Getting to grips with back pain

I’ve been a qualified physiotherapist for over ten years now and I have heard literally thousands of people during that time talk about their ‘really bad back pain’. And to be honest, I never really got it. Patients would complain of severe, unremitting back pain that was there constantly. There was always a little part of my brain that thought, there is no way that this person has pain 24 hours a day. Until a couple of years ago I fell down the stairs (stone cold sober unfortunately!) and landed at the bottom of the stairs, squarely on my bottom. And then I understood what this ‘really bad back pain’ people speak of! I had severely injured a disc in my spine, my sacro-iliac joint and every joint in my spine had received a massive blow with the force I had fallen with. I walked like a stapler for a few days and then eventually managed to straighten up with the help of my physio friend. But as a physio, you rarely go through a full treatment regime (do as I say, not as I do!) and found myself after the initial horrendous pain had settled with this rather nasty classic disc pain that many of my patients had spoken of:

1.     Central pain at the level of my most injured disc. If I touched it, it was tender and there was a good band of pain on either side, and it felt like someone was squeezing

it really really hard.

2.     I did not like to bend forward at all and bending backwards was almost as bad

3.     Sitting was like Chinese torture, particularly if on a couch or something equally as soft and unsupported. Dining room chairs were my only friend.

4.     Rolling in bed was like getting a beached whale back in the ocean. It required a lot of effort!

5.     Being in any one position too long was agony, including long lie-ins.

6.     I was really really sore every morning for ages!

7.     I was lucky in that I had no numbness, no pins and needles and no weakness. Take all these symptoms VERY seriously and get checked out ASAP.

So if this sounds like you, then the good news is that you CAN get through this! But it does take time. So my advice to you is:

Keep moving. Don’t sit/stand/lie for any length of time. Discs like movement, and the reason why you are so sore and stiff in the morning is because the disc has taken up fluid during the night and now you’re stuck with a big swollen disc which already has something wrong with it. Movement helps to get rid of some of this fluid quicker, and prevent the disc from re-absorbing the fluid. Walking is usually really well tolerated so do that as much as possible.

 Ice initially, heat after the first 4 days or hot/ cold contrasts.

Stop picking up heavy things! If you feel your back tighten as you lift something, PUT IT DOWN IMMEDIATELY! Your back is not replaceable, and spinal surgery is not a joke... it’s very expensive and not always that successful! Bend your knees at all times when picking something up, keep it as close to your body as possible and brace yourself as you lift anything (hold your breath if you need to!). The same goes for children, and mum’s unfortunately your child cannot sit on your hip while your back is sore.

If you have to sit down, sit right up against the back of the chair/ sofa so that you are fully supported. If it’s too deep, load up the cushions. Always try to put something in the small of your back, and keep alternating it: with and without support so that you are constantly changing the position of your spine even when seated.

Sleep on your side with a pillow between your knees, it may not be your partner’s favourite thing in the world but will save you having to get up in the middle of the night because you’re in so much pain. Avoid sleeping on your stomach unless on a pillow.

Switch your core back on: When you hurt your back your stabilising muscles automatically switch off. If you haven’t been shown how to do this in the past then ha a look at this video:  http://www.youtube.com/watch? v=aqwx6uCwhUQ&feature=youtu.be or this one is good too http://www.youtube. com/watch?v=dglhzlp474A&feature=youtu.be. When your stabilisers are ‘switched on’ you will start to feel a little more secure in your back.

Stretch before you get up in the morning and when you’re feeling sore.

If you are overweight, lose it! Increased weight puts more pressure on your back (and all your joints). Fat also DRIVES inflammation. In other words, keeps an area inflamed longer than it should. Physically carrying heavy things around is a bad idea, and the same goes for your body, the heavier you are, the harder it will be to get rid of the back pain.

When you’re starting to feel a little easier in your back, head back to the gym, just train smart. Avoid sitting hunched over on a static bike, sit up straight if you choose this as your exercise. Stepping and cross-training will probably be easier for you. Walking on the treadmill is a good idea, running and jumping is not. Playing a sport is not ideal when your back is sore, particularly if it involves twisting and bending, the combination of which is lethal to your back!! Also, the minute there is competition, very few people can control themselves and ensure that they will not get hurt, better to aid the situation and just go to the gym instead!! Avoid squats with weights, and any (LIGHT) weight training you do should be seated and supported, preferably using a machine so that you don’t have to carry the weights around.

Check your posture. Your days of slouching are done. At all times make sure that you are not twisted, hunched over or crossing your legs. Sit with both butt cheeks on the chair and sit up straight. Stand with weight on both feet evenly, reasonably wide apart.

Ditch the high heels till the back feels better. No debate, the two can’t mix.

I hope that has given you some ideas as to how to cope with your pain. Feel free to comment below with any questions that you have.

All the best!!

Kate