July: Low Back Pain

I often hear from patients that they just don’t know what to do when an acute onset of low back pain strikes. Most will stay in bed initially or run to the ER for fear that movement will injure something permanently. Remember, pain is an indication of tissue damage and we want to reduce stress on these tissues to allow healing. So I want to give you some easy guidelines to use which should shorten the early period of intense pain:

  1. Find a position of comfort. Sounds obvious, but sometimes we over think the obvious!
  2. Apply ice 10-20 min at a time and give it an hour between applications.
  3. Take an anti-inflammatory medication (approved by your physician).
  4. Follow the Progressive Upright Posture Principle (see below).
  5. Avoid aggravating activities.

What is the Progressive Upright Principle?

Start Non weight bearing to help damaged tissues to heal without stress (basically, lie down in a position that stops the pain).

Common postures that decrease strain to back are side lying with 2 pillows between thighs, or lying on your back with legs over an ottoman or pillows. Then apply a controlled increase of appropriate stress to tissues which will actually speed up healing. For example, after lying down comfortably on ice for an hour, stand up and slowly walk around until pain returns than resume a lying down or sitting posture of comfort./p>

This principle takes listening to your body and reacting, not continuing an activity or chore until the pain is unbearable. Usually with 24-48 hours of repeated rest and upright movement, the symptoms dissipate and become stable.

After the acute stage of symptoms, if experiencing a daily pain when first waking or after heavy labor and it seems to be more of a stiffness than an inflammatory process, then it is alright to begin using heat.

Now, it’s time to come and see a PT for evaluation to find out what is causing the pain. Usually, low back pain (as in all joints of the body) is generated from a movement dysfunction. However, if symptoms include leg pain and/or leg weakness, it is best to seek the opinion of a spine specialist MD first.