I'm not a patient person. I hate reading long articles that take minutes of scrolling just to get to the point. So I hope to make this as short and informative as I can! But please reach out if you have more specific questions.
The Pinch and Twist: Understanding the cause of pain when you throw your back out
If you've ever thrown your back out, you know how much it hurts! Sharp, stabbing pain with every movement and breath. I've done it myself...picking up a lamp shade of all things. It sucks to say the least. But here's the surprising thing. Despite how severe the pain is, nothing is broken, out of place or damaged! There have been a ton of MRI studies confirming this. The cause of such sharp pain are joints (facet joints) in your back that pinch together instead of sliding smoothly like they're supposed to. They pinch on nerve endings, you get sharp pain, then your muscles spasm and BAM!...you can't move at all. So if this is you, fear not...here's what to do!
Bed Rest is the Plague!
I know such severe pain makes you feel like never moving at all, but please...AVOID BED REST AT ALL COSTS!! Yes, it's OK (and necessary) to rest when your back hurts. But the current recommendation is "Active Rest". This means get up and move as often as you can, even if it's for a very short time. Remember, nothing is damaged...even though it feels like it is. So it's OK to get up (even though it hurts to do so), pace the halls for a bit or whatever you can do. Then go ahead and rest again. But the key point is that the more you move, the faster you will recover...even if it seems counter-intuitive!
Climate Control for Your Back
Ice or heat? The age old question. The usual recommendation is ice for the first 48 hours to calm down any inflammation, then switch to head to decrease the muscle spasm. But for the acute back pain episode, honestly both can be effective early-on. Try them both and use whichever one helps the most...simple as that. 15 minutes, as often as you can. And yes, you can alternate...just make sure you let your skin get back to room temp before switching to the other one!
The Art of Back Support
When you've thrown your back out. You know that getting up from a chair is nothing short of a miracle when you do it! It fu*!ing hurts! So when you are sitting, keep a small pillow or support behind your low back. Just enough to keep you up straight. Do this in the car, at work, at dinner, watching TV...any time you can and it will make those transitions easier. Watch here for a more detailed review of how to get out of a chair with back pain!
What exercises can you do with severe back pain??
Embrace gentle mobility exercises. Picture yourself as a tree swaying in a gentle breeze – not too much, just enough to remind your back that it can still move without sounding the alarms. Because remember, nothing is structurally damaged. Slowly and gently is the name of the game. The 2 best things to do are pelvic tilts and lower trunk rotations. These can be done side-lying (often the easiest position to get into), lying on your back, or even sitting! Watch here for a demonstration of these!
Take home message:
I know it sucks. But hang in there. The pain is terrible, you fear the worst...I totally understand! But I've seen this almost daily in the clinic and experienced it myself. It will get better! Stay moving and follow these guidelines. Check out some other videos below for even more specific advice:
Let me know how the journey goes for you!
-Rob Drenning, PT
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