Acute Back Pain

Here's the thing, even this episode is probably going to get better soon. Most acute episodes of Lower Back Pain (LBP) get better within 24 hours. If not, 8 out of 10 times, LBP resolves after a month, and 9 out of 10 times within two months. OK, but you hurt now, so what should you do?

During the last 26 years I have observed the following:

- Ice really works. Not blue ice packs, not frozen peas, not one of those cloth ice packs you get at a pharmacy, I am talking about refrigerator ice AND water in a plastic bag placed right onto the back in full contact with your skin. And it takes a half hour to an hour to penetrate to the deep tissues that need to be inhibited. 10 minutes per 1 cm, so think that the deep tissues are about 3 cm deep (if you are fat, add time accordingly!) What ice does is a. combat inflammation and edema, b. inhibit muscle guarding, and c. reduce pain.

- Get out and move. It is really important not to lie around when your back is hurting. You need to stay active. Ice will help, but go for a walk at a pace fast enough to work up a sweat. The reason for this is that inactivity promotes muscle guarding, and like the ice, activity helps keep the muscles from guarding. In the spine, the deep rotators "spy" on the adjacent vertebra up to five levels up and five levels down. Activity keeps your uninvolved muscles uninvolved, "quiet", if that makes sense.

- Rotation is key. In a half seated position (feet on the floor butt on the table, wrap your arms tightly around your chest, and rotate back and forth quite quickly (pain free though) for about 5 minutes every hour. Again, this both inhibits muscle guarding and encourages hydration and nourishment of the deep dense connective tissues. And it usually feels much better.

- 90/90 position for rest. Lie on the floor with your legs bent 90 degrees and the hip and 90 degrees at the knee, and your feet supported against the wall. This position is know to be the position with the least amount of intradiscal pressure compared to others.

- What if I am shifted? Well this is a complication for sure...but your first line of defense is described above.

- When should I see the doctor? If you have pain into your leg below the knee, numbness tingling or weakness, or intractable pain, any or all of these symptoms, go see your doctor.

- Is there an emergency situation? YES - if you lose control of your bladder, go to the ER - that is an emergency situation that is time dependent. Wait too long, and your bladder control will not likely return.

Finally, take a deep breath, use ice, go for walks, rotate, this too shall pass.