The #1 cause of disability worldwide is low back pain. This problem directly costs the $99 Billion annually, and indirectly $560-$635 Billion when accounting for lost work and wages1. While back pain may feel debilitating, it doesn’t have to be a life sentence. Most sources of low back pain are mechanical – meaning it originates due to some sort of movement problem. The three causes of injury are too much motion, not enough motion, or improper motion.
Spinal injuries must always warrant immediate attention. The body has an elaborate set of defenses that are hardwired to notify us when something is wrong. Ignoring a signal is like neglecting the wailing fire alarm and smoke coming from the kitchen. Whether you are working out at the gym or cleaning up around the house, an acute onset of spinal pain must be addressed.
While a majority of back pain conditions are benign, some severe conditions may present as back pain but require immediate medical attention. If you are currently experiencing any of the following symptoms in conjunction with low back pain, consult with a health professional IMMEDIATELY:
- History of cancer
- Recent fall or accident
- Rapid weight loss
- Signs of infection (fever, chills, sweating)
- Neurologic symptoms (numbness, tingling, muscle weakness, shooting pain)
- Loss of bowel or bladder control
Heat or Ice
One of the best interventions for sudden and immediate pain is ice. The most effective time window is typically within the first 24-72 hours. Ice is a natural analgesic (pain reliever). It also causes your blood vessels to constrict, in turn reducing the amount of swelling and inflammation in the area.
Never apply ice directly to the skin! Ensure there is a layer of protection, such as a towel, between your skin and the cold source to reduce the risk of skin damage. Apply ice for 15 minutes at a time, allowing at least 20-minutes in between cycles.
If you are beyond the 72-hour window, heat may be another option for relief. Heat functions to warm up muscles and reduce muscle tension. The unfortunate caveat is that heat may also cause blood vessel dilation, promoting more inflammation (and, in turn, more pain) to the injured site. Without a professional diagnosis of the type of injury, it is always safer to error with ice overheat. If you do decide to go with heat, apply for 15-minutes at a time, and follow this up with a 15-minute cycle of ice.
Many years ago, bed rest was the prescription for back pain. The logic was simple: if moving hurts, then don’t move. However, as learned more and more about the neurology of the body and its need for motion, we learned that bed rest not only doesn’t help the back but may make it worse.
Light activities such as walking, swimming, or yoga can help get motion in the body without overdoing it. Avoid more vigorous activities like running or weight training. These are more likely to aggravate your condition.
During any sort of activity, it is always essential to monitor pain levels while you are doing any of these activities. Do not do anything that is going to create more pain. The old phrase of ‘No pain, no gain,’ need not apply to back pain.
We spend almost a third of our day in bed. Could your sleeping positioning be aggravating things? The ideal sleeping position for back pain is typically either on your back or your side.
If back sleeping is more comfortable, we always advise placing a pillow beneath the knees. This pillow placement allows the legs to rest appropriately while taking tension off of the hamstring. Tight hamstrings will pull on the base of the pelvis, which in turn creates stress and pressure across the low back.
If side sleeping is your preferred method of sleeping, we recommend placing a pillow in between the knees. The pad not only prevents the knees from rubbing against each other through the night but also keeps the pelvis in a neutral position without creating excessive torsion or rotation in the low back.
Stomach sleeping is never a recommended position for both symptomatic and asymptomatic individuals. First off, both “side” and “back” sleeping allows spinal support by the mattress. Stomach sleeping doesn’t provide this support, and the spine presses forward instead. A second problem arises from the neck position that accompanies stomach sleeping. Unless you are face down, smothering yourself in the pillow for 8-hours at a time, you’ll likely have your neck maximally rotated to either your left or light. This extended end-range puts stress on the joints and soft tissue in the neck, increasing the likelihood of developing neck injuries down the road.
Consider your Workplace
Another third of the day is spent sitting at work. Poor posture or small, repetitive movements may be another source of injury. The following is a list of ergonomic recommendations for desk-bound individuals to minimize the stresses placed on the body in the workplace.
- The top of the computer monitor should be at about eye level. Monitor positioning avoids any undue strain on the muscles of the neck, looking downward at the screen.
- Ensure key objects are within arms-length. Do you use the stapler or hole-punch throughout the day? Keep it close enough, so you are not repetitively leaning and twisting the back to reach.
- Chair positioning is crucial. We recommend The 90 Rule. This rule means each joint in your lower body makes a 90-degree angle.
- Torso and chest are tall and open
- Hips flexed at 90 degrees
- Knees at the same height as the hips
- Feet are directly under the knees and flat on the ground
- Keep a normal arch in the low back. If your desk chair doesn’t have the support for this, you may use a rolled-up towel or lumbar support in the small of your low back to help maintain this arch.
Limit the Brace
Manual pressure can often override pain. This physiological phenomenon is evident for anyone who has ever stubbed their knee. Our natural response is rubbing the injured site. This pressure on the knee joint neurologically reduces the amount of pain perceived by the brain.
Braces work similarly while providing additional support to the spine. However, we recommend to only wear the brace during strenuous activities that places significant stress on the back. The added support can help get you through a strenuous activity, but constant long-term use will cause the muscles underneath the brace to decondition. This deconditioning leads to muscle weakness and will eventually cause more back injuries.
Consult with a Professional
All of the above advice is general tips that may help with an acute bout of low back pain. Without a proper diagnosis from a licensed health care professional, it is difficult to determine the exact source of injury, severity of injury, and daily habits that may be slowing the healing process.
Chiropractors are trained in dealing with injuries arising from the neuro-musculoskeletal system (nerve/muscle/bone). Our office begins with a thorough health history going over the condition(s). We follow this up with a complete orthopedic and chiropractic examination of the body. These exams consist of specific tests to rule in/out conditions as well as determine the overall mobility and health of the spine. We may also take x-rays of the spine (if medically necessary) to further aid in a diagnosis.
Chiropractic treatment for back pain is research-backed as one of the safest, effective, and cost-efficient treatment strategies for the management of low back pain. We work to get patients out of pain as fast as possible so they can get back to the things they love.
At Life in Motion Chiropractic, we build short, customized, and concise treatment plans that target the underlying CAUSE of your pain, rather than just treating the symptoms. We may combine any of the following therapies to help patients find relief from their back pain:
- Light chiropractic adjustments
- Muscle and soft tissue work
- Corrective rehabilitative exercises
- Take-home stretches
- Massage therapy
- Intersegmental traction
- Ergonomic modifications and recommendations
Our goal is not just to give you a temporary cover-up but to find the root cause of your injury and fix it. We know your time is important. This is why we offer same day and Saturday appointments.
If you’re interested in learning more about chiropractic, please contact us today to schedule a FREE consultation with our chiropractor. Our consultations are a one-on-one discussion with the doctor on your particular condition to determine if you are a candidate for care in our office.
The following exercises may provide relief from many types of mechanical back pain. A famous physical therapist essentially said this: find a movement that offers relief and keep doing it. If you experience worsening symptoms with any of the following exercises, DO NOT PUSH THROUGH THE PAIN. Stop the activity immediately and contact a licensed healthcare professional for further evaluation of your condition.
Knee-to-Chest stretch: While lying on your back, draw one knee to the chest. Use your hands to pull that knee closer to the chest, focusing on the stretch that you should be feeling in the lower back. Hold this position for 3-5 seconds. Repeat with the other leg.
Press-up exercise: While lying face down on your stomach, put your hands flat on the ground under your chest in a push-up position. Begin to press your torso upward up while keeping the pelvis and lower body flat on the ground. This exercise resembles the ‘Cobra’ position in yoga; however, you don’t want to force yourself with as much spinal extension as the cobra position. Hold the upward position for a second, then slowly lower yourself flat. Repeat this exercise 10 times.
Supine Cross-body Piriformis stretch: Begin in a face-up position on your back. Draw a knee up toward your chest, and then pull that knee across the body. Keep the rest of the body flat on the ground while pushing the knee towards the floor. You should feel a stretch along the glutes. Hold this position for 5 seconds before returning to neutral. Perform with the opposite leg.