I just hurt my back! Where to start?
Dealing with a New Episode of Low Back Pain
Most of us have been there unfortunately, whether it was one golf swing, bending forwards to pick up the ball out of the hole or simply bending over to put your socks on the feeling of severe twinging in our low back followed by cramping and pain is something you wouldn’t wish on most folks (unless you have a serious grudge that is) .
The feeling of frustration and uncertainty about the big picture is universal and scary: how long might this go on for? Will this ever go away? How much time might I have to take off? How will this affect my job?
For many of those who experience this type of back pain their stories are similar, their frustrations and fears are similar and it leaves many folks in a place of loss. Many folks don’t know where to go for help, what to do and how to start to resolve the problem. This can often lead to increased length of injury, ER visits, excessive use of pain killers, time off from work, unnecessary imaging and extra appointments that are not getting to the root of the problem.
Where to Start when you have this type of pain
Knowing where to start is key in the process of dealing with a new episode of back pain. For those that like to “ride it out” or “wait it out”, there are many of us out there, you should at least be armed with the knowledge of knowing when to get help or when a situation dictates the need for medical attention. If you do not have any of the below mentioned symptoms you should start with seeing your trusted physical therapist as well as work through the steps below.
When you should seek care as soon as possible ( not a comprehensive list)
If you have an onset of back pain that creates or is paired with:
Significant weakness in either or both of your legs
Numbness/ tingling or loss of sensation in your genital area
Uncontrolled movements of your legs
Loss of coordinated movement
Loss of bowel and/or bladder control
Prolonged bladder retention
Trauma - car accident, fall from height, big hit in football game etc
***NOTE: this is not a complete list, if you are unsure about your specific problem please reach out to your trusted healthcare professional.
What steps can you initially take
When you flare up your back there are many things that you can try to help calm things down. One of the first things you can do is find your most comfortable position and work on breathing.
Work on breathing - Find the most comfortable position for you: it could be standing, laying on a specific side, sitting on your favorite chair, it may be laying on your stomach, or laying on you back with your knees bent. Find that comfortable position and work on belly breathing ( diaphragmatic breathing). This will help to calm down your entire system and can lead to pain reduction and less muscle spasm.
To belly breathe: you will inhale through your nose and allow your belly to rise, and exhale through your mouth and allow your belly to fall, your ribcage should move too, but not a large amount!
Inhale through the nose for a count of 2, hold for a count of 4-5 and exhale for a count of 7-8.
2) Find movements that do not cause pain
You are probably thinking DUHH! Do I really need you to tell me this!? The great thing about our body is that if we are able to find movements that are comfortable and pain free and we move into them we can often reduce the pain of other movements!
For example: if your pain is worse with bending forward, attempt to move backwards in standing or in a press up position off the floor. Does this help ? By moving a handful of times you will have a good idea whether moving in a certain direction may help you. If it does help, simply by moving several times in that direction over the course of the day can really help. This applies to other movements such as bending to one side that may cause pain.
3) Find Exercises that you can do that are relatively comfortable
Whether its going out and walking 10-30 minutes, or performing exercises like the bird dog or hook-lying heel tap, attempt to get moving. This can work to activate and use some of your hip and core muscles that support your back. At the end of the day movement is medicine! Find things that you can do even if they are small.
4) Don’t be afraid to get help
One of the quickest ways to bounce back from low back pain is to seek care early on. Physical Therapists are specialized in treating low back pain and injuries and will be great at giving you education regarding your condition, some treatments that will help alleviate pain as well as information as to why perhaps you are in pain to start with. By getting seen earlier you can take control of your pain earlier and get back to things you like to do faster!!
5) Take an anti-inflammatory if your stomach and health will allow
Everyone’s individual circumstances are different and if you are unsure whether taking an Advil or Aleve is right for you check with your primary care physician or pharmacist. If you have given steps 1-4 a try already and your primary care gives you the thumbs up taking an NSAID may help take some of the edge off for you.
6) Know that your back is strong and resilient!
This is just as important if not more important than any piece of advice I can give you. Almost all low back injuries get better and most more quickly. Know that your back is not a flimsy noodle wiggling everywhere or something that is out of place but a very robust piece of machinery supported by your discs, many ligaments, the joints themselves, and a large group of lots of muscles! Often severe pain and spasm doesn’t mean severe injury, it more often means warning or caution!
REMEMBER!
There are many things you can do for self help and treatment I hope that many of these tips above provide some relief, but please remember there is nothing that beats seeing your trusted health care professional to help guide and support you!
Thanks for reading!
As always here’s to better health and better golf,
Dr. James Ashcroft DPT, OCS, CSCS