I am not a medical expert in anyway, but I have experienced back pain on a off for the last few years. I have learnt a lot through reading different advice and seeing different experts, but mainly through trial and error. What works for me may not work for you, as all back pain is both complex and very individual. However, I felt that it may be helpful to someone, somewhere to share what I have learnt. I hope it helps. We back pain sufferers must help each other – there is nothing quite like it and all my sympathy goes out to anyone who has to deal with it.
Oh the pain!
There are 2 types of pain in my experience. The first is the acute, short term, spasm type pain, which happens immediately after you have aggravated/injured the muscles/discs/nerves and it is short term. It is scary and you may not be able to move. The muscles are in ‘coping’ mode and want to limit your movement.
The second is the pain that may be more long term and although more dull, achey and less acute, can also be very dilapidating as you might find that there are some things you just cannot do, like sitting for any amount of time, sleeping, standing, etc and it may affect your everyday life. This kind of pain, if left to it’s own devices, can also cause secondary problems like Sciatic nerve pain, weakening other muscles and over using others.
• Stress makes it worse – try to relax!
• You can overcome the pain – even if it will be a problem you suffer with for the rest of your life, you will be able to find a way to live with it.
• Just ride out the flare-ups/spasms – let them pass and realise that these are short term.
• Don’t panic!
• Don’t fixate on diagnosing your problem. Backs are notoriously hard to diagnose and generally the prognosis are the same – a mixture of exercise, pain management and lifestyle changes.
• Don’t read too much on the internet and don’t believe that anything will actually ‘CURE’ your pain. Not even the best doctors or surgeons can completely 100% cure back pain.
• The best advice I was given was to exercise.
• The recent advice is only to stay in bed/lying down for as short a period as possible.
• During the muscle spasm stage, you may be unable to move, but you should try to move a little more every day. The bed rest should really only last 2-3 days.
• When the worst of the acute pain is over, you should SLOWLY introduce some simple stretches and strengthening exercises – these could be prescribed by a physiotherapist or simple pilates/yoga movements.
• Build up a daily routine slowly and if you do something to aggravate the problem, take note of the exercise that caused it and rest for a day or two. Re-start your exercises slowly again.
• You should do a mixture of strengthening and stretching.
• Generally stretch and strengthen the back muscles, hips, shoulders, glutes, piriformis, thighs, and abdominal muscles. Realise that your back is supported by all of these muscles working together.
• Find the exercises that YOU find helpful. Take note of how you feel at the end of the day after introducing a new exercise – better or worse? Over some time you will develop your own routine that helps your problem.
• Be persistent. Over 6-8 weeks your body will begin to get used to the exercises and it may take 3 months before you find any real difference in muscle strength.
• Running, swimming, cycling and walking are all repetitive exercises and useful in getting your back muscles loose and strong. However, find the thing that does not seriously aggravate your pain. If you are not a strong swimmer, probably best not to swim. However, if the pain is aggravated only slightly after the exercise, try to work through the pain and use a combination of heat and ice to help the muscles to get used to the exercise. Always start gently and build up slowly.
Pain management/Lifestyle changes
• Ice and heat:
When and how you use these is really a matter of preference. Different experts give different advice. Generally, heat relaxes the muscles, but can also aggravate spasms, so work out what you need at any given time. Ice works on 2 levels – it helps the muscles to contract when they have been overstretched or when they are in spasm, and it also numbs the pain. Ice shouldn’t be put straight onto the skin, and shouldn’t be left for more than 20 minutes maximum.
I use ice after running for 2 minutes to relieve any overstretching and at night to help numb the pain while I fall to sleep.
I use heat in the form of a bath to relax the muscles and ease aches at the end of the day. (I found that having a bath at the end of the day was also the ONLY time in 24 hours when I felt fully relaxed and not in pain. This seems extravagant, but relaxation is so important to your recovery and pain management).
Sleep is so important to your well being and therefore your recovery and management of pain, it is important to do everything you can to help aid a good night’s sleep. These are the things I use to help me sleep:
1. I sleep on my side in the ‘foetal position’ so having a pillow in between my knees and hugging a pillow helps to alleviate pressure and twisting of the hips and back.
2. The best thing I have ever bought is a memory foam topper for our mattress. Some people try these and hate them, but for me it has been priceless. Again in alleviates the pressure on my shoulders and hips and causes my spine to lie flat when sleeping on my side. I wouldn’t recommend it for back sleepers, but if you sleep in your side, give it a try.
3. The right mattress is important. Mostly people believe that a hard mattress is necessary for good back health, but again sometimes this can cause too much pressure on your body. Find the right mattress for you. Generally, I suppose though, an old saggy mattress with no support is probably going to be a bad idea.
1. Make sure you maintain good posture – find a chair that has lumbar support or use a pillow to support the lumbar area. Chairs should be at the right height and generally this is what your posture should look like:
2. I use a kneeler chair which helps me to maintain good posture using the strength of my knees and abdominal muscles. But you still have to remind yourself constantly to sit up straight!
3. Limit sitting time. Sitting is an unnatural thing for us to do as humans! If possible don’t sit for long periods of time. Make sure when you have to work at a desk or travel for any length of time that you take regular breaks to walk around and stretch. If you have the option, walk instead of taking the car, stand on the bus and be the first to offer to make the tea!
1. We have already talked about sitting posture, but when you are walking and standing it also important and a good opportunity to work on your posture and strengthen the correct muscles to help your back. Your daily exercises should also be encouraging good posture, so over time it will improve and help ease your pain.
2. Generally, I like to think of having a piece of string pulling your whole body up towards the sky from the top of your head. Relax your shoulders down the back of your spine, keep your head facing straight ahead and use your eyes to guide you when you are walking. Tuck your tail bone and abdomen in towards your spine and your chest will naturally puff out slightly. It takes some practice but you will know when you have it right.
• Diet and water
There is a huge connection between what you eat and drink and how it helps your body to cope and recover from anything that has gone wrong. For example, eating less sugar can reduce inflammation, drinking plenty of water helps in numerous ways and dehydration can even be a cause of pain, and many people have even successfully beaten back pain by sticking to a very strict diet of fruit and vegetables for a period of time. Maybe now is a time to take stock of what you eat and how much water you drink and see if it makes a difference.
• Lifting, bending and twisting
How you undertake these activities can literally make or break your back! Remember your back is not supposed to do all the work we expect of it at times.
1. Rule number one in these activities is use the other muscles; thighs, abdomen, glutes. Make them share the load!
2. Rule number 2 is to try to keep your back straight at all costs. This will ensure that it is not put under unnecessary strain.
1. Anti-inflammatories like ibruprofen are great for use when you have a muscle spasm and in the first stages of the acute pain. However, they have horrible side effects, like destroying your liver, so it’s best not to use them all the time. Also, they tend to lose effectiveness after the first few days, as your body may not need this kind of drug anymore.
2. Pain killers may be useful in the very acute stages of pain, but remember that they are not a solution, only an aid to help you get through the pain. I found that many didn’t even do the trick, and something like ice was much better.
3. Muscle relaxants may be prescribed by your doctor. Again, don’t rely on these as a cure, but follow the doctor’s advice.
• The most useful person I saw was an osteopath – I can’t recommend them highly enough. They are holistic and will give you advice about your lifestyle, as well as work your muscles and correct any structural problems. Their aim is not to have you locked into a series of treatments for the rest of your life, but to help you back to health in as shorter time as possible. They are expensive, but worth every penny.
• See a physio for exercises and massage of the problem areas.
• Surgery and scans should be a last resort. Often these are quick fixes, and many people who undergo surgery still have flare ups and reoccurring problems. They can cause a false sense of security, meaning that you won’t strengthen the muscles, or take care of your posture in everyday life, causing the same problem to return or get worse. As I said before, usually a diagnosis won’t make that much difference to the prognosis anyway.