Acute back flare-up? 5 Steps to get you out of pain more quickly!
"Damn my back flared up again last night bending over to get my shoes. I had some pain relievers but I'm in agony this morning, can you help?"
Here are two sentences that as a Musculoskeletal Physiotherapist you can hear nearly on a daily basis. They most typically relate to back pain of a Discogenic origin. Between 25-40% of chronic lower back pain can be attributed to disruption of the lumbar spine intervertebral discs with acute flare-ups of the issue generally occurring due to awkward movements, poor carrying/lifting technique or repetitive motions into a forward flexed position.
The factors that lead to chronic low back pain of Discogenic origin must be addressed to attain improved function and long term cessation of symptoms such as unrelenting pain and neural compromise (It is one of the greatest misnomers in health that we must live with lower back pain as we get older...a post for another day). However there are steps that can be done immediately to ensure an acute flare-up of your symptoms doesn't floor you for months. Here are the 5 steps you can take to reduce our pain more quickly.
1) Anti-Inflammatory Medications Can Assist Greatly - Not by masking the pain as most people assume but by reducing the swelling that is caused by disc dysfunction. Inflammation is a normal part of the healing process however just like a bruise on our skin that we keep bumping, our disc will stay swollen if we do not take steps to reduce the pressure on it. NSAID's play a role in allowing you to start performing normal movement patterns again, removing the bodies internal protective mechanisms such as muscle spasm when they are not necessary. So take some as directed as quickly as possible (If you do not have any at home find someone that can retrieve them for you!).
2) Use Personal Support - The reason we get someone else to retrieve the medication for you is that in the first 48-72 hours your normal daily functions (Such as driving) can aggravate your symptoms. Don't be to proud to ask for help from a friend, colleague or loved one as reducing the load you place through the region in the short term will get you back doing the things you love more quickly as the healing process will not be stunted.
3) Contact Your Trusted Health Professional Before Booking An Appointment - Therapy may be an important part of your treatment protocol however it may be more successful once you have taken a day or two to assess the level of symptoms. If you go into the clinic the hour in which you have flared the treatment you receive may not be as effective as it could be. Ring your health professional (or a recommended therapy clinic if you don't have one) and discuss your current symptoms with an expert. They will guide you as to when/if you should visit the clinic for more hands on treatment.
4) Pillows Will Be Your Best Friend - Once someone has flared there are two things I will always suggest they do. Number one is sleep with a pillow between there knees whilst lying on their side. This reduces the amount of unsupported flexion or extension the spine has to perform whilst symptoms are improving and provides an easy leverage point for assistance to come from if necessary. Number two is holding a pillow tightly to their chest if they need to cough or sneeze. Coughing & sneezing increases pressure in the stomach which can severely aggravate lower back pain. By holding a pillow to your stomach you will have an external brace present that can reduce the discomfort you feel.
5) Be Aware Of The Way You Sit & Stand - With discogenic dysfunction aggravated by flexion sitting from standing and visa versa can be two of the hardest movements to perform. They are also the ones that can lead to long term dysfunction if technique isn't improved quickly as you can become reliant on using your hands to perform the motion rather than your legs. If you need to sit make sure you are at a height where your knees are not above your hips (Higher the better), wiggle to the front of the seat when you intend to stand and lean forward at your chest until your bottom starts to lift. By doing this you use your legs to stand and reduce the work your back needs to do, reducing the painful mental patterns that can lead to long term issues.
Even though these 5 steps will get you out of pain more quickly the most important thing to remember is that the reasons behind your pain are individual to you and that it is not normal to feel discomfort in that region. You Do NOT have to live with lower back pain and while relief isn't always smooth or simple your life can be so much better without the constant worry of pain aggravation. Once you are back to your normal state seek the help of a professional that has expertise in treating the issues behind lower back pain.
Low back pain and the reasons behind it are a passion of mine so if you have had issues in the past, presently being affected by pain or just looking to bulletproof your spine connect with me at https://stackhealth.accelerware.com/bookings.cfm?fid=1857&tp=3538 . We can chat about your personal situation and determine the best way of becoming the optimal version of you!
Yours in Wellness :)
Bryce Finck - Stack Health Physiotherapist specialising in physical dysfunction.