Oh dear,
It’s that horrible feeling – “Oh no – my back’s gone”.
Always at the worst time when you have so much to do!
Don’t worry, there are a series of simple steps you can take to minimise the chances of acute back pain or strain turning into days off work and stopping you from living your life.
The most important thing is to implement these steps as soon as possible.
*Disclaimer – do not proceed with this if you have any sign of the following.
Neurological symptoms like leg weakness or numbness.
Loss of bowel or bladder control related to the episode, you must go to your doctor or hospital emergency immediately for treatment. Those things could be a sign of a serious problem that requires medical attention.
Do A Self Assessment
Step 1. First – don’t panic. Do a quick self-assessment.
Stand up straight if you can, and breathe.
Notice where the pain is. Is it in the middle, or on one side of your back, is it in your leg?
If any of these steps make your pain *worse*, including it peripheralising spreading down your leg or making it harder to move go straight to step 7.
Step 2. Find a place where you can lay down on your tummy. If you can’t get onto the floor your bed is fine. I have clients that have done this in truck stops (a great reason to keep a beach towel in your car), in their office, many random places!
Step 3. Lay on your tummy with your head turned and arms near your sides. Relax. Try to breathe naturally and let the muscles in your back and hips relax.
Notice what happens to the pain. Does it move to the centre?
Does it ease off and disappear? These are both signs to proceed to step 4.
Step 4
With your hands in front of you, gently draw your elbows underneath your shoulders, propping on them, so that your chest is off of the floor. Lift your head and chest and let your lower back and hips relax. Hold this position for a moment while you breathe out, and then relax back down to flat.
If the pain is better or not worse-performing this movement several times you can safely move to step 5.
Step 5. Press-ups (back extension) is one of the main exercises to treat back pain.
As you did for the previous two, begin by laying flat on your stomach with your elbows bent and your hands flat on the ground under your shoulders.
Keep your back and hips relaxed, and then use your arms to press your upper back and shoulders up (similar to the upward dog yoga pose).
Hold the press-up position for two seconds. Then slowly return to the starting position.
Repeat the exercise for 10 repetitions.
5. Monitor for signs of centralisation. If your symptoms are moving toward the center of your spine, that’s a great sign the press-up exercise will help resolve your symptoms.
Step 6. If your symptoms don’t change or get worse as you press up, you may need to try the ‘prone press up with hips off-centre’.
Lie on your stomach and slide your hips to one side and your feet to the opposite side (usually, your hips should slide away from your painful side).
When your hips are offset to one side, perform the press-up exercise. It may feel awkward at first, but just continue to monitor your symptoms as you press up as far as you can.
A Lumbar Roll
Remember – you are looking for the pain to reduce, centralise, or disappear as a result of repeating the exercise.
If these exercises help, you can repeat them often – ideally every 2 hours until the symptoms are resolved.
Step 7. If your pain is *not* better – i.e. reduced or centralised, if it is not improving, resolving or if it is worse as a result of trying these exercises you will need help so make sure you make an appointment with your Physiotherapist for assistance.
What else?
Also VITAL is that along with these exercises the key to helping a back strain recover quickly is to not continue stressing the tissues that are damaged.
The “cut finger analogy”
If we have a cut finger it’s pretty clear that the thing to do to let it heal quickly is to quell the bleeding and put a band-aid on, to keep it in such a position that the cut is not being stretched open – we keep the finger straight for a while to allow the cut to heal. This can take a few days to weeks depending on how deep it was.
Treat Your Own Back by Robin McKenzie
Once the cut has stuck back together and the soft tissues have reconnected we can start moving it safely. But if we over stress it too early it will tear again and bleed.
It is no different for your back injury. For your back to heal, the structures need to stick together in the same way as the cut finger. Depending on the severity of the strain this can take from 3 -21 days (up to 6 weeks for a severe injury)
During this time try to limit sitting to only when necessary, maintain your lumbar lordosis at all times (the arch that is there when you stand tall) even while sitting. A lumbar roll can be useful for this.
Avoid soft low couches, long car trips, things that stress your back like heavy lifting, vacuuming and bending.
If you follow these steps and the pain goes away, congratulations!.
You have made the first steps into self management – its an empowering place where we can relearn autonomy over our bodies, by listening and responding to their needs, instead of reaching for pharmaceuticals, or relying on someone else to fix us every time.
“Treat your Own Back” by New Zealand Manipulative Physiotherapist Robin McKenzie is a very excellent book we can recommend if you want to learn more about self treatment for low back pain.
Your local Physiotherapist can help with treatment, exercise prescription and coach you in self-management practices.
Treat Your Own Back – Robin McKenzie
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