Low back pain is among the most debilitating injuries in the American workforce today. Firefighters are not immune. But what can we do ourselves?
There is no magic bean for mechanical low back pain. There are a variety of choices for care for your back pain: chiropractic, massage, acupuncture, physical therapy, pain killers and muscle relaxants. Whatever your choice: Your healthcare provider cannot help you nearly as much as you can help yourself. Any treatment they do really needs to be additive to what you do yourself.
Acute Low Back Pain
Pain is often rated on a pain scale of 1-10: 1 is barely noticeable, and 10 is so bad that one is unable to move or function. The initial, extreme pain that gets people to their doctor is called the acute or inflammatory stage. Most people rate that as 7, 8, or 9 out of 10. It can be marked by localized swelling, and heat in the immediate area. Some doctors prescribe anti-inflammatory medication for that. I prefer rest, a few exercises, and ice - in that order.
The chemical bi-products of inflammation actually soften the tissues in the area. This leaves those tissues more vulnerable to tearing and long term injury. Taking soft tissues to end range by bending, lifting, and twisting can be especially damaging. So- don't push things during that time. Rest is important at this time. The objective is to break the inflammatory process, re-create flexibility, and move on to strengthen and improve coordination. This will, if all goes well, lead to less painful episodes less often.
In this article, I will talk about ways you can do the first 2 steps: reduce inflammation and re-create flexibility. Of course, you should check with your doctor to make sure there is nothing that he/she needs to treat you for or with before you undertake self care.
The Rand Study (20-plus years ago) proved that chiropractic adjustments work to reduce acute low back pain. This is certainly true in people who have an inflammation of the facet joints in that area. However, this can be a short lived quick fix. If the muscle spasm is not reduced, the motion restored, and the trunk strengthened around it, the bouts of low back pain will likely return. I am a big believer in deep tissue muscle work, manipulation or adjustment, and therapeutic exercise - all properly applied. They work when used at the right stages in the healing process.
Let's talk about what you can do on your own, though, as an adjunct, or at home to get yourself some relief. The 3 things I would have you do for acute low back pain are as follows:
See your doctor to rule out pathology. Then...
Get comfortable. This can be very difficult at this time. I find that people with low back pain often respond well to the 90-90 position. This is; hips and knees both bent to 90 degrees. Lay on your back near a sofa or ottoman. Your hips bent, and knees bent so your behind is "scooched" up close to the sofa. Your calves will be on the sofa. This will take the lordosis out of the low back and allow the facet joints a break from each other… take some of the pressure off the area. This is a great position as it is easy on your low back and you can slide an ice pack under your low back as well.
Ice is a great tool for reducing and breaking the inflammatory process. It will also slow the pain nerve's transmission signal to the brain by up to 60 meters per second for up to 12 hours. It needs to be used repeatedly, and quite often for a few days when you really hurt. Try to ice every 4 hours for the first 2-3 days of your flare up. (I know- that's a lot to ask, but, it works.)
Remember that the inflammatory process is like a camp fire. You might think it's been put out, but if you don't go back and stomp on it several times, and dump more buckets of water on it, it might just smolder for a few days and come back full bore and put you right back where you started.