Low back pain affects most of us at one point or another during our adult life. For those of you that have suffered with back pain, you will know and understand the pain and disruption that it can cause. In this blog post, we are going to talk through the 4 phases that your pain and symptoms are likely to go through. Keep reading as we discuss strategies that can be used to get you through these phases as quickly and as comfortably as possible.
It is important to note that no two episodes of acute low back pain are the same and that advice following an assessment from a qualified health professional will always supersede generic advice.
However, it is also very useful and re-assuring to understand the typical journey of low back pain to reduce your worry or panic. This is especially important when low back pain first occurs as the pain levels can be very high and concerning. This might result in taking action that is unnecessary such as going for a costly MRI scan or taking medication that has little to no effect on this type of pain.
The lower back pain that we are going to discuss is the type that comes on suddenly – think bending and twisting to pick something up off the floor. This type of pain is commonly located across the lower back with one side being worse than the other. If you experience any pins and needles, numbness or weakness in your legs then you should definitely seek medical attention. But again, for the purpose of this blog we will assume that it is a case of isolated lower back pain.
Phase 1:
Bang! Your back has gone into spasm in reaction to a movement. Probably a movement that you have carried out thousands of time before. But this time, your lower back has reacted and you are struggling to get yourself into an upright position.
The temptation in this situation is to sit or lie down and don’t move. This feels comfortable and safe. It is often the only thing that gives temporary pain relief. But unfortunately, it will also result in additional pain when you move out of sitting into standing. It will also allow the muscles to get set in one position and any subsequent movement is likely to cause lots of pain!
My best advice is to continue moving as often as you can. It is fine to take breaks and sit or lie down but set a timer so that in 10-15 mins you stretch and move. You can also use a heat pack or hot water bottle to try to keep the muscles calm and less reactive.
The pain during this phase can often last between 1-7 days depending on the severity and irritability of your symptoms, but if you can keep moving and stretching then your symptoms and movement have a greater chance of improving.
Some of these exercises might include knee rolls, a cobra stretch and a child’s pose which give an all round approach to movement at the lower back. You can find videos of the exercises on our Facebook page.
Phase 2:
You will still be experiencing some spasm type pain during particular movements, or if you have been stationary for too long. However, there tends to be more of a constant ache through the lower back that is now the predominant feature of your pain. Although less intense than the spasm type pain, it is often nagging and draining as it simply won’t budge.
Often you will be back at work now and so exercises are a little more difficult to carry out. You might have to be creative with desk based exercises or subtle movements that can be carried out when you are on a break or even around other people.
This phase of symptoms can last anywhere between a few days all the way through to 5-6 weeks post injury.
Some of these exercises might include sit to stands, shoulder bridges and pelvic tilts, which give a good mix of flexibility and early loading activity for the lower back region. You can find videos of the exercises on our Facebook page.
Phase 3:
The last 10%. Often the final bit of improvement is the trickiest to obtain. You are working hard at your exercises and keeping up with your physiotherapy management plan, but you still get a small niggling pain during certain tasks or activities. In this case, we have to trust the process. Your neurological system is still calming down the pain response from your initial injury and it isn’t quite ready for you to be pain free just yet. However, we can be re-assured by the exercises that you are carrying out that our lower back is getting stronger and more robust with each day. This phase can often last up to or beyond the 6 weeks post injury timeframe. In other cases, you can be here after a week.
Some of these exercises might include squats, single leg shoulder bridges and deadlifts, which provide more of an emphasis on loading through the legs and trunk region. You can find videos of the exercises on our Facebook page.
Phase 4:
Pain free. Once pain free, everything is great in the world again! You can play your sport, sit at your desk, and play with kids without having to worry about any symptoms. This is a great place to be. Unfortunately, we do know that statistically, you are now more likely to have a future episode of low back pain compared to if you had never had it before. So, what can you do to help prevent any future episodes?
Sadly, there is no good evidence to support one form of exercise over another. However, being active does seem to provide a protective mechanism. So, in simple terms, being active will help and picking a form of exercise that suits you will likely be more beneficial because you are more likely to carry it out with regularity. There is no point in doing Pilates if you hate Pilates!
At The Physio Rooms, we take a pragmatic approach and apply some simple strengthening exercises that are manageable and achievable so that you are building resilience in the muscles surrounding your lower back. We can give you these exercises to do at home, in the gym or you can even attend one of our tailored exercise classes to help keep you motivated. We find that this approach gives our clients great outcomes and promotes self-management in the medium to long term where people are confident carrying out meaningful strengthening exercises for their back without the fear and apprehension that they are doing something wrong.
If you find you are struggling managing these steps by yourself book an appointment with us!
