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FAU’s Charles E. Schmidt College of Medicine Researchers Call for More Research on Alternative Medicine Therapies for Low Back Pain

Commentary Published in the Journal of Alternative and Complementary Medicine

BOCA RATON, Fla. (October 21, 2013) — Charles H. Hennekens, M.D., Dr.P.H., at Florida Atlantic University, in collaboration with Patricia Hebert, Ph.D., M.S.N., and E. Joan Barice, M.D., M.P.H., both affiliate associate professors of FAU’s Charles E. Schmidt College of Medicine, have published a commentary titled “Treatment of Low Back Pain: The Potential Clinical and Public Health Benefits of Topical Herbal Remedies.”

In the U.S., low back pain is a major clinical and public health problem affecting eight out of 10 people at some point during their lives. Treatment is varied depending on the degree of the pain and includes cold packs, exercise, prescription drugs, injections, and in some cases, surgery. Hennekens and his colleagues note that while there are therapies of proven benefit, such as non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 inhibitors (COXIBS), these offer only limited benefits for the treatment of low back pain and have both cardiovascular and gastrointestinal complications.

Hennekens and his collaborators explain that two topical herbal remedies, Capsicum frutescens or cayenne or capsaicin and a combination of wintergreen oil and peppermint oil offer potential alternative treatments to NSAIDs and COXIBS, and, in addition, are likely to have far fewer side effects.

Capsaicin is a powerful local stimulant that, with repeated applications, leads to persistent desensitization of pain. Furthermore, wintergreen oil is a compound closely related to aspirin and when applied to the skin with peppermint oil has painkilling properties. In addition, the combination of both of these oils may enhance the effects of each individually, thereby enabling the use of lower doses, which, as a consequence, is likely to produce fewer side effects.

"If these alternative medications were equivalent or superior to the existing therapies, their lower risks may favor their more widespread use," said Hennekens.

The researchers point out that clinical challenges for healthcare providers who treat chronic lower back pain should be viewed as a major challenge to researchers—a challenge to compare the benefits and risks of these potentially promising and safer alternative treatments to conventional therapies.

"Dr. Hennekens and his colleagues are raising important issues about the efficacy and safety of different treatments for this common clinical problem," said David J. Bjorkman, M.D., M.S.P.H., a gastroenterologist and dean and executive director of medical affairs in FAU’s Charles E. Schmidt College of Medicine.

Science Watch ranked Hennekens as the third most widely cited medical researcher in the world from 1995-2005, and five of the top 20 were his former trainees and/or fellows. In addition, in 2012, Science Heroes ranked Hennekens No. 81 in the history of the world for having saved more than 1.1 million lives.  


Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU’s world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of three signature themes – marine and coastal issues, biotechnology and contemporary societal challenges – which provide opportunities for faculty and students to build upon FAU’s existing strengths in research and scholarship. For more information, visit

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