Low back pain can happen to anyone - and actually the chances of it happening to you are pretty high. 80% of us will experience it at some point in our lives, which makes knowing how to handle it very important. An experience with low back pain can be very scary as you don’t know how serious it is, how soon it will fix itself, or if it is going to happen again.
The good news is that most cases of acute low back pain will go away by themselves after a few days or weeks. Knowing what to do while that happens can be pivotal in helping the healing process and in reducing the chances of it happening again. No one like to miss out on work, important meetings, or big social events because of an illness or an injury, and low back pain is a common culprit in all of these things.
So, if it has happened to you, what can you do to help speed up the healing process and to help prevent it from happening to you again? Should you go to the ER, call an ambulance? See a chiropractor?
Emergency Room Visits For Low Back Pain
The presence of “red flags” that accompany low back pain should always be immediately investigated by a healthcare professional (see our blog on Red Flags And Low Back Pain) and patients with co-morbidities such as hypertension or diabetes may potentially be admitted to the hospital following an ER visit. Research has shown however, that there are almost 2.6 million annual emergency room visits for low back pain issues. Nearly 30% of these patients do not receive adequate care and end up reporting functional pain or impairment 3 months later, putting them at risk for developing chronic low back pain.
When it comes to ER visits, one in three visits will include an imaging exam which has been criticized by some healthcare professionals as unnecessary. This overutilization is occurring despite industry guidance to only image cases with “red flags” so as to not expose patients to unnecessary costs and radiation. Data also suggests that around 40% of patients who visit the ER are treated with an opioid during the visit, and 40% are prescribed an opioid on discharge, despite international guideline consensus that opioids should not be used to treat low back pain.
So what should you do for low back pain?
Well, the overwhelming evidence and international expert guidelines recommend staying active for low back pain. Participating in low impact aerobic exercise, avoiding bed rest, and engaging in strengthening exercises to help support the spine are all highly encouraged activities for assisting both acute and chronic low back pain. These treatments are not only helpful for reducing the amount of time that people suffer from low back pain, but they can be helpful in preventing future flare ups or injuries. This article takes a look at some of the most popular and recommended activities and how you can do them at home, by yourself.
Many guidelines and physiotherapists recommend Pilates for low back pain. Pilates is a form of low impact exercise that looks to strengthen your muscles, while helping with posture and flexibility. Pilates was originally created to help rehabilitate injured athletes and to help muscles recover from strain or injury. Pilates has a high focus on targeting and strengthening your core muscles to help support your spine. The exercises performed in a typical Pilates class often target poor posture, and help to stretch and relieve tight muscles.
Pilates is a low impact, yet very powerful workout that is proven to help low back pain and the best news is that, while there are many classes that you can do in studios with the help of special equipment called reformers, there are many moves that can be performed in the comfort of your own home with very little equipment necessary.
If you are looking to try a Pilates workout at home you will need the following:
Mat (can be any mat, like a yoga mat)
Exercise ball (can be a small ball that is not too hard or too inflated - around the size of a soccer ball)
Pilates ring (nice to have but not 100% necessary)
There are lots of free apps that you can try, as well as seeing if there are any local studios where you live that will offer a free online trial class. Here are some of our favorite Pilates apps:
5 Minutes Pilates Workouts
30 Days of Pilates
When you think of a massage, most of us picture luxurious spas and Swedish massages. But the truth is that there are some tips and tricks to doing a low back massage at home, by yourself. Massage has long been recommended for treating low back pain as it improves blood circulation and relaxation. Improving circulation helps the muscles to recover from any soreness they may feel after physical exertion. Relaxation helps to reduce tension and inflammation in muscles, as well as helping to improve range of motion and flexibility for the future.
When it comes to the science supporting massage for low back pain, in 2011 a study showed that participants who received regular massages for 10 weeks reported that they were less likely to use medication for their low back pain than those who did not receive massages. The study participants also reported fewer days in bed and fewer days of lost work or school. After 6 months these improvements were still there, but unfortunately, after one year they had disappeared.
Some healthcare practitioners don’t see massage as a final treatment or solution, but as another tool to use in the management of low back pain. Low back pain is so intensely painful and debilitating that it can be really hard to stay active, which only makes back pain worse. Regular massages can help to break up that pain-inactivity cycle by helping the muscles to be more relaxed and flexible enough to help patients keep moving.
With just a few tools and some basic massage techniques, you can ask a friend or family member to give you a low back massage or you can make use of some of the latest in home massagers (see our gift guide for reviews on some of these).
How to do an at-home massage with tennis balls:
Lie face up on a mat or the floor and gently place two tennis balls under your back (one on each side of your spine).
Keeping your feet on the floor, gently bend your knees.
Slowly roll yourself up and down, extending and bending the knees accordingly, while the tennis balls roll up and down your back.
If this is too challenging for you, try one of these highly recommended tools:
It is important to know that the updated clinical guidelines from the American College of Physicians include massage therapy as an option for the treatment of acute low back pain, but not for chronic low back pain. Most international guidelines do recommend spinal manipulation for low back pain, which often includes massage therapy,
Biofeedback is a technique that is used to control some of your body’s functions, like pain sensations and heart rate. With biofeedback, electrical sensors are connected to your muscles to help receive information on your body. This feedback can help you to make subtle changes in your body, such as improving muscle relaxation that can help you to slow down your breathing, your heart rate, or relax your muscles. Basically, biofeedback helps you to control your body, often with the aim of helping to improve physical performance or to help with certain health conditions. The principles of biofeedback depend on us being able to measure the signals coming from our muscles, EMG is one tried and true way that we can do this.
EMG (Electromyography) is a way that we can measure muscle activity and receive the biofeedback to help us learn to control our muscles. The signal comes from our muscles and it is then interpreted by special algorithms to give it meaning to people. Using this information, the use will learn to decrease muscle tension.
Some of the ways that EMG can help with low back pain are:
EMG can measure muscle activity
Help us understand how we are using our muscles
See which muscles are being used and if we are using some more than others, creating imbalances.
See which muscles are being used too much
See which muscles are not being used enough
Help us learn muscle balance
Unfortunately many of the high quality EMG units are very bulky and expensive and need experts to interpret and analyze the data. This means that often EMG can only be done in hospitals and sports clinics. As technology evolves, however, more options are becoming available for customers to use themselves.
Digital Physical Therapy
A growing area of technology is digital physical therapy. With the rise in popularity of telehealth services to help patients who are homebound or in remote areas, digital physical therapy also looks to join in the trend. Online physical therapy programs work much like the traditional in-person therapy, but without the in-person bit. Physical therapists are able to do virtual appointments, including assessments and workouts, and can assign patients virtual exercise homework as well.
Telehealth is a wonderful way to help reduce wait times, decrease expenses in traveling or child care, reduce the amount of time people need to take off work for appointments, and increase access to care for many people. A study published in the journal Federal Practitioner showed that veterans who might not otherwise seek PT or who are unable to travel to a clinic can benefit immensely from remote rehabilitation sessions.
Companies such as Hinge Health, Kaia Health, and Sword Health are bringing their own flair to these digital physical therapy programs with apps and sensors that can track your range of motion to help you see if you are staying within the parameters of an exercise and doing it correctly. They can also measure your flexibility.
At the end of the day, the most important thing that you can do for your low back pain is exercise. Experts across the globe unanimously agree that keeping exercising is one of the most effective, but also under-utilized treatments for low back pain.
Exercise strengthens the muscles that support the spine, which takes pressure off the spinal discs and facet joints. Exercise is also key to improve circulation, which in turn distributes nutrients throughout the body - including your spinal discs. Aerobic exercise is a great way to increase blood flow and circulation, as well as reducing stiffness and improving flexibility.
Swimming, walking, yoga, Pilates, tai chi and many other types of low impact activities are all equally beneficial for strengthening low back muscles and helping with flexibility. For more information on different activities, see our blog on Best Exercises For Low Back Pain.
As you can see, there are quite a few things that you can do from the comfort of your own home, to help reduce low back pain and get you moving again. The key thing is to make sure that you avoid prolonged bed rest after an incident. Keep moving but make sure you see your healthcare provider if you have red flags or other chronic underlying conditions that may accompany your low back pain.