I am a Physical Therapist and I see back pain patients in my clinic every week. Some of them come through my door with severe pain and spasms in their low back. The first thing I do is to educate them on how to get rid of the immediate pain and restore some natural movement in their spine.
In most cases a major contributing factor to acute back pain is the back muscles themselves. The muscles in the low back react to the injured spine by tightening up and restricting motion and blood flow. This is the body's natural reaction to pain in joints and bones. However when it comes to the back this can actually be an obstacle to healing.
My initial treatment focuses on five things that can help reduce a patient's pain immediately.
Sitting Position Sitting is often the most painful position for people with an injured back. Avoiding prolonged sitting is crucial if sitting is painful. Substituting a standing position for a seated one can go a long way to relieving low back pain. If a sustained standing position is not possible then it is important to set a timer to remind yourself to get up from sitting every 20-30 min to walk and stretch. Sitting in a slumped or flexed low back position can also be a source of pain. Slumping while sitting can exacerbate symptoms in the low back.
Stretching Low back extension stretches can be very effective at restoring natural motion in the low back. Simply stand with your palms on your low back and lean backward pushing the pelvis forward, arching the low back. Hold this for 5-10 seconds and repeat about 10 times, one session per hour.
Heat or Ice Heat or ice can be used on the low back. Which one you use depends on how the back reacts. The one that feels better afterward is the one that should be used. Most of the injuries to the low back are too deep to be directly affected by the application of heat or ice. There is no right or wrong with heat or ice. However the back muscles that react to the injury can be affected by temperature (heat or ice) and this can lead to a decrease in pain and stiffness.
Blood Flow Any gentle physical activity that can be done without increasing the pain is good. The deeper structures in the spine that are generally injured need increased blood flow to expedite the healing process. Activities such as walking, swimming, recumbent biking etc. help increase your core temperature, which in turn facilitates blood flow down to the injured area in the spine.
Medication In some cases acute low back spasms can be so intense that the only thing to be done is to take muscle relaxors and anti-inflammatories as prescribed by an MD. These medications can be essential to getting the back calmed down to the point where the above measures can be effective.
Addressing the acute pain and restoring natural motion is just the first step in dealing with low back pain. Getting rid of the pain for good requires a well-organized treatment plan that focuses on stretching and core strengthening.