The 7 Back Pain Mistakes
Many people who suffer from back problems make the common mistakes below. If research studies are correct, 80% of us will have an episode of low back pain at some point in our lifetime. With low back pain being this common, let’s discuss things that you SHOULD and SHOULD NOT do when you suffer from low back pain.
ICE versus HEAT: Ice is an “anti-inflammatory” agent, meaning it reduces swelling. Ice reduces congestion or pushes painful chemicals and fluids that accumulate out of the injured area when there is inflammation and usually feels good (once it’s numb), maybe not initially because it’s cold. Heat does the opposite of ice. It’s a vasodilator meaning it pulls fluids INTO the area. Sure, it feels “good” initially, but often people will say it makes them worse later. That’s because the additional fluid build up in an already inflamed area is kind of like throwing gasoline on a fire. When Low Back Pain is chronic (it’s been there more than 3 months), heat MAY be preferred. Contrast therapy or, alternating between ice and heat can work as an effective “pump” pushing out fluids (with ice) and pulling in fluids (with heat). Here, start and end with ice so the first and last things done are “anti-inflammatory.” This can help you a lot with your back problems.
IGNORE YOUR LOW BACK PAIN: The comment, “I was just hoping it would go away,” has been used by all of us at some point. Though Low Back Pain can get better over time, it’s simply impossible to know when or if it will. If you have suffered from back pain previously, then you already know that getting in quickly for a chiropractic adjustment BEFORE the reflex muscle spasm sets in can stop the progression, often before it reaches a disabling level. If you want to reduce the chances of missing work or a golf game due to Low Back Pain, come in immediately when the “warning signs” occur – you know, that ‘little twinge’ in your back that’s telling you, “…be careful!”
BED REST: There is a time for rest and a time for exercise, but knowing what to do when is tricky. Another “true-ism” is the best exercise when done too soon may harm you, but when done at the right time will really help. So, here are some general guidelines: a) no more than 24-48 hours of mostly bed rest; b) walking is usually a great, safe starting activity after or even during the first 48 hours; c) avoid activities that create sharp pain (like bend, lift, twist combinations); d) use ice or contrast therapy a lot during that initial 48 hours; e) follow your doctor’s exercise instructions and treatment recommendations.
STAY STILL: You’ve heard, “… don’t do that – you’ll get a bad back!” There is something to be said about being careful, but you can be too cautious as well. In order to determine how much activity versus rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain DURING the activity, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short… within minutes to hours… then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.”
FOCUS ON X-RAY OR MRI FINDINGS: Back problems can show up on x-rays or MRIs. But, did you know that about 50% of us have bulging discs, and 20% of us have herniated discs in our low back and yet have NO pain? That’s right! Many of us have “disc derangement” but no symptoms whatsoever. Similarly, the presence of arthritis on x-rays may have no relationship to an episode of Low Back Pain. It’s easy to blame an obvious finding on an image for our current trouble, but it may be misleading. In fact, it can even make a person fearful of doing future activities that may be just fine or even good for us. The WORST thing for some types of arthritis is to do nothing. That will just lead to more stiffness and pain.
SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but trying non-surgical care for at least 4-6 weeks and maybe several months is usually the best approach. As the saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as bowel or bladder weakness and or progressive neurological losses like worsening weakness in the leg. If there are no “surgical indicators,” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this case. There are general guidelines based on research studies on back pain treatment, and these guidelines recommend non-surgical care for back pain initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic care carries the highest patient satisfaction.
DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner… reduce your ability to lift heavy weights if you’re a weight lifter… or reduce your ability to cycle as fast if you’re a cyclist. Though this seems silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears, at least for now, that it applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, there is a “right” versus “wrong” TIME to stretch and a “right” vs. “wrong” WAY to stretch. For example, when low back pain is worse in flexion but gets better in extension, there is plenty of evidence published that doing the stretch INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice on how to stretch safely and effectively… and watch your back problems go away.
Here’s a patient talking about her experience with our treatment.