Whiplash Injury | Back Pain Treatment

First aid for back pain - treating yourself

For most people, most of the time, lower back pain is easily defeated when it strikes. Here are "Cameron's Rules" for winning the battle with low back pain. They apply to the most common type of low back attack which is pain mainly in the back with some pain in the buttock or thigh. Nerve irritation - shooting pain down the leg as far as the ankle - needs a slightly different plan of campaign.

•  Rule One - DON'T PANIC!
Remember that most people who suffer from an attack of lower back pain will improve within a week or so - although it can take up to a month to go away completely. Avoid getting into a negative state of mind at the outset and the battle is half won.

•  Rule Two - Give your back a chance.
All attacks of low back pain benefit from an initial short period of rest to allow them the best chance of recovery. It's important to spend as little time as possible in bed as the muscles and bones of the spine will begin to lose some of their natural strength. Forty eight hours is the maximum you should allow yourself and if you can get up sooner then so much the better.
Some will find lying on their back most comfortable, others will prefer lying on their side with knees curled up and a pillow between the legs. Try to lie on a firm high bed if possible. Getting up off the floor can be very difficult and rolling like a log out of a high bed is much easier. Keep things like a flask of tea or coffee by the bedside so that you can minimise the time you spend up and about. When you are on your feet then encourage circulation of blood around your spine by gentle back and forward movements.

•  Rule Three - Try to ease the spasm .
Even though a facet joint or a lumbar disc is probably triggering the pain, it is often muscle spasm which keeps the lower back pain going. If you can begin to release this spasm then things will settle more quickly. Some prefer ice, others like heat - I find a combination of the two works well.
Use a hot water bottle wrapped in a towel to apply heat for up to twenty minutes. Gently mobilise the spine afterwards by encouraging slow, small back and forward movements and then apply ice. Frozen peas make a better ice pack than ice cubes because the latter melt into a puddle within five or ten minutes. The peas can be re-frozen ready for use again later. Do mark the bag with a pen though - otherwise they may end up accompanying your fish and chips at a later date!

Should you try a back support? I'm often asked this question by patients and to be truthful it's never easy to be dogmatic about the answer. Many patients with acute back spasms seem to benefit from wearing some kind of support strapping (strapping with magnets in the support seems particularly helpful). But I've yet to find a foolproof way to predict which back pain patients will benefit. These devices are fairly inexpensive however so my advice usually is "try it and see."

•  Rule Four - Medication often helps.
I know many of you worry about using pain killers or muscle relaxing tablets in case you become addicted. True, this can be a problem if the medication is taken continuously over a period of months but will not happen with short term use. Try simple paracetamol (tylenol) or aspirin - despite glossy adverts from drug companies there is no evidence that any other drugs are better. If this is not helping in twenty four hours then your doctor should be able to prescribe something a bit stronger.

Take your pain killing medication regularly - every six hours is a good idea. Don't wait for the pain to get bad before you reach for the tablets - this is a classic mistake. It is much easier to stop a pain from coming than it is to get rid of it once it arrives. Don't be a "brave soldier" - you'll get better much quicker if you can break out of the pain cycle.

•  Rule Five - Get the circulation going again.
After an initial time of rest you must get blood flowing around the spine again. The heat and ice described above will help but nothing beats gentle movement - discs depend on it to keep them nourished. When pain strikes then the sooner normal mobility returns the better. The fluid which feeds discs is squeezed in and out as the bones move.

If possible, get someone to gently massage the tight muscles of the spine. Then, still lying in bed, begin to move. Lie on your side and to start by curling up the legs towards your tummy. Go as far as you can without causing a lot of pain. Gently unwind again and then go in the opposite direction by slowly arching your back. Again, stop short of causing pain and try to repeat this process six times every hour if you can. You should notice benefit quite quickly. Keep this type of spinal movement going for several days once you are back on your feet again. Even a pain free spine will enjoy this as a warm up routine first thing every morning and a cool down last thing at night. Get into this habit and you may prevent further problems. 

•  Rule Six - look at your lifestyle.
Smoking at any time is bad for your back. I know doctors always say that but it's true. The chemicals in the smoke lessen the bodies ability to repair damage and make attacks of back pain more common and longer lasting. Smoking during an acute attack is crazy.

Small amounts of alcohol can ease pain and spasm but avoid the temptation to use it as a pain killer. We all know the morning after feeling of thirst that a boozy session can produce. An inflamed disc needs as much water as it can get to speed recovery but alcohol causes fluid loss from the body. Drinking more than a glass or two of wine in a day will slow down the recovery process.

If you are stuck in bed for a day or two then take the opportunity to reassess your overall lifestyle. Are you overweight. Do you really get as much exercise as you should. Make a few resolutions as you lie there and turn the negative experience of back pain into one with a positive long term outcome.

And on the subject of bed - if you are prone to recurrent spells of back ache then you should be taking a close look at your either your bed or your mattress or both. Too firm, too soft? The eternal dilemma for the back pain sufferer.

Following the simple guidelines above will see most of you well on the way to recovery within two or three days. If you are not getting better by that stage then seek the help of someone trained in "hands on" manual therapy for your back. This could be an osteopath, a chiropractor or a physiotherapist depending on local availability or your preference.

An attack of sciatica pain

For those of you unlucky enough to suffer an attack of true sciatica then most of the above still applies. Real sciatica is nerve pain that shoots down the leg, often reaching the foot. It will have an electric shock kind of feel to it and the slightest movement of the back is enough to bring it on. The sufferer may have only minimal back pain and sometimes will have no pain in the back - it can all be in the leg. Pins and needles or numbness can also be a problem. This kind of pain nearly always means that a nerve root has been severely irritated - often by a bulging lumbar disc or an inflamed lumbar disc.

It is still worth applying the principles above because although the pain of sciatica is more severe, most people will get better without any specific treatment after a week or two. You will probably need to spend longer in bed than someone with back pain - perhaps up to a week. This makes it all the more important to start mobilising the spine as described in rule five. Heat and ice will also help and a positive attitude makes a big difference to the outcome. Strong painkillers can get you over the hump of the first two or three days and your doctor should be able to prescribe these. Take care that they don't make you constipated. Many strong painkillers do and straining to open your bowels is very unpleasant if a nerve root is inflamed. Take the painkillers but use a laxative too.