How to Get Out of Acute Lower Back Pain
In this video, Dr Luke Madden gives you a snippet of the anatomy of back pain and then demonstrates soft tissue release techniques to alleviate muscle spasms, mobilisation techniques to move joints and stabilising exercises to strength the body and prevent lower back pain flare ups. He talks fast so feel free to watch a couple of times…
Key Takeaways
Let’s quickly break down the most common back pain and how to deal with it.
The lumbar spine is 5 segments with 5 discs. The discs take the load, the joints facilitate movement. The ligaments hold the bones together. And the tendons connect muscle to bone. The muscles provide movement and some stability.
In acute low back pain, the majority of dysfunction is a joint sprain or a disc issue. Due to the location of the spinal cord behind the disc, when discs bulge they pinch a nerve or the spinal cord, characterised by pain going into the bottom and down the leg. When joints sprain, it’s a sharp localised pain that feels like you can;’t move anywhere or you’ll make it worse. In both instances the muscles tighten up to protect your spine. Makes sense. Good system. The problem is you have to keep living and that involves moving which involves muscle control and joint stability. To zoom out for a second, in regards to the muscular system, there are a couple of oblique or diagonal slings that stabilise the low back and pelvis. 2 at the front and 2 at the back. (Ignoring core for a second), the font sling is made up of your obliques and adductors connected and the back sling is the lats and the glutes. Weight should be even between both back and front.
In acute pain, the back sling spasms and the front sling is now stretched. So it doesn’t work properly. People like me, will release the back sling, correct the joint dysfunction. Others will go straight to exercise and stretch prescription, but in my view until you release the back, you can’t strengthen the front. So if this is you. Let’s get you up off the floor and start to correct your back.
1. Release the back sling… this can involve a trigger ball, spikey ball, tennis ball, gold ball whatever. You lie on your back, knees bent (this should be a comfortable position anyway). You lift up and place the ball under your lower back beside the spine where the spasm is and you lower down onto the ball and breathe. After 30 sec, move 1cm up and down, or left and right to start to release the lumbar spasm. This may take 2 mins, this may take 6 mins. Whatever, it feels nice so just do it.
2. Movement without pain – we now need to tell your nervous system that movement does not equal dysfunction. This is where you will take the ball out and rock side to side with your feet still on the ground and your shoulders remaining on the ground. Start low, go slow. This may take a few minutes each side.
3. Remember our slings. Lower back to glutes. Now we release glutes. This can be with the ball or a stretch. I will show you both.
Ball – similar to our lower back, but under the glute, Cross one foot onto the opposite knee and roll slightly to that side with the ball under the glute and roll 1cm up and down, side to side etc. Till it stops hurting. The stretch is similar except you slide your heel back further to get a greater glute stretch.
Now that the back sling is released, we can now strengthen the front sling.
This is where we build up our obliques and adductors.
Roll to your side. Use your arms and roll to the front and then push up on top of all 4s. Or what if we can 4 points quadruped. Start with small flexion and extension of the spine to once again create small movement. The more we move, the better we feel and the more we train our brain that it’s ok. Find your neutral position. This should be halfway between full extension and flexion. Now don’t fully extend. We just released this. Don’t fully flex. We don’t want to set something off. We just gently find our neutrality. Then we add a small pelvic tuck. Not a lower back tuck or abdominal tuck. It’s like you’re a dog in trouble and tucking that tailbone underneath slightly. Hold this position and visualise you are holding wind in and you can’t let it out. (this will engage your pelvic floor and your core). Then draw your knees together but don’t actually move. It is a static hold to recruit our adductors. While you’re doing that, draw your right hand down to your left knee and your left hand down to your right knee, but don’t actually move it. It is a static hold. This way we have our core on, and we are engaging our front sling. Hold for 1 inspiration and 1 expiration. Repeat x 10.
The 2nd last thing is a hip flexor stretch.
Start in a proposal position. One one knee, the other leg in front. Do it on a pillow next to a table for balance. Square up the hips to be in line with the shoulders. Remember the pelvic tuck we just did… do it again. Breathe in and as you breathe out, move your weight forward over your bent leg but DO NOT extend your back. Hold for a breath and as you breathe out move 1cm further. Repeat x 10.
And finally a last stretch.
Find a door jam, hold the handle, and then slowly start to pull your body away starting with the hips. Imagine there is a rope hooked on the back of your hip and it is slowly being pulled behind you. Hold stretch for 2 breaths and then slowly unload and pull yourself back upRepeat x 10.
Now you should be able to stand up. DO NOT TEST YOUR BACK. Instead, go for a 10 min walk.
You can repeat this as many times as needed in conjunction with pharmacy advice regarding analgesia and anti-inflammatory medication. Ice is your best friend throughout this as cold therapy reduces pain.
That program now shows you what you’ve more than likely done, and how to get out of a bad situation with it. You have now stabilised your slings. As with any advice, this does not replicate medical intervention, if pain persists you know what to do – seek help. This does not replace any health advice you have received nor does it diagnose to treat your condition etc etc
That should get you through until you can see one of my team whereby we can make an appointment and fix your back properly. But this is a strong start.
If this is you or someone you know and you need assistance with managing a lower back injury, we’d love to help. Call us, facebook us, look us up on instagram or book online via kt-health.com.au. Otherwise, enjoy the rehab and we hope to help you with another video soon.