Lower Back Pain and Hydration (Drinking Enough Water)

By John S. JamesJohn S. James, 2018-10-08

Waterfall
Waterfall, Pixabay, cc0

I had lower back pain off and on for more than 50 years. It started in my 20s - and stopped almost completely on June 13 , 2018, when I heard a health worker talk on a different subject. In an aside he told the audience that a fellow train passenger noticed his obvious discomfort from back pain, and suggested that he drink 6 glasses of water a day. And he hadn't had a back problem since.

It worked as well for me - quickly, within a day or two. You don't need to drink lots of water - just enough water. There is no solid medical consensus on how much water people need (6 glasses 8-ounce each is often suggested, or sometimes it's 8 glasses).

Dehydration is a common problem for older people, because our bodies can need water even if we don't feel thirsty. So I keep water within reach all the time.

Cognitive Improvement Also

A recent study found that even mild dehydration can cause worse performance and increased errors in some cognitive tasks; this is easily corrected by drinking enough water. For a July 2018 report on the study by NPR (National Public Radio), see Off Your Mental Game? You Could Be Mildly Dehydrated.

Why Didn't Your Doctor Tell You?

Lower back pain is a major reason for doctor visits. So we checked online to find some medical sites to recommend.

Our Google search in (October 8, 2008) for:
"lower back pain" hydration
reports about 900,000 pages. We checked the top 30 results, and all of those are relevant to this issue.

So we looked for major, well-known, mainstream medical sites - such as cdc.gov and other government sites, Mayo Clinic, Cleveland Clinic, major research universities, and some of the well-known and respected medical advice sites, and found none in the top 30 results. Most of the top 30 were chiropractic and natural-healing sites - which mainstream doctors tend to dislike.

But a bigger reason mainstream medicine largely ignores correcting dehydration as a backache treatment or prevention (while strongly recommending drinking enough water, for other purposes); there are no clinical trials of hydration for lower back pain. And mainstream medicine legitimately prides itself on being evidence-based, so doctors are very reluctant to recommend something unless there is scientific evidence that it works. Fine, but this carefulness can go too far, as sometimes there is no evidence - and sometimes there couldn't be, because clinical trials cannot be done due to ethical, scientific, or economic obstacles. Treatment guidelines might pay more attention to such cases. Deciding not to use a treatment due to the absence of evidence for or against is not always best for the patient.

Probably the best database of clinical trials - past, present, and future, throughout the world - is clinicaltrials.gov, by the U.S. National Library of Medicine: "Explore 286,328 research studies in all 50 states and in 204 countries" (2018-10-08). Our search for "hydration" alone found 165 studies; "dehydration" found 131, and "lower back pain" found 1295. But
"lower back pain" hydration
found just one, and it is not directly relevant as it tested a different treatment entirely. No wonder doctors don't tell you about correcting dehydration to prevent lower back pain. There is no "evidence."

Will drinking more water work for everyone's back pain? Of course not; lower back pain can have many causes. But it's worth trying since the cost and risk are negligible, and you will likely know in a few days if it helps you or not, maybe longer depending on what damage has already been done. (Recommending enough water for health in general isn't enough, since people are much more likely to remember and use advice if they can see or feel a clear health benefit for themselves, than if there is no way to tell whether or not what they are trying is helping.)

There are policy issues, too. A major though largely ignored cause of the extreme cost of U.S. medical care is that only the very expensive treatments are likely to be tested. For example, new cancer treatments can cost well over a hundred thousand dollars per patient (and no refund if it doesn't work) - so those treatments are taken seriously and millions are spent on the research. But a potential treatment for lower back pain that costs maybe a penny and has almost no risk (provided the public water supply is safe to drink) has had no mainstream research at all.

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