Lower back pain is very common; in fact, research suggests up to 80% of adults in the UK will experience back pain at some point in their life.
This blog post will discuss musculoskeletal back pain caused by tightness and dysfunction in the muscles surrounding the spine and pelvis. Just to note, if you do experience new persistent back pain, please ensure it is assessed by a medical professional first.
It is important to understand that pain is mostly a helpful biological mechanism that tells our body that something is abnormal, damaged or putting us at risk. It is our body’s way of telling us to stop doing something or to pay attention to something.
Acute pain can usually be associated with or traced back to a specific injury or incident. In the following days, weeks or short months, our pain will follow a negative correlation with healing time; the more time that passes, the less pain you feel as the body heals. Examples of this are a sprained ankle, a fractured bone or post-surgical pain. The pain is present to remind your body to rest and allow it time to heal.
Chronic pain is different, as it does not tend to serve the same biological or survival purpose. It will persist after 12 weeks and does not follow the same pain vs healing time pattern as acute pain.
Musculoskeletal causes of acute back pain include:
- Muscle or ligament sprain of the surrounding muscles of the spine and pelvis
- Muscle spasm of the surrounding muscles of the spine and pelvis
- Herniated (‘slipped’) disc in the spine
Chronic back pain will persist for longer than 3 months, with no clear cause or that persists after the initial injury has healed. This can be more common during cancer treatment, especially during or after surgery or chemotherapy, where you may have been mobilising less than usual.
It is important and empowering to know how to manage your back pain, in order to look after yourself and to keep doing the things you enjoy. We will look at three different ways to manage your lower back pain:
1) Keep moving!
This is one of the most important rules for managing lower back pain. After an initial injury, resting more than usual may be helpful for the first 48 hours. Beyond this, gentle movement will help to improve pain and prevent further complications. Start small and build up as you can tolerate.
Avoid high impact activities that involve jumping, jogging or jarring movements. This can irritate the soft tissues in the back and cause them to tighten more in order to protect your spine. Low impact activities such as walking or swimming (note: be mindful going to a public pool if you have low immunity!) are usually recommended.
2) Stretching and strengthening
The following exercises are helpful to maintain mobility and strength around the spine and pelvis and prevent recurrent injury/pain. If you are unsure on how to do these exercises, please get in touch or ask Sarah! Exercises may feel uncomfortable, but should be pain-free. If they are painful, ask for advice or come back to the exercise at a later time.
- Bridging (lying)
- Squats (standing)
- Cat-cow stretch (4-point kneeling)
- Knee hug stretch (lying)
- Lower back rotation (lying)
- Pelvic tilts (lying or sitting)
3) Non-pharmacological pain management techniques
Using pain relieving strategies, such as TENS, heat or cold, are great ways to manage your pain without using medications (although you should always take these if instructed or if required!)
TENS machines can be purchased from a pharmacist or online. A physiotherapy can guide you on how to best use a TENS machine. You must not use a TENS machine:
- If you have a pacemaker
- Are pregnant without advice from a health professional
- In the shower
- While sleeping (if using to help you get to sleep, you can select a timed setting)
- Over an open wound
- Over a recent radiotherapy site
- On any part of your head, face or throat
- Over your chest and your upper back simultaneously
Outside of this, a TENS is generally an effective, cost-efficient and low risk way of managing pain relief. It works by interrupting the pain signals being sent to your brain from your back. Imagine the feeling when you stub your toe and you rub it to reduce the pain. This is the same thing; overriding a pain signal with an alternative stimuli or sensation.
Heat can be very helpful in managing back pain and is a natural technique that has been used for centuries! Using heat is not suggested in the initial 72 hours after an injury, as it can increase swelling. It is important to note that not all swelling is bad! Swelling means our body is delivering all the nutrients required for healing the injured area, which is positive.
The benefits of heat are:
- Relaxing the muscles, helping to minimise spasms
- Causing vasodilation (‘opening the blood vessels’) which increases blood flow to the area and increases the delivery of required nutrients for healing (i.e. swelling)
- Providing an alternative sensation to override pain signals, similar to a TENS machine
Cold therapy usually involves using ice compresses over an area of injury or pain. It is most commonly used in the initial 72 hours after injury, to reduce excessive inflammation/swelling which can cause increased pain. After this, it can be used alternatively with heat, to maintain a manageable level of inflammation and reduce pain.
The benefits of cold are:
- Numbing the area for a temporary period to relieve pain
- Causing vasoconstriction (‘narrowing the blood vessels’) which reduces blood flow to the area and decreases the delivery of swelling
- When removing the ice, the blood vessels will re-dilate and flush away inflammatory waste products, helping with the healing process
When using either heat or ice, it is important to ensure there is a layer between the temperature source and your skin. Do not use heat or cold for more than
Generally, back pain will resolve after a few weeks if adhering to the above advice. Aiming to maintain normal function where possible is always best!
With a known cancer diagnosis, it is advised that all new persistent back pain is assessed by a medical professional, as it can sometimes be a sign of another medical issue, such as kidney infection, conditions or cancer of the reproductive organs, cancer of the spine, fractures or chronic spine conditions (such as osteoarthritis, rheumatoid arthritis or spinal stenosis). If your back pain is accompanied by symptoms such as nerve pain, changes to bladder and bowel, numbness, increased pain at night, weakness in the legs or fever, it is important to seek immediate medical advice.
If you need any further support, reach out to me at hannah@strongerthan.co.uk!