As chiropractors, we understand the back is a complicated structure of bones, joints, ligaments, and muscles that house and protect the central nervous system.
And because of the complexity and proximity to the body’s pain signaling system it’s no surprise that low back pain is one of the most common reasons for doctor’s visits and missed work.1
Chiropractors are trained to identify pain that can be generated from sprained ligaments, strained muscles, ruptured disks, and irritated joints. In addition, chiropractors are trained to detect pain that may be caused by arthritic changes, poor posture, obesity, and understand that psychological stress can also cause or complicate back pain.
Most of us are aware of the of physical benefits a chiropractor can provide, but may be unaware of the training they also receive to help with nutrition and lifestyle. One of the major benefits of this training is that it allows you, as the patient, to receive more than just a physical approach to decreasing pain and improve function.
One of the nutrients most chiropractors stock on the shelf in their clinic is magnesium. Most of us are aware that magnesium is an essential mineral. However, most of us are not aware of why we may need it or how it plays a role in reducing pain and improves your body’s function.
The benefits of magnesium
Every cell in your body contains magnesium and it is needed to maintain normal biochemical reactions performed by enzymes. Much of our body’s magnesium is found in bone (60 percent), while the remaining amount is in the cells of muscles, fascia, ligaments, tendons, and some free magnesium in the blood.2
Magnesium assists the enzymes in your body to convert food into energy, create new proteins from amino acids, create and repair DNA and RNA, relax muscles, and regulates neurotransmitters that send messages through our brains and nervous system.3
Magnesium also plays a role in the active transport of calcium and potassium ions across cell membranes, a process that is important to nerve impulse conduction, muscle contraction, and normal heart rhythm.7
Unfortunately, in the U.S. over 50 percent of the population is deficient in the bare minimum of magnesium that is required to help our bodies perform all these essential functions.4
The impact of magnesium deficiency
Magnesium deficiency can cause muscle spasms, twitching, and tension on the annoying side of things. However, even early signs of magnesium deficiency can result in loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur. Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted.5,6
Your nervous system also depends on magnesium for its calming effects, due to its ability to block excitatory nerve receptors, called NMDA receptors. Magnesium literally blocks glutamate from setting off our NMDA receptors in our brain and spinal cord. An increase in glutamate activity and NMDA firing has been associated with higher amounts of sympathetic activity (fight or flight system).
We need a balance of excitation and relaxation from our nervous system. When our parasympathetic nervous system can function properly we get a calm, relaxed state, rather than a high alert, stress-induced, adrenaline-driven mode of sympathetic nervous system. When our sympathetic nervous system is dominant this can not only lead to more frequent pain, but more intense pain as the “block” to calm the excitatory signals is removed.8-10
While most of us operate in a sympathetic mode this is not sustainable over the long run. Our bodies demand more magnesium under both mental and physical stress.
Adrenaline burns through magnesium stores rapidly as heart rate, blood pressure, vascular constriction, and muscle contraction all demand a supply of magnesium for proper smooth muscle function. Eventually this elevated sympathetic state can lead to chronic stress, anxiety, irritability, fatigue, insomnia, and depression. In a randomized controlled trial of depressed older adults, 450 mg of magnesium improved mood as effectively as an anti-depressant drug.11
With all the benefits and key functions of magnesium it really comes as no surprise that it has been found in clinical studies to help prevent and treat migraine headaches and low back pain. In one study, supplementing with one gram provided relief from a migraine more quickly and effectively than a common medication.12-15
Magnesium deficiency has even been suggested to be a cause of low back pain, and the potential effects of magnesium supplementation for reducing chronic back pain. In one study 80 subjects were recruited who suffered from chronic lower back and nerve pain. All the participants had received traditional treatment such as physical therapy, antidepressants, and pain relievers.
In addition, half of the participants received magnesium first through an intravenous (IV) infusion for two weeks, and then capsules were taken by mouth for four weeks, while the other half received placebo during those six weeks. The results were that the magnesium group reported significantly reduced pain, compared to the placebo group. Researchers also found significant improvement in spine range of motion during the follow-up.
The research team concluded that receiving magnesium through IV for two weeks and taking magnesium capsules by mouth for four weeks may help reduce pain and improve mobility in people with chronic low back and nerve pain.15,16
There is no doubt magnesium is essential and the benefits are widespread. Talk to your chiropractor about the best form of magnesium and what dose may be best for you.
Frank Bodnar is 2010 graduate of Palmer College of Chiropractic with a M.S. degree in Human Nutrition from the University of Bridgeport and is certified in sports nutrition through the International Society of Sports Nutrition (CISSN). He practices in Racine, WI where he lives with his wife and two children. He is passionate about using nutrition to improve patient outcomes, and enhance lifestyle changes through counseling and education. He can contacted through frank.bodnar.dc@gmail.com, 262-930-2188, follow him on twitter @drfrankbodnar or connect on LinkedIn.
References
- Steven J Atlas, MD, MPH and Richard A Deyo, MD, MPH Evaluating and Managing Acute Low Back Pain in the Primary Care Setting J Gen Intern Med. 2001 Feb; 16(2): 120–131.
- Gröber U, Schmidt J, Kisters K Magnesium in Prevention and Therapy 2015 Sep 23;7(9):8199-226.
- de Baaij JH, Hoenderop JG, Bindels RJ. Magnesium in man: implications for health and disease Physiol Rev. 2015 Jan;95(1):1-46.
- Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev. 2012 Mar;70(3):153-64.
- Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press, 1997.
- Rude RK. Magnesium. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare; 2010:527-37.
- Rude RK. Magnesium. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Baltimore, Mass: Lippincott Williams & Wilkins; 2012:159-75.
- Petrenko AB, Yamakura T, Baba H, Shimoji K. The role of N-methyl-D-aspartate (NMDA) receptors in pain: a review. Anesth Analg. 2003 Oct;97(4):1108-16.
- Li YF, Mayhan WG, Patel KP NMDA-mediated increase in renal sympathetic nerve discharge within the PVN: role of nitric oxide. Am J Physiol Heart Circ Physiol. 2001 Dec;281(6):H2328-36.
- Marie L. Blanke and Antonius M.J. VanDongen. Biology of the NMDA Receptor. Chapter 13: Activation Mechanisms of the NMDA Receptor
- Barragán-Rodríguez L, Rodríguez-Morán M, Guerrero-Romero F. Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial. Magnes Res. 2008 Dec;21(4):218-23.
- Wang F, Van Den Eeden SK, Ackerson LM, Salk SE, Reince RH, Elin RJ Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. 2003 Jun;43(6):601-10.
- Köseoglu E, Talaslioglu A, Gönül AS, Kula M. The effects of magnesium prophylaxis in migraine without aura Magnes Res. 2008 Jun;21(2):101-8.
- Shahrami A, Assarzadegan F, Hatamabadi HR, Asgarzadeh M, Sarehbandi B, Asgarzadeh S. Comparison of therapeutic effects of magnesium sulfate vs. dexamethasone/metoclopramide on alleviating acute migraine headache. J Emerg Med. 2015 Jan;48(1):69-76.
- Ellen C G Grant, Magnesium deficiency as a cause of back pain: BMJ 2004;329:708
- Yousef AA, Al-deeb AE. A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia. 2013 Mar;68(3):260-6.