What 4 Things to do FIRST When Back Pain Begins

  1. Stop trying to figure out WHY and just get on with it!

Of course, pain is not normal– it’s your body telling you that something is going on. You do need to pay some attention. Most of the time back pain begins for no obvious reason– you could just wake up with it, or some harmless movement like bending forward to pick something up starts a sudden pain. When this happens, it’s scary. It’s also human nature to wonder what the heck happened, and you can wrack your brain to try to figure it out, but most of the time you won’t know for sure. Most commonly it is cumulative stressors to your back that creates the problem– it finally just has enough, then you’ll do something innocuous– like wash your foot, and you can’t get up. Try to keep moving as best as you can.

  1. How much are you sitting? HOW are you sitting?

It has been shown that people who have desk jobs have more of a risk of back pain than construction workers. Sitting is hard for your back, and your body is meant to move. In life, many people spend WAY too much time sitting– not just at the computer, but traveling to and from work or school, sitting to eat all of your meals, and all entertainment (TV, out for dinner or a pub, reading)– all sitting!

If you’ve been sitting in any chair for awhile, odds are you’re relaxed into it and assumed a slouching position. This slumped posture is the same thing as being fully bent forward as far as your back goes. Fully. Forward. Evidence shows this is a position of vulnerability for your back, and how much do you do it? Every day, likely for long periods. For details on correcting your sitting posture, refer to the post on proper sitting posture.

  1. WHERE is the pain?

Does your back pain stay local, or do you feel something in your butt? Your leg? Is it all on one side or is it both? Does it come and go, or is it truly always there? All important questions you need to assess. If you’re feeling pain away from your back into your butt or lower, that pain is likely referred from your back itself. Even if your leg hurts more than your back, it’s very common that the source of this pain is coming from your back. Location, location, location. It’s the radiating leg pain that you want to address first, and start looking at different back positions to see if any can help the pain.

  1. WHAT happens when you lie on your stomach?

This can be a weird movement for some, and many people never spend time in this position. Lying down on your stomach keeps you not weight-bearing through your back, and has your spine in a fairly neutral position. Try to be here for a few minutes, and just see if any back, buttock or leg pain starts to settle down. This is a positive sign when that happens, but don’t worry if you don’t notice any change.

The most efficient thing to do from here is get to your Physiotherapist or Chiropractor. This person should be asking you the above questions, and you can easily give them this information– this will help form an individualized program that will help you settle this pain quickly, then work to prevent this from happening again!

How Do You Sit?

I’m sure you’ve heard by now that sitting is the new smoking. Many people spend WAAAYYYY too much time each and every day sitting– commuting to work, eating all of your meals, sitting at your desk, and all entertainment (reading, watching TV, dining out, going to a movie or theatre) — yep… all sitting.

Do you ever think about HOW you’re sitting?  Odds are, you tend to slouch in your chair after you’ve been there for awhile. This slumping position keeps your back fully rounded forward and over time, some of the structures can become irritated and cause you pain. People often don’t realize how often in life we get into this fully bent forward position!

Even an “ergonomic” chair that will have some curve built in is often not enough to prevent your pelvis from tipping backward so that your back is rounded.  Many people find it helpful to use a supplemental lumbar roll. This round cushion is firm enough that when you sit and relax into it, your pelvis is not able to tip back, allowing your back to maintain the normal curves that are there when you’re standing.

There are manufactured lumbar rolls you can buy, and we like the McKenzie Lumbar Roll or McKenzie Super-roll because they are firm. We do not receive any money or gain from mentioning this product specifically, we just like them best and this is what we sell at the clinic.  Alternatively, you can make a supplemental lumbar roll by folding a towel in half length-wise and rolling it up so that the roll is about 10-15 cm (~4-5″) in diameter.  Be sure to wrap some tape or elastic bands around it because if you’re constantly having to re-roll it, you won’t use it for long!

Once you have your lumbar roll, sit down in the chair with your buttocks close to the back of the seat, push the lumbar roll down until it hits the top of your butt, and relax around it. The roll should be where your back has it’s natural inward curve, and is just there to support it. Now try to slouch– the roll should be firm enough that it prevents your pelvis from tipping backward.

Often we hear that the roll feels too big or intrusive, and that is because so many people sit slouched that it starts to feel normal, and even a correction toward neutral seems exaggerated. It definitely takes some getting used to! That said, it shouldn’t be aggravating to any back pain that you feel.  If it seems to irritate your back, then you should speak with your Physiotherapist or Doctor to determine if a modification would be better for your back.

A Little Movement Goes a Long Way!

So it has been said that motion is lotion, and nowhere is it more important than your spine! Whether it’s shifting your sitting position or standing up to grab something or going for a little walk—make sure you keep your body moving. Every little bit counts.

Why? Almost all of your bones—including your spine– have a layer of cartilage at their ends that acts as a cushion and help spread the pressure you put through your joints with everyday movements. Surrounding the ends of the joints are capsules that hold a thick fluid that helps to lubricate the joint. When you move around even a little bit, that fluid is pushed around the joint. Another way to lubricate your joints is to drink plenty of water.

While I will still gladly ask someone with back pain to spend time sitting with a supplemental lumbar roll and correct sitting posture, newer research shows that shifting position in the chair frequently is better for spine health. If you have been sitting still for awhile, try rocking your pelvis forward and back several times to change the alignment of your pelvis and spine. This takes only a few seconds and then you can get back to it!

If you’re the type of person that needs to reward yourself for your positive behaviour, it might be worth investing in an activity tracker. The annoying vibration to inform you to move your 250 steps each hour is a helpful reminder, and it’s great to get your accolades at 10,000 steps in your day!

Flexion Inspection

Most back problems are not really muscular.  It sounds weird to say, but so many people’s pain actually starts for no obvious reason, without any trauma. They might wake up with pain, or it might just start in their back after they’ve been sitting for awhile.  It is really common to hear that back pain starts when someone stands up again after bending forward to pick something up.

In life, we all spend WAY too much time bending forward. That forward bending movement is called flexion, and think about it– whenever you sit, are you slouching much?  Do you sit to get to and from work in a car or on transit?  Do you sit at work?  You certainly sit to eat your meals, and when you have a chance to relax you will likely sit more in front of the TV, or reading, or out for dinner or the movies.  Pretty much all our entertainment is in back flexion. Then if you sleep on your sides, your hips and knees are bent, allowing your pelvis to tip backward, and hey, more flexion. Then you bend forward to brush your teeth, sit on the toilet, tie up your shoes, reach into the fridge, etc.  You see my point: we live life in a flexed, rounded forward position.  It is no wonder that eventually your back can have enough and freak out a little.

It is important to make sure you get out of this back flexion quite regularly:  you can try sitting with a lumbar support, change your position at your desk often, get up and move around if even for short periods, and some will find that moving your back into extension (arching) is helpful relief.