The importance of moving after an episode of low back pain is gaining more and more attention. However, I still see people come into the clinic that have spent the last 2 days in bed following an acute episode of back pain. By not moving you are only prolonging your recovery time. This is because, in the majority (90%) of acute low back pain episode the pain is non-specific, meaning there is no specific structure or cause of the pain. It is instead due to an aggravation of soft tissue which has resulted in muscle spasm, inflammation and secondary abnormal movement patterns. By not moving the muscles become weaker and less flexible and your movement because extremely limited due to pain and weakness.
It is understandable that during the early stages of acute back pain you will need to rest more than normal which will require, MORE bed rest not COMPLETE bed rest. This needs to be kept to a minimal and only for the first day or two. Walking is by far the best exercise you can do during the early stages of acute back pain
Inadequate pain relief
It is extremely important in the presence of acute back pain you are able to manage the pain as best you can. I often hear from patients that they do not want to take pain relief because they don’t want to mask the pain. THIS IS RIDICULOUS! This implies that they are fearful of “damaging” their back because they cannot feel the pain to tell them to stop. Again, majority of acute low back pain is non-specific, therefore, HURT DOESN’T EQUAL HARM and the pain you are getting is not because you are “damaging” your back. By not managing the pain you will continue to have limited movement due to pain and will prolong the recovery to full function.
When your pain is well managed, you can do more, move more and start reconditioning your muscles and increase the speed of your recovery.
The method of pain relief you use will depend on you and what has been recommended by your GP. Your GP and/or Pharmacist can advise on appropriate pain and anti-inflammatory medication, however, remember the humble ice pack can be a great way to reduce inflammation. On that note, a reminder that in the presence of inflammation and acute pain CHOOSE ICE NOT HEAT.
“Wait and see” approach
This method will inevitably work because as I keep repeating, in the majority of acute low back pain cases the pain is non-specific and will eventually settle and your pain will reduce. So, while this approach may work it is far from the most effective method. WHY? Knowledge is power! When you seek the advice and assessment of an expert you know exactly what is going on and most importantly what is causing your pain and how to reduce it.
If you are not advised and educated on what is going on with your pain how can you manage it and make it go away? You are just stabbing in the dark and with every failed attempt you are getting more and more frustrated thinking “this is never going to get better”.
Another reason why the “wait and see” method is ineffective is, as your pain settles and you feel you are better you are at a greater risk of re-aggravation. This is because, in the presence of acute pain the muscles that provide stability switch off. If these muscles are not reconditioned you do not have the stability in your trunk to prevent re-aggravation of your low back. If you think about it, after an episode of acute pain you move a lot less than normal and, therefore, will not be activating your muscles regularly during this period. This causes a state of deconditioning and weakness around your low back.
For more information on how to best manage acute low back pain or advice on managing other injuries and areas of pain contact our team of experienced Physiotherapist. We are here to help and get you out of pain fast!