Hello everyone, today I would like to share about the ways to manage intense back pain. It is a little bit different to a lot of the back pain we see, usually from sitting too long, driving too long or some muscle imbalance
The intense type of back pain is usually a different type from heavy lifting or from any sort of injuries. From lifting or doing any physical task with an awkward position which put our spine in a very stressful situation.
To manage that condition is a little bit different to managing other types of back pain which are a little bit more chronic. So I'd like to hop on and talk about that a little bit today.
First of all let's talk about the mechanism of injury and the types. I talked about it's usually from an actual injury from lifting something heavy or lift or from a very specific injury.
Usually that results a muscle strain, a muscle being pulled in the lower back. Sometimes it’s the actual spine itself being affected and then most of the time it is the disc, the intervertebral disc of our spine. Then the presentation of that is usually a little bit different…
If it's a muscle strain, usually the muscle pull that's happening immediately. You may or may not hear a pop but then the pain will come on immediately after that and then you know most likely that's a muscle pull. That’s a muscle strain.
For a disc injury usually people would have a misunderstanding that they "slip their disc.” We often heard that term. That is not necessarily a correct way to describe it because discs don't usually slip like that.
The pain of the disc injury is from the swelling of the disc and then the swelling usually won’t build up until over time. Usually people would experience discomfort several hours later.
Say if they were doing some awkward physical tasks and hurt themselves. Usually it's that evening when they start to relax, laying down in bed. Then the muscles are relaxed, not supporting their back anymore. The disc start to inflame and then swell up very badly.

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That's usually the presentation which is a few hours delay. Then usually also because of the swelling, the disc is expanded that can also press on the nerve root and then causing some shooting pain into the leg.
The main difference is the muscle pull usually would result in immediate pain. The disc related back pain usually is several hours later and then usually that will be accompanied with some shooting pain into the leg.
That's the main mechanism of injury and the type of those very acute type of back pain. These are a little bit different than some of the other types of back pain we are dealing with and then how are we able to manage that?
There are some major ways, there are some major principles or tips I should say that is considered the "first aid" to manage these conditions.
The conditions can be very complicated from person to person. Hence seeing a physical therapist for a thorough evaluation is very important to figure out what's going on. In general these first aid tips can help the majority of the people to immediately relieve their symptoms when they notice that they have injured their back.
The first thing for either the muscle pull or a disc injury is we want to give them as much extension or back bending as possible.
The purpose of that is whenever our back is getting injured that way. The injury is usually from a motion of separating a tear, a separation of the tissue something like that.
That's causing the injury and then the inflammation and then the backward bending situation can make us approximate the tear. By keeping them approximated to each other we are able to facilitate healing that way.
A lot of backward bending or laying on your stomach are some sort of treatment ways or tips or exercises. Like that are all facilitating extension is to help people to manage very acute immediate back pain during that time.
The second tip is we want to avoid the activities that are the most stressful to our body which are abbreviated as the BLT.
No bending, no lifting, no twisting!
Especially during that acute phase of the back pain, we want to make everything calm down and then start the healing process of our body. So definitely avoid those stressful situations during that time.
The third thing is reduce the inflammation.
To reduce the inflammation here are a couple of things to think about. Oftentimes we know that if we put ice or cold on it we are able to immediately calm down the inflammation.
Remember that the acute phase of inflammation only lasts for 72 hours. So it's only valid for you to put ice on your body for the first 72 hours or the first three days. Then beyond that time it's okay to switch to heat.

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If you want to start the heat earlier you can also do that too. Heat doesn't necessarily have a specific time that's indicated but for ice definitely only the first three days.
Another thing I want to talk about ice is that ice does limit blood circulation and the limits of swelling.
If you put ice on your body for too long it actually caused the blood vessels to be expanded. Then the circulation will actually be facilitated again.
We usually only suggest people to put ice on a certain region for 15 to 20 minutes. Don't go any longer than that. Heat doesn't necessarily have that problem. If you are doing any types of hot pack, it's okay to do 25 minutes, 30 minutes.
Ice the first three days. Heat you can start whenever you want . That helps with pain relief, helps with relieving inflammation and also helps to facilitate circulation.
Another thing about calming down the inflammation is related to your diet. We know that certain diets, certain foods you eat can definitely trigger your inflammation and we want to avoid that. Taking too much sugar it's a big no-no.
Eating any foods that’s processed too much, having too much artificial processing, we want to avoid those. Make sure you eat a lot of vegetables and fruits and then particularly a lot of citrus fruits, berries and nuts and also dark leafy greens.
Those are the things that can really help us calm down the inflammation within our body. But then another thing is that it's related to fat that we are eating. We know that we want to have unsaturated fat to help our body to get healthier but then there are many different types.
The major ones are omega-3 versus omega-6 and then during that time you definitely want to lower omega-6 and then increase omega-3. So that you can facilitate the healing of your body and then calm down the inflammation.
This is very, very generic health and wellness perspective of diets. If you have any specific dietary needs definitely consult a registered dietitian.

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These are the three major tips but then like I said earlier, everybody's back pain presentation can be a little bit different depending on different types of activities they are doing. These first aid tips are only helping you to immediately relieve the symptom right after the injury.
In order for you to get better you also need some sort of hands-on work to relieve the muscle guarding and then to improve your range of motion for flexibility and also your endurance and eventually going back to work.
These are the three major tips but then like I said earlier. Everybody's back pain presentation can be a little bit different depending on different types of activities they are doing. These first aid tips are only helping you to immediately relieve the symptom right after the injury.
In order for you to get better you also need some sort of hands-on work to relieve the muscle guarding. Then to improve your range of motion for flexibility and also your endurance and eventually going back to work.
You definitely want to see a licensed, qualified provider and then ideally a physical therapist can help you with the recovery process. With this being said, definitely chew on the first aid tips but then whenever you guys need any help definitely look up a qualified provider.
I'm Andy Tseng, Physical Therapist, Occupational Therapist and also a Pilates Instructor at CORE Therapy and Pilates.
You can find more information from our website www.therapyandpilates.com or call us at 512-215-4227 for more information.
We will be happy to help you. That's all I would like to share with you guys today. I hope you guys have a great day. We will talk soon...later.