Over the last 15 years Severe Low Back Pain is probably one of the most common things I see at my office. The following tips are what I send my patients home with to help them through the first few tough days.
Avoid sitting as much as possible.
Either stand or lie down. If you can, lie on your side with a pillow between your legs (One side may be a lot better than the other). If this doesn’t work then lie flat on your back, hips at 90 degrees, and knees at 90 degrees, calves resting on a chair (if you are on floor) or several couch pillows (if you are in bed). If you absolutely have to sit make the seat as high as possible. A bar stool with a cushion on top will be far more comfortable than low soft couch. Reason for tip: Seated position puts a reverse curve in the lumbar spine which puts more pressure on the back end of the discs causing more inflammation.
Cryotherapy (Cold therapy).
Icing 20 minutes on and 40 minutes off, continuously. There is a reason why the worlds richest pro athletes use ice all the time for their injuries … it works better than anything else at reducing inflammation and pain. In the early stages of your injury do not use heat because it will keep the area swollen, instead focus on cold. Since it is easy to lose track of time, a good rule of thumb is once your skin feels about as cold as the ice, then it has been about 20 minutes and is time to remove the cold. Once that same tissue feels about the same as tissue on the opposite side of the body then you have warmed backup enough to reapply the cold. Make sure you put a thin cloth between the cold source and your skin. If you can swing by the office we carry some “old school” ice bags that you can put directly on the skin, don’t leak at all, and you can’t burn yourself because the ice bags stay at 34 to 40 degrees. Unfortunately, the convenient cold packs have additives in the solution that allow them to be colder than ice and are likely to burn you if you leave them on too long. Reason for tip: In a severe injury the body is flooding the area with fluids filled with chemicals that will help heal the injury. Unfortunately so much fluid is packing into the area that it becomes swollen and the circulatory system goes into a gridlock situation where nothing gets in and nothing gets out. By applying cold therapy it causes the blood vessels to constrict and squeeze excess fluid out of the area including waste products that are generated by the injury. When you take the cold off and the tissue begins to warm up again the body now can flood the area with chemicals that will help facilitate the healing process. Performing the cold therapy repeatedly helps to pump the waste products out of the area and the healing products in.
Strap it on as tight as you can. A back brace can make your suffering a little easier. At the very least it may allow you to move around with less pain. You should only wear it when in severe pain and if you have to, wear it in bed to help you sleep. Once you can go without it discontinue use immediately as you will heal faster if the joints in your low back are unrestricted and able to move more normally. You can pick these braces up at my office as well as most grocery or drug stores. Generally the more you pay the better the brace will be at locking down your lumbar spine. Reason for tip: If the nerves in your low back are aggravated they will be sending your back muscles into a severe spasm. The muscles in your low back go into a spasm and tightly contract to create your body’s own “back brace”. After 12 hours of constant, unrelenting spasm, the back muscles that are protecting the injury sometimes begin to hurt more than the low back joints that are the cause of the original pain. If the brace can keep the back from wobbling around it will allow the back muscles to relax just a bit, and make your life a little more bearable.
Stretching and Motion.
As soon as you can tolerate it you need to get the low back moving. Short 10 minute walks each hour are a good start. If you have access to a pool then walking back in forth in the pool chest deep works great and I highly recommend it. Cat/cow yoga stretch and pelvic clock are pelvic/low back stretches which I will demonstrate in a later post that help get fluids moving in and out of the injured area.
Drugs, lotions and potions.
If you hurt too bad to go to work without using drugs, then you shouldn’t go to work. There are many topical analgesics that you can rub into the skin that can ease your symptoms a bit, “Bio-freeze” is a good one. If you choose to ingest over the counter medications to cover up your pain please be very careful. If your body is injured and the pain killer works well enough to allow you to go back out into your yard to finish shoveling the last ton of gravel, you may be ignoring the last warning before you do severe damage.
In conclusion, there are many different causes of low back pain and the level of your pain is not an accurate indicator of how severe the problem may be. A competent health care professional should be able to help you decide what needs to be done, or whom you need to seek for assistance. There are a few symptoms related to low back pain for which I would recommend you go straight to the emergency room and that would be loss of bowel and bladder control and loss of use of the thigh, leg or foot.