Obviously, stressing/straining the local muscles, ligaments, joints etc. will cause pain and discomfort, but as with the shoulder, other structures in the body are also capable of ‘throwing’ pain to a distant location.
The kidneys, small intestine, colon/rectum, stomach, pancreas, spleen, gallbladder etc. are all known to cause low back pain.
Surprising few of the female readers of this blog, the ovaries and uterus (womb) are also more than capable of causing low back discomfort (especially at ‘that time of the month’ or during pregnancy); as are problems with the blood vessels, heart, various types of infection, cancers, and hormone disorders.
Because of this, it is always important to have your back pain screened by an appropriately-trained healthcare professional, especially if you have noticed other changes before or after the onset of the pain.
For the purposes of this blog, we will ignore all of the slightly more esoteric factors, and instead focus on non-specific (or mechanical) low back pain. As mentioned above, this is usually due to irritation of the moving parts of the spinal column, namely muscles, tendons, ligaments, vertebral bodies, intervertebral discs (the ‘shock absorbers’ between the vertebrae), and facet joints (the joints between one level of the spine and another).
Most mechanical low back pain resolves on its own, most often within 2-4 weeks. However, that can feel like a long time when you are in pain! So, what can you do to help speed that process up?
The problem with inactivity is that it impairs the blood flow to and from the affected areas, slowing the healing process. The spinal column has up to eight (depending on definition) pump systems that help to support its health, which rely on normal physiological (to do with normal function of living organisms and their systems) movement to drive them. This is, in part, what osteopathic treatment does: to mimic these normal movements and restore some of these pumps. It also helps to ‘show’ the body that nothing catastrophic will happen if it allows a little bit more movement through the area (the influencing of the central nervous system we were talking about earlier), thus promoting further relaxation and decrease of nociception (the nervous system’s response to harmful/potentially harmful stimuli, i.e. the first part of feeling pain).
Having said all of that, exercising when your back is in full spasm (i.e. just after the injury) may be counterproductive, if the body feels like it is under attack, it will try to protect itself (largely by tightening up the muscles further). Make sure you listen to your body, and don’t perform any movements or activities that actually hurt (some discomfort is normal, and to be expected). If you cannot move at all without pain, then consider:
Heat & Cold
Heat is very good for helping tight and sore muscles relax, and increasing the blood flow to an area. How good does a nice hot bath (or shower) feel after a long day of working hard?!
However, both have their caveats: Heat will aggravate any inflammation present, and part of the inflammatory process is to increase fluid in the area (swelling), so the last thing you need is more blood flow to the injured part. Cold also has the potential to cause muscles to contract to protect themselves and keep warm. So, the golden rule is: if you put on ice/heat and it makes it feel worse, then stop! Ask your osteopath whether heat or ice would be more appropriate given the nature of your injury.
Pharmacological (drug) management
Please note: I am not qualified to give pharmaceutical advise. Always read the label, and consult your doctor or pharmacist regarding the suitability of any given medication for you and your condition.
Stretching and Exercise
Maintaining mobility and flexibility is one of the biggest things you can do to help prevent injury, but in the instance that it’s a little bit late (after all, you’re reading this looking for tips as to how to manage your existing low back pain), there is also a lot you can do now. In general, the basic tenet is that movement is medicine, and both stretching to relax muscles and general mobilisation (taking the joints and muscles through their normal range repeatedly) can help significantly with your symptoms. For further details, please see here.