Help! My Back Hurts!

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    Having back pain can be a scary situation. While not all cases are debilitating, often symptoms are severe enough to stop your daily activities or even leave you calling in sick from work. Luckily less than 1% of cases seen in a doctors office involve any serious damage, injury, or serious medical pathology. This is not to say that the pain may not be very severe! Think of most new low back pain as being similar to a stubbed toe or the common cold.

Like a stubbed toe, the pain is initially debilitating, so much so that you can’t put weight on that toe! But after a few wiggles and moving it around a bit, you realize that it is not broken and all will be back to normal in a few days at worst. If you limp for a few days, maybe your hip starts to hurt a bit, or maybe not putting weight on your toe stops you from realizing that it is getting better! Low back pain is very similar in nature to a stubbed toe. About 80% of cases are resolved in 6-8 weeks and some early treatment and exercise can help to speed that process. Also, by changing the way you go through your daily life, other issues may arise that complicate the current situation.

Like the common cold, low back pain is experienced by almost all individuals. In fact, between 26% and 80% of people may report back pain in a given day! Like the common cold, we do not have a solid explanation for why each case started in the first place. Maybe there is a mechanical answer such as lifting something heavy or twisting in a way that is unfamiliar, but most cases have no one event that can be labeled as the cause. Like a cold, the cause is usually somewhere between a few factors including, but not limited to: a lack of sleep, a lack of hydration, decreased strength, stiffness, decreased endurance for a specific task, depression, anxiety, or stress.  

While all this information is great to know, I assume your primary concern is how to get back to your normal life.  Luckily, there a few things that you can do to help yourself out. Below is a list of tips for a recent onset of low back pain. If you are someone that has experienced low back pain or has recurrent low back pain, these tips are most likely applicable for you as well.

  1. Try to maintain your regular life to the best of your abilities. That does not mean to force yourself to do the most painful activity, but it does mean to avoid forced bed rest. If there a specific activity that you cannot perform, make sure to get to a physical therapist as soon as possible to help you regain the ability to do what you need to do. The timeline is most often more speedy when treatment is initiated early, even in the most severe cases.

  2. If your pain started due to a traumatic injury such as a car accident, a fall, or some type of impact, consider immediate medical attention and ask if imaging such as an x-ray is appropriate for you.  If these are not the case, an x-ray or MRI is most likely unnecessary. Most low back pain is not due to a specific anatomical change and imaging rarely impacts your treatment. Make sure to talk to a physical therapist first who is more than qualified to let you know if you need to see a physician prior to beginning care.

  3. Exercise can help! This does not mean to perform your maximum deadlift, but some cardio even as simple as a recumbent bike can be helpful. Elevating your heart rate can unlock your body’s internal medicine cabinet full of endorphins and help out with pain!

  4. Spinal mobilization and manipulation can help! Studies show that patient’s can greatly benefit from spinal mobilization or manipulation when symptoms have been present for <16 days. That does not mean that it will not be beneficial at 17, or even 21 days, but it tells us that starting treatment early is a great option

  5. It might be your abdominal strength, it might not be. Low back pain typically has a few factors playing into the condition. I use abdominal strength as an example because it is common for patient’s to ask us if this is the most important factor for recovery. It is important to seek medical advice to find out what is most applicable to your case. It may be related to a specific strength issue, or may be just improving your tolerance to a specific activity. Each case is different! Make sure to get an individualized examination.

  6. Heat, Ice, Pain meds, massage, spine manipulations, spine mobilization, TENS, E-stim and adjustments may help your symptoms, but know that passive treatments that do not involve you as the active participant are not a good long term solution. One of the most important pieces of low back rehabilitation is actively involving you, the patient. Whether this is in slowly increasing activity to specific exercises to suit your needs, make sure your treatment involves YOU actively doing something!

Hopefully these tips are good knowledge to have in the brain bank or even help you with a current injury. Give us call if you have any questions. Even if you do not think PT is appropriate for you currently, we are here as a great source of information.

Paul Coviello PT, DPT

American Physical Therapy Association. (2011). Current concepts of orthopaedic physical therapy. LaCrosse, Wis: Orthopaedic Section, APTA.

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