Last week we took a look at the causes of back pain. Depending on whether your back pain is acute or chronic, here are some few tips on what you can do to manage it.
Acute back pain:
Apply heat and ice
Apply an ice pack to the affected area; you can create one using a bag of frozen vegetables. Don’t put the ice directly on your skin, as it can lead to a cold burn. Put a wet cloth between the ice and your skin. If ice doesn’t work, try using mild warmth from a hot water bottle. Don’t put the hot water bottle directly on the skin – cover it so it isn’t too hot. A hot bath or shower might also be helpful.
Usually pain medication such as paracetamol or ibuprofen helps – If you still need them after more than a week talk to your doctor. Topical anti-inflammatory gels such as ibuprofen can be massaged onto the skin over the back.
Try to relax to reduce muscle tension which creates a vicious cycle of pain. Take a warm bath or listen to relaxing music or have some massage. Stress can also create muscle tension, causing a loss in flexibility that can lead to back pain. To reduce stress, try exercise, yoga, meditation, getting more sleep or listening to music.
The body produces endorphins which are natural painkillers when you exercise. Some types of exercise, such as walking and swimming, don’t put too much stress on your back. Research shows moving around is much more helpful than lying in bed.
Gentle exercise can build strong back and stomach muscles i.e. core muscles to support your spine and maintain flexibility.
Walking, cycling helps, swimming is especially good as it strengthens the muscles while supporting the body with water. However, get professional advice and evaluation before starting any exercise regimen from your doctor or physiotherapist and get exercise tailored to your needs.
Exercise dos and don’ts
When exercising, make sure you do:
- Choose exercises suitable to your level and work up gradually
- Take things at your own pace
- Drink water before, during and after exercise
- Do gentle warm-up stretches before and after exercising
- Wear good footwear and appropriate clothing
- Continue with an activity if it hurts your back
- Eat a large meal before exercising
- Perform exercises on a stone or concrete floor
- Exercise if you feel ill
- Do exercises that put weight or excessive strain on an acutely painful joint or spine
Getting back to normal
In most cases, the back recovers naturally if allowed to do so and the pain should settle in a couple of days. Once this has happened, continue getting back to normal activities and try not to stay in one position or do any one activity for more than 30 minutes.
Avoid lifting, bending or twisting until the pain has gone for a few days. Refrain from returning to the activity that caused the pain for a week or so, even if you feel better, and gradually build up your exercise and activities day by day.
Dealing with back pain at home
The best way to sit down is to do it without bending your back. Stand in front of the chair with one foot behind the other, almost under the chair. Bend your knees, and at the same time place your hands on the arms or seat of the chair. Lower yourself gently into the seat. A chair with arms makes this much easier.
The following can also help back health in the home:
- Make sure work surfaces are a comfortable height so you don’t have to bend your back
- Use a ladder or stable chair when painting or cleaning – don’t stretch too far
- Squat or kneel when cleaning the bath or reaching low shelves
- Use an upright vacuum cleaner or broom and keep it close to your body
- Ensure easy access to each side of the bed so you don’t have to stretch when making it, and kneel or squat to tuck in sheets and blankets.
- Take regular breaks from time-consuming tasks
If you have children, make sure you:
- Bend your knees to pick up a baby – don’t twist
- Kneel down to talk to toddlers rather than picking them up
- Adjust the height of the cot so you don’t need to bend, or choose one with drop sides
- When unloading a pram’s shopping tray, always bend from the knees
When getting into bed, sit on the edge, lower your body on to one elbow and shoulder and draw up your knees and then feet. Reverse the procedure to get out. If you’re experiencing back problems, you might want to try the following:
- Replace a sagging mattress
- Lie on your back with a pillow under your knees or on your side with a pillow between your bent knees
- Don’t have too many pillows – they support your neck, not strain it
Your bed should allow ease of movement but mould to the contours of your body. Don’t assume a bed marked ‘orthopaedic’ is what you need – the word can sometimes be used as a marketing tool.
To test if a bed is giving you the correct level of support, lie on your back and slide your hand, palm down, between the small of your back and the mattress. If you can:
- Work your hand through with some resistance, the bed support is probably about right
- Slide your hand easily through a large gap, the bed is probably too hard (or saggy)
- Hardly force your hand through at all, the bed is probably too soft
If you’re in pain, the easiest way to turn in bed is to bend your knees, bringing your heels up towards your buttocks. Let your knees fall to one side and as the weight of your legs takes you over, bring through your hip and shoulder – don’t twist.
Dealing with back pain out and about
In the car:
- Adjust your seat properly so your arms have a slight bent at the elbow when your hands are on the steering wheel
- Support your lower back with a small cushion or rolled up towel
- Take regular breaks on long journeys and get out of the car for a stroll and a stretch
Dealing with back pain at work
Employers have a responsibility to ensure their employees don’t get back problems as a result of working practices. They can face law suits if they fail to identify and assess risks to staff and take preventative measures to overcome those that are found.
Employees also have a responsibility to look after their own backs but they should be properly trained in back care by their employer.
Preventing work-related back problems
If you spend much of your time at work sitting at a desk, there are steps you can take to reduce your risk of back problems.
A properly adjusted chair reduces the strain on your back.
- Sit up straight
- Make sure your knees are level with your hips
- If your chair doesn’t provide enough back support, use a rolled up towel or cushion
- Are your feet flat on the floor? If not, use a footrest to relieve pressure on your joints and muscles
- Avoid crossing your legs or sitting with one (or both) twisted beneath you
- Your computer monitor should be about 30cm to 75cm (12in to 30in) from your eyes – a good guide is to place it at arm’s length
- The top of the screen should be roughly at eye level
- Position the monitor so it reflects as little overhead lighting and sunlight as possible
- Keep your wrists straight, not bent up or down – a wrist rest may help
- Your elbows should be vertically under your shoulders – position the mouse as close to you as possible to allow this
- A mouse mat with wrist pad can help keep your wrist straight
- Learning keyboard short cuts may also help
- Position frequently used objects, such as a telephone or stapler, within easy reach – it’s important to avoid repeatedly stretching or twisting
- If you spend a lot of time on the phone, consider using a headset – holding the phone sandwiched between your ear and shoulder can strain the muscles in your neck.
Take a break
- If your job is computer-based or you sit for long periods, make sure you take regular breaks – for every hour at your keyboard or desk, have at least five to ten minutes’ rest.
- Get up and move around
- Rest your eyes regularly – look away from the screen and focus on something in the distance for a few seconds
How to stand
- Don’t round your back – imagine you are being lifted by a string fixed to the top of your head
- Avoid hunching your shoulders and tensing your neck when stressed
- Wear comfortable, low-heeled shoes – high heels put pressure on the lower back.
How to lift
- Always look at alternatives to lifting – can you push or pull?
- Lift only what you can handle and get help if you need it
- Bend your knees and keep your back straight and your feet apart when lifting
- Avoid lifting and twisting at the same time
- Always lift and carry close to your body
- Bend your knees rather than your back when putting a load down
Remember the warning and red flag signs I wrote about last week however, and report to your doctor quickly if you have any of them.
Chronic back pain
Chronic pain is more difficult than acute pain to treat and sometimes doesn’t respond to treatments such as over-the-counter painkillers and physiotherapy.
People with chronic pain often need specialist advice and support. Sometimes, they are referred by doctors and physiotherapists to pain clinics.
What doctors can do for back pain
There’s no quick fix for most back pain and your doctor is unlikely to be able to ‘cure’ you. However, they will be able to:
- Check you don’t have a serious condition
- Discuss your posture and activity level
- If needed, help with a weight-loss programme
- Prescribe another type of painkiller
- Refer you to other health practitioners who can help
- Treat osteoporosis
Other people who can help back pain
If your back problem doesn’t clear up quickly, your doctor may refer you to another health practitioner. This is most likely to be a physiotherapist or another doctor, and may involve a visit to the hospital for examinations, tests and treatment or you can talk to a properly trained physiotherapist, osteopath or chiropractor or acupuncturist, but this can be expensive.
Remember your back problem is unique – just because a specialist helped a friend it doesn’t mean they’ll be able to do the same for you.
As always, I urge you to keep informed and stay healthy!