So, let us start with some facts. Apparently, over 80% of people will have back pain at some point in their life. And for most people, it will resolve within at least 12 weeks. This is what we call 'acute' back pain. The other term you might hear for back pain is 'chronic' or 'persistent' back pain. This simply means it has lasted longer than 3 months, and it is not an indicator of the type of back pain you have, or how serious it is.
What do you do when you have back pain?
This is easy to say when you don't have back pain! However, we know the majority of back pain is not serious, and does resolve. If you have an onset of back pain, it is highly likely it is not going to be serious. The times we would be worried about back pain would be when you experience a combination of the symptoms mentioned here:
Severe low back pain
Motor weakness, sensory loss, or pain in one, or more commonly both legs
Saddle anesthesia (unable to feel anything in the body areas that sit on a saddle)
Recent onset of bladder dysfunction (such as urinary retention or incontinence)
Recent onset of bowel incontinence
Sensory abnormalities in the bladder or rectum
Recent onset of sexual dysfunction
A loss of reflexes in the extremities
Other things that mean you may need a medical assessment can also include:
Recent violent injury to the back
Recent back surgery
A history of cancer
Recent severe infection
2. Take pain relief
So, assuming you don't have any of the symptoms mentioned above, we can count on the pain being something that isn't going to need urgent medical attention. That means that the sooner we get the pain to calm down, the better. And what better way to do that than use pain relief?
Now I often see people in my clinic who do not like taking pain relief. This is completely understandable, I do not like taking medications un-necessarily either. However, in this case, I would say it is necessary if you are struggling to do daily tasks such as put your socks on!
If we think of it in this way: the sooner you can settle the pain down, the sooner it is likely to go away.
3. Try to keep moving
This is where the pain relief will help. It is important to keep moving a little even with pain. This is in order to prevent things stiffening up even more, and causing you more pain from where your muscles and joints have tightened up.
It is a good idea to keep doing a bit of walking, and try some gentle stretches to ease the pain and keep moving.
If you can still do your activities such as running without much pain, then there is no need to stop. You may need to reduce the intensity / distance / speed to make sure you are comfortable, but there is no need to stop completely unless it is making you a lot worse.
Nobody should ever stay on complete bed rest with back pain, unless you have had a recent trauma.
4. Be realistic
As mentioned at the beginning, 'acute' back pain can sometimes take 12 weeks to settle completely, but will get better gradually within this time. We expect most cases of back pain to start improving withing the 4-6 week period, but occasionally can last longer. It is important to remember that these timescales are normal, and that not all pain goes away within a week or two. If it does, then great!
5. Don't rely on passive therapies
Sure, massage, acupuncture and the likes can be helpful when you are in severe pain, however these therapies do not 'fix' or 'cure' anything. We know now that manipulation of the spine or the joints does not actually put anything back into place. Nothing would have been out of place, unless you had been in a major accident, and if something was out of place, it would be very surprising that you hadn't been completely paralysed!
It is worth remembering this. We now know that therapies like this do not actually break down 'knots' in the tissues, but they simply change the signal going from that painful part of the body to the brain, and in turn, the brain outputs a different response. A bit complicated really.
All I am saying, is that it is ok to have some of these treatments sometimes, as long as you understand the reasoning behind them. They are simply something to reduce the pain, like pain relief, but do not fix the underlying issue, if there is one. And a lot of the time, the pain would have gone away by itself anyway!
What are your thoughts? Have you been told different or conflicting things by healthcare professionals?
If you are not sure, please discuss with a healthcare professional that you trust.
Thank you for reading!