raise your shoulders off the floor.  Breathe out as you raise your shoulders. Don't lead with your elbows or use arms to pull your neck off the floor. Hold for a second, then slowly lower back down. Repeat 8 to 12 times. Proper form prevents excessive stress on your low back. Your feet, tailbone, and lower back should remain in contact with the mat at all times.
The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back.
Rest: The basic treatment for relieving acute back pain from strain or minor injury is a limited period of rest for 24 to 72 hours. An ice pack can be helpful, as can aspirin or another nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and inflammation. Do not give aspirin to a child aged 18 years or younger because of the increased risk of Reye syndrome. After the inflammation subsides, applying heat can soothe cramped muscles and strained connective tissue.
Low-level laser therapy (LLLT) is a noninvasive light source treatment that generates a single wavelength of light without generating heat, sound, or vibration. Also called photobiology or biostimulation, LLLT may accelerate connective tissue repair and serve as an anti-inflammatory agent. Wavelengths from 632 to 904 nm are used in the treatment of musculoskeletal disorders. A Cochrane review of 7 small studies with a total of 384 patients with nonspecific low back pain of varying durations found insufficient data to either support or refute the effectiveness of LLLT for the treatment of low back pain. Because of the varied length of treatment, LLLT dose, application techniques, and different populations, it was not possible to determine optimal administration of LLLT.71 No side effects were reported.
Magnesium is the fourth most abundant mineral in the body. Involved in over 300 biochemical reactions, it helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and preserves bones strength. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis.
Injections. If other measures don't relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
Evidence from the small number of placebo-controlled trials does not support the use of transcutaneous electrical nerve stimulation in the routine management of chronic low back pain.36 Evidence from single lower quality trials is insufficient to accurately judge efficacy of transcutaneous electrical nerve stimulation versus other interventions for chronic low back pain or acute low back pain.10
Did you know that aside from coughs and respiratory infections, back pain is the most common reason for seeing a doctor in the United States? More than 85 percent of Americans will experience back pain at some point in their life, and back pain is the leading cause of disability worldwide. Yet surgery is rarely needed to treat back pain. So, what’s the answer? Why is it such a problem and, more importantly, how can you prevent it from becoming a problem for you? This article will help answer some of those questions as well as give you some of the best exercises to beat back pain.
The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back.
You probably don't know it, but you and Paula Abdul have more in common than you think! You are both part of the 65 million Americans affected by back pain. The good news is 95 percent of cases involving back pain do not require surgical treatment. As we age, lower back pain becomes increasingly more and more common. Not to mention, muscle elasticity and bone strength decrease over time, leaving your back vulnerable to strain and injury.
According to Susi Hately, owner of Functional Synergy, Inc., in Alberta, Canada, and author of several international best-selling yoga books, yoga can be very therapeutic for people with back pain as well. A review of scientific studies published in 2013 in the Clinical Journal of Pain found strong evidence that yoga can help reduce chronic low back pain. Yoga may help improve back pain by loosening tight muscles, building strength and range of motion, and improving breathing, explains Hately. Yoga also focuses on relaxation, which may help to relax your muscles as well as reduce pain perception.
One of the new back pain remedies is a muscle stimulation machine. In the past, you would need to visit a chiropractor or physical therapist to receive the benefit of one of these machines, but they now sell them over the counter. However, they are expensive. They make the muscles of the back “twitch,” and this helps to strengthen them. After several sessions with the stimulation machine, your muscles are better able to handle the stress and strain of everyday life again. When a back muscle is hurt, it loses some of its primary strength, and the stimulation machine can restore that to a point. The over-the-counter versions are limited, though, and you may need to see a professional if your back pain persists.
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
Medication: If back pain keeps you from normal daily activities, your doctor can help by recommending or prescribing pain medications. Over-the-counter painkillers such as Tylenol, aspirin, or NSAIDs -- such as ketoprofen, ibuprofen (Advil, Motrin), and naproxen (Aleve) -- can be helpful. For severe pain, your doctor may prescribe prescription strength anti-inflammatories/pain medicines or may prefer to prescribe a short-term combination of opioid (narcotic) and acetaminophen medications such as Vicodin or Percocet. Some doctors also prescribe muscle relaxants. But beware, some of these medications have a direct effect on the brain and often cause drowsiness.
2010 — Upgraded: Section now includes discussion of that bizarre and already infamous paper in the New England Journal of Medicine (see Berman). I also make an important new point: exactly why acupuncture placebos are such a problem for low back pain patients in particular. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]
If you have an attack of lower-back pain that is severe, continuous and not improving, assessment and treatment by a health care professional who focuses on the back or other musculoskeletal problems may help. These practitioners may use both active and passive techniques to help you feel better. Examples of passive techniques that may be used to get you moving include:
When you're working to strengthen the core, you'll want to focus on exercises that don't exacerbate lower back issues. "It's important to find out which movements (flexion, extension, rotation) cause pain or discomfort and to avoid those movements, while continuing to work into ranges that are not provoking," Dircksen says. Crockford suggests focusing on exercises that keep the core stable and avoiding twisting movements to avoid exacerbating pain.
Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
Most people — and most health care professionals — believe that back pain is usually caused mainly by structural problems, either injury or degeneration of the spine. This idea is not supported by the scientific evidence.25 Indeed, just the opposite is more the case: “The evidence that tissue pathology does not explain chronic pain is overwhelming (e.g., in back pain, neck pain, and knee osteoarthritis).”26
This movement is helpful to stretch tight abdominal muscles and the lower back. Start by lying on your stomach with your legs extended and with palms planted on either side of your head with your forearms and elbows flat on the ground. Slowly, push your body upwards, so your weight is resting on your forearms. Be sure to keep your hips on the ground. Once you reach a comfortable position that gently stretches your abdominal muscles and lower back, hold for 10 seconds. Slowly return to starting position and repeat five times. If you have more flexibility in your lower back, try straightening your arms.
Stretching your lower back is going to be really helpful in alleviating your lower back pain. Kneel on all fours, with your knees directly under your hips and hands directly under your shoulders. Ensure your spine is in a neutral position. Keep your head in line with your spine, your shoulders back and avoid locking your elbows. Take a big deep breath in and as you breathe out slowly take your bottom backwards towards your heels. Hold the stretch for 20-30 seconds. As you breathe in bring your body up onto all fours again. Repeat six to eight times.
If your purse or briefcase tips the scales at more than 10% of your weight, it’s too heavy. And you need to carry it right. Your best bet is a model with a long strap that lets you position it across your chest like a messenger bag. Our pick: the Ellington Leather Moroccan Shoulder Bag ($169.90). Can’t part with your shorter-strapped number? Switch shoulders every 20 minutes.
Do you want to prevent back pain? Try a few basic exercises to stretch and strengthen your back and supporting muscles. Repeat each exercise a few times, then increase the number of repetitions as the exercise gets easier. If you've ever hurt your back or have other health conditions, such as osteoporosis, consult your doctor before doing these exercises.
There are a number of medications that can relieve back pain. Over-the-counter pain relievers, muscle relaxants, topical pain relievers and narcotics are all extremely effective in increasing your comfort. In addition, cortisone injections can decrease inflammation around the nerve roots and low doses of antidepressants can relieve certain types of chronic back pain.
Muscle relaxants: Muscle spasm is not universally accepted as a cause of back pain, and most relaxants have no effect on muscle spasm. Muscle relaxants may be more effective than a placebo (sugar pill) in treating back pain, but none has been shown to be superior to NSAIDs. No additional benefit is gained by using muscle relaxants in combination with NSAIDs over using NSAIDs alone. Muscle relaxants cause drowsiness in up to 30% of people taking them. Their use is not routinely recommended.
Spinal manipulation: The U.S. Agency for Healthcare Research and Quality recognizes spinal manipulation by chiropractors and osteopaths as effective for acute low-back pain. Its effectiveness for treating chronic back pain is less well established. Some researchers suggest that early manipulative treatment for acute back pain may prevent chronic problems from developing. Other doctors warn against some chiropractic manipulations, particularly those that involve rapid twisting of the neck. Spinal manipulation can be considered a form of conservative care for the treatment of acute and chronic back pain as it is not invasive and does not employ prescription medications.
This myth of “mechanical” failure of the low back has many unfortunate consequences, such as unnecessary fusion surgeries — a common and routinely ineffective procedure — and low back pain that lasts for years instead of months or weeks. The seriousness of chronic low back pain is often emphasized in terms of the hair-raising economic costs of work absenteeism, but it may well be far worse than that — a recent Swedish study shows that it probably even shortens people lives.8 The stakes are high. “Tragedy” is not hyperbole.
Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.
Physical therapists often recommend aquatic therapy — including exercises done in warm, therapeutic pools — for back pain. The buoyancy of the water helps alleviate strain on the joints to encourage strengthening and gentle stretching of the muscles. Even floating in warm water can help relax muscles and release tension as well as increase circulation, according to the Arthritis Foundation. With home whirlpool baths, try aiming the jets directly at your sore spots for a soothing underwater massage.
The seated position anatomically means that we don’t engage our abs and glutes, which can result in them switching off and falling asleep. The fall out of this is that other muscles have to work harder to compensate and support the body.  The muscles in our lower backs become overworked while our hip flexor muscles mainly the psoas — that attaches to the femur and lumbar spine — become tight and tense. It’s this imbalance that triggers the pain, especially in our lower back.
Nonsteroidal anti-inflammatory medications (NSAIDs) are the mainstay of medical treatment for the relief of back pain. Ibuprofen, naproxen, ketoprofen, and many others are available. No particular NSAID has been shown to be more effective for the control of pain than another. However, your doctor may switch you from one NSAID to another to find one that works best for you.
Since I first started treating low back pain in 2000, there’s been an explosion of free online information about it — countless poor quality articles. Back in the day, we actually had to go to a doctor or buy a book to get shoddy back pain information — now it’s just a Google search away.234 Even many better articles still have serious “attitude” problems.5 But it’s worse than that: even professional back pain guidelines are often misleading.6 For instance, despite overwhelming scientific evidence to the contrary, it’s extremely common to incorrectly portray back pain as a “mechanical” problem, as if the spine is a fragile structure which breaks down and causes pain.7 This is based on decades old misconceptions about how backs work, and how pain works, which the medical world is only gradually learning to leave behind.
People who used an ointment that contains this plant-based extract for 5 days reduced the intensity of lower back pain by 95%, according to a 2009 study conducted by Merck (which manufactures the ointment). In comparison, a placebo group had a 38% reduction in pain during that same time, according to the study in the British Journal of Sports Medicine. Look for comfrey root ointment in health food stores or online. Just don't use it for more than 10 days at a time—it can be toxic.
When you're working to strengthen the core, you'll want to focus on exercises that don't exacerbate lower back issues. "It's important to find out which movements (flexion, extension, rotation) cause pain or discomfort and to avoid those movements, while continuing to work into ranges that are not provoking," Dircksen says. Crockford suggests focusing on exercises that keep the core stable and avoiding twisting movements to avoid exacerbating pain.
One of the most common reasons people develop low back pain is posture. Postural problems, including spinal abnormalities, along with muscular compensations or inactivity put added pressure on the back. Although people of all ages experience low back pain — including both athletes and those who are sedentary — middle-aged to older adults (especially when they’re overweight) are most likely to develop severe symptoms and therefore can benefit from lower back pain relief treatments like chiropractic care, soft tissue therapy and regular exercise.
Do you want to prevent back pain? Try a few basic exercises to stretch and strengthen your back and supporting muscles. Repeat each exercise a few times, then increase the number of repetitions as the exercise gets easier. If you've ever hurt your back or have other health conditions, such as osteoporosis, consult your doctor before doing these exercises.
Luckily for 95 percent of people with lower back pain, the ache goes away within a few months. But for a few, it becomes chronic. “If pain becomes sharp and keeps you from sleeping, starts radiating down the front or back of your leg, or wraps around your side, get to the doctor,” says Strassberg. Another clue you should get medical attention: It’s “directional,” meaning it hurts more when you sit or stand in certain positions, she says. Start by avoiding these 15 everyday habits that hurt your back.
One of the new back pain remedies is a muscle stimulation machine. In the past, you would need to visit a chiropractor or physical therapist to receive the benefit of one of these machines, but they now sell them over the counter. However, they are expensive. They make the muscles of the back “twitch,” and this helps to strengthen them. After several sessions with the stimulation machine, your muscles are better able to handle the stress and strain of everyday life again. When a back muscle is hurt, it loses some of its primary strength, and the stimulation machine can restore that to a point. The over-the-counter versions are limited, though, and you may need to see a professional if your back pain persists.
Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
That being said, the best medicine for dealing with back pain is (drum roll please)…. EXERCISE! And before you jump to the conclusion that the fitness professional is turning to exercise yet again, there are just a few other professionals who would agree, namely Harvard Medical School, The American Academy of Orthopedic Surgeons and the Mayo Clinic. All three organizations list exercise as their number one solution for low back pain prevention. In addition, the American Council on Exercise recommends specific dos and don'ts for exercising with low back pain. Yes, the recommendations for exercise seem to be overwhelming when it comes to dealing with back pain. However, the type of exercise you perform is going to make a difference and when it comes to exercising to relieve back pain there are two important goals:
I have had life-altering low back pain for more than 8 years. I’ve had the fusions at L5-S1. Prior to my first surgery I spent 18 months seeking relief through physical therapy, intense massage therapy, myofascial “release” therapy, a visit to Dr. Sarno himself, injections, dry needling of trigger points and massage from a physiatrist, chiropractic work and more. For years between surgeries I tried core strengthening, acupuncture, PT, more massage, two rhizotomies, and visits to the Mayo clinic and Johns Hopkins’ pain management in-patient programs. So I’ve been through a lot. And your book is the first thing I’ve read that dispassionately and entertainingly dissects all of the options and offers some realistic, pragmatic suggestions. It’s a gift to all back pain sufferers.
Steroids: Oral steroids can be of benefit in treating acute sciatica. Steroid injections into the epidural space have not been found to decrease duration of symptoms or improve function and are not currently recommended for the treatment of acute back pain without sciatica. Benefit in chronic pain with sciatica remains controversial. Injections into the posterior joint spaces, the facets, may be beneficial for people with pain associated with sciatica. Trigger point injections have not been proven helpful in acute back pain. Trigger point injections with a steroid and a local anesthetic may be helpful in chronic back pain. Their use remains controversial.
There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Both have some side effects, and some people may not be able to take them. Talk to your doctor before taking pain relievers. And don't expect medication alone to solve your pain problem. Studies show you'll probably need more than one type of treatment.

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Medical Disclaimer: These products are not intended to diagnose, prevent, treat, or cure any disease or ailment. The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any exercise program.

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