TREATING LOW BACK PAIN
Lower-back pain is so common in our population that according to leading researcher, Professor Buchbinder, "we should treat it like the common cold," it’s VERY common. In contrast to the common cold, rest is not recommended for low back pain, getting up and moving is. One of the best things for low back pain is walking, sitting can be painful as it places more stress on your back than standing.
Below is a detailed general recovery treatment plan for an acute episode of low back pain:
Minimising Pain: Day 1 & 2- The first few days of injuring your back can be debilitating and painful. For many, just getting in and out of bed can be an arduous task. In the first 1-2 days, minimal movement and avoiding activities that aggravate your back is wise. You may choose to take some anti-inflammatory medication (see your doctor for advice). Heat (heat pack) is often appropriate and helpful in easing back pain.
Increasing Range of Movement and blood flow to the area: Day 3- After 48 hours it's a good idea to book an appointment with your therapist. They will assist in gaining back some range of movement and helping to relax any muscle tension around the area. They will also be able to provide a thorough assessment. Remember - scans and imaging are NOT often required for low back pain. Now is a good time to start some gentle movement including short, flat walks.
Getting back into your normal routine: From Day 3 onwards- You may not feel comfortable doing this for a week or so but one of the most important things I recommend those with back pain do is move! Evidence shows it is important to gradually get moving again and partake in your normal day-to-day activities, including lifting, twisting and bending, all of which help to strengthen and regain movement in the back. Avoiding doing such movements will mean a slower recovery.
Chronic Low Back Pain
Pain that lingers longer than 3 months is generally considered to be chronic. This needs to be treated differently to an acute episode. Movement is vital with chronic back pain, being immobile is often the worst thing you can do. Walking is highly recommended for relief, avoid sitting for long periods (car and plane travel). If you are required to sit take numerous micro-breaks. Heat is excellent for chronic back pain as the muscles are nearly always involved at this stage and heat will increase blood flow to the area.
The next time you encounter low back pain, rather than booking an appointment with your GP, give it a few days of gentle movement and walking. If you are experiencing pins and needles or referral pain down your leg, or if your symptoms do not improve, it’s wise to see your therapist. They are the most skilled in assessing your symptoms, if there are any ‘red flags’ they will refer you to a medical practitioner but in most cases of low back pain, exercise, education and at times manual therapy will be the key to getting you back to your normal self.
When to see the doctor
Very rarely, there can be a more sinister cause of Low Back Pain. If you experience any of the following, it is best to consult your doctor.
Cauda Equina syndrome: Recent problems with bladder or bowel function, often accompanied with severe low back pain, numbness, weakness and/or loss of strength in the legs. This could be a rare but serious condition called Cauda Equina syndrome which requires immediate medical attention.
Spinal Tumour: Back pain that does not abate with a change of position, or activity. Pain that is worse at night or morning and does not settle with rest. A general feeling of being unwell, loss of appetite, weight loss, nausea, vomiting. Pain that is severe with direct manipulation or compression of the area.
Direct Trauma: If you have been in a recent accident or had direct force applied to the spine (tackle, fall etc).