What to do if I hurt my lower back?

The first thing you need to know is that you want to avoid bed rest. Bed rest may seem like a logical decision to “rest” the body to allow it to recover. Although, research has shown that lying in bed for extended periods of time following an acute lower back injury will result in a slower recovery. Also, bed rest may cause increased use of pain medications and higher incidence to re-occurrence once you return to normal activity.

Should I ice or heat my back?

Neither. With an acute back injury heat may feel better, although you are most likely making it worse in the short term due to increased blood-flow to the injured tissue. Ice provides a short term decrease in pain from the superficial numbness that it causes, but it will also slow down the bodies amazing natural ability to heal itself.

Should I get a X-ray or MRI?

The answer to this is, it depends. If you are having a non-traumatic episode of lower back pain, the answer is no. What if you actually fell down or got into a motor vehicle accident, than the answer is yes you should get a x-ray.

How about if you are experiencing neurological symptoms such as bowel or bladder issues? You absolutely need to get to the hospital for diagnostic testing, such as a MRI. However, this is more of a rare circumstance so for the majority of lower back injuries that occur imaging is not needed.

The x-ray results may be not related to your symptoms anyway. For example, say you had a x-ray performed and you were told that you have degenerative disc disease. You may be thinking, now I know why my back hurts. However, that is most likely not the case because degenerative disc disease is actually a fancy way of saying your spine is going through the natural aging process. If your doctor would have taken the x-ray several weeks or months BEFORE your back was bothering, the results of the x-ray would be the same, meaning that the recent diagnosis of degenerative disc disease is irrelevant to the current acute episode of back pain you are experiencing.

Why am I experiencing the pain?

This is the 1 billion dollar question. The truth is the specific diagnosis for the cause of acute lower back pain is very difficult for healthcare providers to accurately diagnosis. The reason being is that imaging results due not correlate to symptoms very well. This is why it is important to see a movement specialist, such as a physical therapist to determine what individualized approach you should be taking to recover. You may be surprised how quickly you can feel better following a painful back injury.

So, what should I do?

During the acute or painful stage, it is recommended that you walk as much as you can tolerate. Also, continue moving as you normally would to the extent that you can. If your back pain has not improved from the onset of the injury within 5-7 days you should schedule an appointment with a physical therapist or your primary care doctor.

3 Tips to decrease shoulder pain

Fix your sitting Posture: Changing how sit can actually help with shoulder pain. People who sit with poor posture which would include rounded shoulders and a forward head have an increased risk for developing shoulder pain. This is due to how poor posture affects the shoulder joint. With this posture your humerus sits too far forward within the joint putting you at increased risk for shoulder impingement syndrome. This means you will be compressing your rotator cuff tendons/bursa, which is called sub-acromial impingement syndrome. The good news is this can be fixed!

Exercises to Perform to decrease shoulder pain

  1. Sitting in an upright posture (pretend someone is pulling a string at the top of your head) you are going to bend your elbows to 90 degrees with with palms facing up. Next, you will move your hands apart while keeping your elbows by your side, finally you will try to pinch your shoulder blades together. Hold each rep for 5 seconds and repeat 20 times. Do this exercise 2-3 times per day for best results.
  2. For this next exercise you are going to perform sliding your hand up a wall(also can do this in the shower to decrease friction). Stand with your shoulders parallel to the wall, bend your elbow and place your hand (the side of your hand closest to your pinky finger) against the wall. Slide your arm up the wall within a pain free or pain tolerable range of motion. As slide your arm up, your elbow should be straightening. Hold for 5 seconds at the top of the stretch and repeat 15 times. Do this exercise 2-3 times per day as well
  3. If the first two exercises are too painful I recommend starting with a shoulder pulley which can be found here. I recommend sitting in a chair while the pulley is hooked to the top of a door and performing shoulder flexion active assisted range of motion for 5 minutes. Perform the pulley exercise two times per day. If these exercises are increasing your pain I recommend seeing a licensed physical therapist.

Dr. Lance Berry DPT