WHAT TO DO IF YOU HURT YOUR BACK

Low back pain is a very common occurrence and is said to affect 80% of people at some time in their life.  Common causes of acute low back pain are sudden unexpected movements, such as bending and lifting while twisting, or trauma, such as a fall or a motor vehicle accident.  Other back injuries can occur in some individuals simply by bending over to brush their teeth, sneezing, or while doing other simple tasks.  The low back pain can either come on instantly, with acute muscle spasm or ‘locking' (sometimes it is impossible to move or to straighten to an upright position), or it can come on more slowly (up to 2 days post injury, as swelling and muscle spasm gradually accumulates) .

What to do:

1) Relax! 

No matter how bad the pain is it will get better.  Back pain is very common and while it can be debilitating the more anxious and stressed you are, the more the pain will increase.  Focus on staying positive.  Keep reminding yourself that you will improve.  Find a comfortable position and use relaxation breathing techniques.  This can very helpful in reducing pain .

2) Ice or heat.  

If the pain is less than 48 hours old, use ice.  Use heat if the pain has been present for more than 48 hours. Heat can be in the form of hot showers,an electric heating pad, a microwaveable pad or hot water bottle.  Heat works best when an area is achy.  The ice can work to numb the area and is especially good if the injured area feels hot and burning.    Some people find relief alternating between ice and heat provided the best relief.

3) Stay Mobile

Try to remain as active as the pain will allow. Some discomfort with moving around is normal. Research has proven that keeping active i.e. puttering around (stand a little, sit a little, walk a little) will allow you to get better faster.  Strict bed rest, while once commonly prescribed, will typically slow down your progress.  

4) Find the best positions to rest and sleep.

If you are unable to move or movement greatly increases the spasm and pain, then you may require more rest.  Finding comfortable positions for sleep and rest is important to unload your back as it gets tired or the pain starts to increase.  See the sleep position article for some advice on the best resting positions.  

5) Get treatment.  

There is good evidence that manual physical therapy will get you better faster. Research has proven that manual physical therapy for acute low back pain performed in the first 16 days is most effective. 

6) Leg Pain? Learn the right exercises and positions and try traction.  

Pain radiating down the leg will also improve with manual therapy but also requires specific exercises and/or positioning to relieve the pain. Traction can be of benefit especially when the leg pain is radiating below the knee.

7) Pain relief with physiotherapy modalities.

Physiotherapy modalities such as electrical stimulation, i.e. TENS or IFC, can be of benefit.  Electrical stimulation works to block the pain impulses that are being transmitted, providing an analgesic effect.  As the impulses are blocked the muscle spasm will relax.

8) Prevent a reoccurrence. 

Talk with a manual physical therapist about recommendations to try and prevent the acute pain from happening again.  This can involve education on posture, sport techniques, lifting, etc.  It can also involve learning a specific therapeutic exercise program to improve mobility, improve joint stability and improve strength.

9) Medication?  

If the pain is constant you may benefit from anti-inflammatory medication.  If the pain is keeping you from sleeping you might consider a muscle relaxant.  If the pain is unbearable then you might consider a pain reliever. It is best to discuss this with your physician or pharmacist.