Acute low back injury is a common though debilitating injury. Acute low back injury is an umbrella term for a range of different injuries pertaining to the low back, though all back injuries are usually quite painful. Injuring your back can be quite scary because, historically, we have been led to believe that our spines are fragile, vulnerable structures and that a back injury is a life sentence. This is NOT the case. Most acute back pain is managed very simply, which may come as a surprise to you. Rehabilitation does not need to be complicated; pain management is paramount and so is a timely return to normality. So, what should you do if you have hurt your back?
- Depending on the severity of your issue, it is always advisable to see a physiotherapist who can help to develop a management plan.
Physiotherapists have the capacity to assess your injury and identify any cause for concern. Your physiotherapist will test your strength and sensation in your legs, your reflexes, and a bunch of what are called “special tests” to gauge and understanding of the nature of your pain. Usually, these tests are all negative and suggest that your back pain is self-limiting and easily overcome with pain management strategies, movement and return to normal activity. Even so, acute low back pain that radiates into the legs is usually not of great concern, but should it not resolve in a timely manner a referral to a specialist might be considered.
- You most likely will not require imaging
Unless your physiotherapist is concerned about significant injury, which they will screen for (which again, is VERY unlikely), you do not need to get a scan. A scan will not change your management plan. Evidence shows that many findings on diagnostic scans do not correlate with clinical findings, so if you are looking for an accurate representation of “what’s going on”.
- Activity modification is key!
Most of the time, when we hurt our backs, we are told or intuitively believe that rest is best. This is NOT the case! Movement is an excellent form of pain relief and is integral for recovery. Rest is advised in the way of activity modification, not complete rest. Modifications to activity should allow you to participate in your daily activities to the best of your ability, whilst facilitating your recovery. Too much rest can lead to unnecessary deconditioning and delay return to normal activity. You can talk to your physiotherapist about what modifications you can make to your activity and participation.
- Pain management
Short term symptom relief can lessen the burden of acute pain, though it is not going to “fix” it. However, short term pain management strategies can assist you to get moving return to normality. Although not essential, a desire for short term relief is understandable and your physiotherapist and general practitioner can work together to help you. Analgesia, exercises, massage, bracing, heat, and water therapy are some short-term symptom relief modalities that may be suitable to incorporate into your management plan.
If your experience of pain is concerning to you, it is beneficial to find a physiotherapist who can educate you about pain science, injury mechanisms and tissue healing, and provide you with reassurance so that you have the self-efficacy and confidence to manage your acute experience of pain. Catastrophic thinking, rumination, fear avoidance and maladaptive coping strategies may hinder your recovery, so finding a physiotherapist that you trust, who can guide you and empower you in your recovery makes all the difference!
- Expect a full recovery!
Most people believe that once they injure their back, it will never quite be the same! This is not the case and can quite often be a self-fulfilling prophecy. The low back is a robust, adaptive, and strong structure and has a great capacity for recovery, just like every other structure in our body. Pain is complicated, and sometimes individuals do go on to develop persistent pain, though this very rarely has anything to do with the integrity of the spine. Injury can be overwhelming, but you should expect to make a full recovery after an acute bout of low back pain.
I hope this article has been insightful for you. This is a basic guide and is intended for the purpose of management of acute benign low back pain. Please discuss with your health practitioners the most suitable way to manage your back pain- just know that, most of the time, it is nothing to fret over!