Living with back pain can be horrible. Everyone has the occasional twinge, but for those with chronic back pain, even the smallest movement can be agony.

Back pain, which includes neck pain and sciatica, is extremely common, affecting 80 percent of Americans at some point. Low-back pain is among the most common reasons for medical appointments, with one in four adults reporting low-back pain within the previous three months.

But back pain is a symptom of another underlying condition, not a diagnosis. The pain may come from problems with nerves, discs, muscles, or osteoarthritis.

According to a 2008 study in JAMA, Americans spend more money treating back and neck pain than almost any other medical condition, but much of those funds may be wasted. Between 1997 and 2005, total medical costs for back and neck pain increased by 65 percent—about $86 billion a year in today’s dollars. Still, during those years, patients actually experienced more disability from back and neck pain, along with more depression and physical limitations.

Today, those with back pain spend nearly twice as much for medical care each year as those without. Back pain expenses nationally have risen faster than health care costs overall. Escalating use of newer narcotics (Vicodin, OxyContin) is chiefl y responsible for the increase.

University of Washington scientists found that the nation’s dramatic rise in expenditures for the diagnosis and treatment of back and neck problems has not led to expected improvements in patient health.

Many people fi nd help with very simple treatments— stretching exercises, yoga, or massage, yet some chronic back pain progresses to require medication and more intensive treatment. Here are three natural methods that can be very helpful.

Remedy 1. Willow Bark: Nature’s Aspirin
Willow bark (Salix alba and other species) is a natural pain reliever that lives up to its reputation. The bark contains salicin and other related compounds, the herbal forerunners of aspirin, which relieve pain, lower fever, and ease infl ammation.

An Israeli study confirmed the herb’s use for back pain. Subjects were given an extract containing either 120 mg or 240 mg of salicin per day. The benefi t, after only 1 week of treatment, was great. The higher the dose given, the more effective the outcome.

In a University of Sydney study, researchers compared the effects of willow bark extract to refecoxib, a COX-2 inhibitor pain medication. When 114 patients received an herbal extract containing 240 mg of salicin, and 114 received 12.5 mg of refecoxib every day, both sets of subjects had a comparable reduction in back pain after four weeks.

Willow won’t cause the bleeding problems common with aspirin. It probably does not thin the blood and should therefore not be used for heart disease prevention. However, caution is still advised if you have a bleeding disorder or take blood-thinning medication. Use a tea brewed from up to 1 ounce of the raw herb per day, or an extract containing 240 mg salicin per day. Willow is safe for long-term use.

Remedy 2. Turmeric Root: Inflammation Fighter
Curcumin, the compound that creates turmeric’s distinctive yellow color, has anti-infl ammatory effects comparable to the drug prednisone. But unlike prednisone, curcumin is nonsteroidal, so it has no negative side effects.

Curcumin treats pain by stimulating production of nitric oxide, a painreducing chemical messenger, and also suppresses pain through a mechanism similar to many drugs (COX-1 and COX-2 enzymes). For acute back pain, take as much as 1 ounce (4 tablespoons) per day. Stir the powder into water and swallow, or make into a paste with honey or a bit of oatmeal. For ongoing pain relief, use 1 g per day as a spice, or in capsules. A daily dose of 1,500 mg of curcumin (standardized extract) is also a good choice.

Remedy 3. Cayenne: Potent Pain Rub
Capsaicin is the active ingredient that gives chile peppers their kick, and the chemical that kills pain. Applied to skin, cayenne ointment containing capsaicin has been found to deplete substance P— a neurochemical that transmits pain, reducing pain signals in nerves. There may be a delay of up to two weeks before pain relief begins. Apply a peasize amount of ointment over painful areas, and rub in completely. Apply four times daily for two to three days, then two to three times daily thereafter. For the fi rst few days, you may experience increased pain as the nerve cells release their substance P. Once the cells are depleted, pain decreases.