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Acute back pain: what should I do?

Low back pain is the leading cause of disability in UK and it is estimated that 80% of adults will develop at least an episode of low back pain in their lifetime. While in most of the cases pain subsides within 6 weeks, in up to 20% of those people becomes chronic. We know that one third of people who experienced back pain in the past will have another episode within one year from the previous episode.

A severe episode of low back pain can be very challenging and scary. Pain can be very intense and spread down the legs as well. It can come along with pins and needles, sensations of burning and pulling and it can be triggered by simple movements.


When you get hit by pain so suddenly and so violently the first thought is that something has gone wrong. Something inside the lower back must have snapped, slipped or broken.

There are cases in which pain is really linked to a more serious medical condition but this cases are quite rare. Vertebral fractures, malignancies and spinal infections can cause low back pain but the likelihood you have one of this is extremely low and your GP or physiotherapist would be able to spot them.


For the vast majority of people suffering from back pain is currently not possible to detect a specific cause driving the problem.


Despite a high level of pain most of the time there is no significant tissue damage nor there is more potential for damage to happen. See it this way: a barking dog doesn’t bite. It wouldn’t be wise to jump on the upset animal and pet it but if you approach him calmly and gently it will relax.


So what should I do if I develop acute back pain?


Research tells us that keeping active and moving is the best thing you can do to tackle pain. It may hurt, it may be unpleasant but it is going to help. Bed rest will not help.


The easiest way to be active is walking. Several short walks during the day may be better than a long one. It is safe and wise to exercise as well. Should the pain be too intense to make it difficult a physiotherapist can help you to find some strategies to get fully back to your life building up your activities gradually.


If it happens you develop low back pain try to carry on life as normal: you are not going to do any damage, should be the pain be too intense to do so you can reduce some of the most painful activities but it is vital that you stay active. Should the pain persist more than few weeks a physiotherapist can be very helpful to speed up the recovery process and to avoid it becomes chronic.


Thanks for reading,


Davide


lanfranco.therapy@gmail.com





References:


1) Buchbinder, R., van Tulder, M., Öberg, B., Costa, L. M., Woolf, A., Schoene, M., Croft, P., & Lancet Low Back Pain Series Working Group (2018). Low back pain: a call for action. Lancet (London, England), 391(10137), 2384–2388. https://doi.org/10.1016/S0140-6736(18)30488-4


2) Clark, S., & Horton, R. (2018). Low back pain: a major global challenge. Lancet (London, England), 391(10137), 2302. https://doi.org/10.1016/S0140-6736(18)30725-6

Foster, Nadine & Anema, Johannes & Cherkin, Dan & Chou, Roger & Cohen, Steven & Gross, Douglas & Ferreira, Paulo & Fritz, Julie & Koes, Bart & Turner, Judith & Maher, Chris & Buchbinder, Rachelle & Hartvigsen, Jan & Underwood, Martin & Tulder, Maurits & Cohen, Stephen & Costa, Lucíola & Croft, Peter & Woolf, Anthony. (2018). Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 391. 10.1016/S0140-6736(18)30489-6.


3) Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., Underwood, M., & Lancet Low Back Pain Series Working Group (2018). What low back pain is and why we need to pay attention. Lancet (London, England), 391(10137), 2356–2367. https://doi.org/10.1016/S0140-6736(18)30480-X


4) https://www.nice.org.uk/guidance/ng59/resources/low-back-pain-and-sciatica-in-over-16s-assessment-and-management-pdf-1837521693637


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