First Aid for Low Back Pain

If your back has gone out, or is on the verge of doing so, and the situation is such that you can’t visit a chiropractor, or an osteopath (who does manual manipulation), then you need to help yourself. In fact it’s a good idea to have this basic understanding of structure & function (and pain) – it helps you to appreciate and be responsible for your body.

The advice below is just the tip of the iceberg – it’s general knowledge. This means the information is NOT all there is to know about back pain. If you do not get relief from these remedies, then you need to visit someone who knows more than you do about it. In fact, it’s a good idea to get yourself to an appropriate type of doctor to treat the structural cause of your pain. Even if you completely feel better (which can happen in 1-3 days), there may still be misalignments in your joints that need professional attention.  Keep in mind when the pain stops, it just means your spastic muscles have found a tension level they can live with – it does not mean all your parts are positioned or functioning correctly.

The body is a metaphor for the mind

Body and the subconscious are always in communication – the goal is to increase awareness by adding your conscious understanding to the mix. The more you understand about how your body works, the more you can mentally help it along by guiding it through its processes. If you are totally ignorant about how your body works, then you may be likely to create counterproductive behaviors and neuromuscular feedback loops which imbalances, that can lead to injury. This means, not only may you have poor biomechanics, but pure stress can also cause your back to go out. The cacophony of stressors, ignorance, misconceptions, assumptions, and wrong beliefs bouncing around inside your mind are the chronic commands you are giving your body to manifest: resulting in unhealthy habits and movement patterns, and a general lack of awareness to what your body is trying to communicate to you.


What the Pain Means:

The explanation of the nerve-muscle-bone-joint-connective tissue system is another story. For now the issue is that an imbalance in your body structure has diminished your ability to channel mechanical forces within the earth’s gravitational field, and something is about to get injured. The body’s response is to “splint” or brace the area by contracting muscles to keep grossly imbalanced joints from moving. You may not have been conscious of the imbalance, but the body’s mind is always monitoring it – and sending you hints that you were ignoring or overlooking. There are usually warnings. If back pain “strikes without warning”, chances are you have not been paying attention.


The Goal:

Muscles contract because nerves tell them to. In order to get a muscle to relax, the nerve needs input (sense stimulation) that tells it that it is safe to do so. Resting over time tells the nerve that you have stopped moving, and eventually the feedback will convince it that motion has stopped, and it will release its hold on the muscle.

Once the muscle relaxes, the joints can reposition themselves; which rearranges all the mechanical forces of the muscles around a joint, to a safer alignment… which allows you to get up and start moving carefully… allowing more-fine tuning of the nerve-muscle-joint complex… until you are back to normal (though your “normal” may require some work…).

The general releases described below create gentle traction in the spine; providing a reason for the muscles to relax (the spasms occur in response to reasons to contract: your mechanical structure is failing in it’s ability to move within gravity; and an injury is imminent). You may hear pops in your joints as they realign (either immediately, or shortly after you get weight-bearing again and start moving around).

The key to doing these things without hurting yourself is to PAY ATTENTION to what you are sensing in your body.  Is what you are doing making it better or worse; is the action causing a problem somewhere else? Your spine may be so dysfunctional at the moment, that any movement (including traction) will only trigger more contraction (spasms). If this is the case, skip down to the hip blocking, and get to the right type of doctor as soon as you can. If you are in serious pain, you can ice (see below), but otherwise I would suggest using heat to relax the spasms. If you can self muscle test, you can ask your body which it prefers.

General Releases of the Low Back

For general low back pain discomfort, or feelings of compression, or that your back is about to go out.

1. Spinal Twist

  1. Lie on your back on the floor or other firm support, with your arms out to your side 90 degrees
  2. Bring one knee across your body …
  3. Grab it with the opposite hand and gently but firmly pull it toward the floor (you may hear pops in your spine, as the joints fall into place)
  4. Once the knee is across your body close to the floor, you may want to try moving your knee into different positions (from straighter, to having it closer to your chest), as this will put leverage in different parts of the spine.

Spinal Twist

Spinal twist in a chair

2. Hanging Traction

This method generates low back traction by using the weight of the lower body. If you cannot hold your weight, have your feet touch the ground, or stand on a chair to support some of the weight. Generally you want the waist down to be free hanging, as this will provide traction in the low back area. Modify the hanging as required, but keep the goal in mind – and be careful.

  1. Hang and relax from waist, down (don’t tense up your whole body)
  2. Gently hike up the left hip then the right
  3. Gently twist left and right (from the hips, then the shoulders)
  4. Gently bring your knees to you chest
  5. Stretch your arm/shoulder/side by hanging more weight from one hand


3. Balance Ball

This method generates low back traction on the front of your spine; relaxing the large muscles (psoas) used to flex your torso allowing you sit. The psoas muscles deep in your abdomen get shortened with chronic sitting.

Many of us spend the day flexed forward (sitting). Regular arching of the spine into extension, helps to relieve back pain, and ensure we don’t grow hunched over forward in our later years.

Many of us spend the day flexed forward at the hip (sitting). Regular arching of the spine into extension, helps to relieve back pain, and ensure we don’t gradually grow hunched over forward in our later years.

4. Inversion Table

Inversion Table

 

Specific Manipulation of the Hips

For acute, debilitating pain, and spasms that don’t respond to the general release methods above, you may need to specifically move a part of your body in a certain direction. It’s best to go to a chiropractor or osteopath for this, but if you can’t, you may want to try to  move a pain-causing joint on your own. Be careful and stay aware, as you are guessing which way to release the pain. If one direction makes it hurt more, try the other direction.

Block Your Hips

Blocking the hips is a chiropractic method from a body of knowledge called Sacro Occipital Technique (SOT). There is much more to blocking your hips than mentioned here.  This is not chiropractic training, it is an appreciation of the importance of pelvic stability in structural balance and pain syndromes. The goal with everything on this site is to increase awareness and empower you to help yourself and learn more.

The pelvis is a major player in spinal health. In terms of mechanical forces, the spine rests upon the foundation of the pelvis. A chronic twist in the pelvis will create compensating bends in the spine; which will result in muscle spasms and potential for injury. This method uses gravity and the weight of your body to reverse a twist in your hips.  Imbalances in the pelvis can create an unstable spine, which may go into spasm to hold itself together, and prevent injury.  Some chiropractors use SOT blocks; you can use shoes, 2 rolled up towels, or even straddle someone on the floor and pull up on their hips in the right areas.

Block Dimensions:

The SOT Blocks pictured above have a footprint of approximately 8″ x 4″, and the height is about 4.5″. Your towel should be rolled tight to about 4″ in diameter. If you need to (larger body or soft towel) you can fold the roll in half for greater height. If you bring one end of the folded roll to the middle of the length of the roll (vs aligning it with the other end), you can create a stepped “wedge”.

IMPORTANT: you have to pay close attention to how you feel with this, because you are actively moving body parts in a specific direction (as opposed to the general shot-gun methods mentioned above). If you know how to self muscle test, this will also indicate if you have the blocking position correct, as well as how long to leave the blocks in place. The goal here is to find a position of relief.

  1. Lie on your back on the floor (or firm surface). Place one wedge under the sitting bone of one side, and the top of the hip on the other, so the two wedges are positioned diagonally from each other.
  2. If it feels like a relief – you are blocked correctly.
  3. If it makes it worse – you need to reverse the blocks (if you positioned the wedges left-high and right-low > switch to left-low and right-high…
  4. If this still does not feel right, position blocks opposite each other, either both high or both low…
  5. Additionally you can also try these procedures while on your stomach.

Note: the view here is the “doctor” looking down on the “patient” lying on their front/prone (left) or back/supine (right). You can block either way. The anterior (front) and posterior (back) positions are NOT blocked the same way in these diagrams. When the patient flips over from lying prone to lying supine, the blocking has to switch sides also. Switching patient sides gives the mental illusion that the blocking needs to be reversed – but it does NOT; since the required switch occurred when the patient flipped over. Remember that the patient’s body weight settles down (toward the bench/floor/etc) where there are NO blocks. If you examine what is happening with the pelvis in both diagrams, you will see that the block positioning, relative to gravity (depending on how the patient is lying) untwists the pelvis in the same direction (notice the markers “A” – for what parts of the pelvis are being shifted to the patient’s anterior). In this example: we want to shift the patient’s right illiac crest anterior (because pain is caused with it being posteriorly twisted). This anterior shift is created by gravity, if the patient is lying prone; or by the block, if the patient is lying supine.

IMPORTANT: Only lie like this for a minute or two (as the torque you are creating in the body will first take out the twist that was causing you pain, then (if you leave it there too long) it will start to twist you further into the opposite pain pattern).


Movement:

“Movement is Life”… so start moving as soon as you can – gentle micro movements are great to help retrain your nerve-muscle mechanism how to move. Read Hanna’s Somatics; the work of Feldenkrais; and Trager’s Mentastics.

Be sure to sit on firm chairs, and in a way that keeps your back vertical, and has both legs/knees parallel/even to each other (to avoid twisting your hips). Do not slouch in a soft couch, as the lack of support will probably makes things worse.

Be careful getting in and out of bed:

IN: Sit on the bed (firm is best) with feet on floor. Keeping your feet and knees together, lower your upper body to the head of the bed, supporting your upper body with your elbow and the opposite hand… while you hold your knees bent at 90 degrees, and allow them to rise up to the level of the bed. Then slide back toward the center of the bed.

OUT: The reverse of getting IN bed…roll to one side, with knees pulled up to “sitting” position, in the direction of the side of the bed you wish to exit. Slide knees to edge of bed. Push up, away from bed with your upper arm and lower elbow… while you lower your legs (feet and knees held together) to the floor. Move your spine gently and slowly in micro movements (stretch vertically, arch/bend, twist, bend left/right), to get it reacquainted with gravity before you stand up.

Sleeping:

Sleep on your side, with a pillow the width of your shoulders (to keep your spine straight), and pillows between your knees (to keep hip aligned), and under your upper arm (to keep shoulders straight). While sleeping on your back, you may want a pillow under your knees. Try sleeping on your back without a pillow under your head (or use a thin one). Thick pillows keep your neck bent forward all night, and if you work with your head in this position all day, your neck rarely gets any vertical time… which means, your neck starts to grow bent forward… an accident waiting to happen.

Sitting and Standing:

Support your upper body weight with your arms, on your knees/thighs as you lower yourself slowly to the seat edge. Then slide back into the seat. Reverse to get up.

Getting In and Out of a Car:

This is the same general idea as getting in and out of bed: keep your spine straight, and your hips from twisting (by keeping feet and knees together). Open the car door and turn away from the car seat. Sit down as you would on a chair, supporting yourself on the door. Swing legs into the car together, supporting as much weight as you can with your arms on the steering wheel or other roof grip. Reverse the procedure to get out of the car.

Ice or Heat:

You may want to put ice or heat on the spastic muscles of your low back – see which feels better. Be careful with ice to avoid frostbite: wrap ice in a washcloth (to keep it off the skin), and only keep it on your body for 15 to 20 minutes at a time (you can ice again in an hour). Ice will block pain, but slow metabolism, and disrupt nerve-muscle  communication. Heat supports metabolism and healing.

Prevention:

Core exercises
Body Weight exercises
Regular spinal adjustments (at least 1x/month)
Proper bio-mechanics
Techniques to clear stress (such as EFT)
Body Awareness
Stretching breaks at work

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