Many people can go a long time with minimal or no low back pain, then it will suddenly flare up.
In this video I’ll explain what you can immediately do to lessen the pain caused by a flareup.
First, you can apply ice or heat. One or the other usually works for different people in different ways and one is not necessarily better than the other; it’s what works best for you.
There are some key points to keep in mind, though.
The benefit of ice therapy is that it quickly reduces inflammation which causes pain and swelling. For ice therapy, you can use a bag of frozen peas, and conform it to your low back, and then after twenty minutes return it to the freezer to use again at a later time. It’s an inexpensive way to apply cold to your back.
Another easy solution is to buy the plastic, gel-filled packs that are sold at most pharmacies. You’ve seen them before. Those are those usually the blue ones and they’re kind of flexible. And you put them in the freezer. They work really well.
The key is to apply the cold pack for twenty minutes at a time; no sooner than every 2 hours.
The amount of time you apply the ice is important because less than 20 minutes and you’re not going to get the optimal effect and more than 20 minutes counteracts the effects the ice creates by causing a reduction of inflammation, swelling and pain.
The benefit of heat is that it decreases muscle spasm. Heat can be used about every two hours for twenty minutes at a time.
Moist heat is better than dry heat because it penetrates the skin deep into the tissues faster than dry heat. Examples of moist heat are a hot bath, steam room, or a chemical moist heat pack.
If you are going to use dry heat such as a heating pad, it’s really important to remember - do not go to sleep with the heating pad on your back, even if it’s on low. The effect of heat is cumulative, and you can get a severe burn even on a low setting. So it’s best to use the timer function on a heating pad so that way the heat will automatically turn off at the appropriate time, even if you fall asleep. This will prevent a severe injury.
You can take an over-the-counter anti-inflammatory medication, but only take medication if you don’t have medical problems that would create a problem if you took them.
There are quite a few issues and potential risks involved with taking anti-inflammatory medications, including ibuprofen and other forms of non-steroidal medications that you can buy over the counter, so it’s always a good idea to check with your doctor before starting one of these medications.
Another thing you can do is to rest in a position that takes stress off your back.
For example, lie down with your hips and knees at 90 degrees while supported such as lying on the floor in front of a couch with your legs supported by the seat rest. This is known as the “90-90 position” and there is good research supporting how well it unloads the stress on your low back.
If you’re sitting in a desk chair, make sure your knees are at a right angle, and if not either sit in a chair with a higher seat, or conversely, place a large book or a box under your feet to get the right angle for your knees – this sitting position will also help lessen the stress on your lower back.
Relative rest is important early in the recovery process. This means laying down for 30-60 minutes to an hour or so and then getting up and moving around at regular intervals throughout the day. This is important because it helps speed the healing process by bringing fluids and nutrients to the painful areas of your spine.
If you’re in severe pain, you may only be able to walk for short periods, and that’s OK.
Research has shown there is no role for absolute bedrest for more than 2 days.
For very severe pain, or pain that is accompanied by other symptoms, you may consider going to the local emergency room.
At the emergency room, you can be evaluated and treated for any serious issues, such as loss of bowel or bladder control. Otherwise, oral or injected pain medication may be given to help reduce pain and improve the quality of the symptoms that you are having at that time.
Any flareup of back pain, even if it seems relatively minor, is a signal that you need rehabilitation. With the right program of strengthening, stretching and aerobic conditioning you’re more likely to minimize the duration and severity of a flareup.
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