What do you do when you have pain that hurts so bad that you can’t stand up? That's what it feels like for the 64% of people with back pain that have to miss at least one day of work because of illness or injury. For most people back pain is something that happens at least once in their life but it generally goes away by itself after a few days, or weeks, at most. Unfortunately this is not the case for everyone. For many lower back pain sufferers the pain persists and becomes agonizing, often lasting for weeks, or even months, or keeps recurring from time to time.
The National Institute of Neurological Disorders And Stroke defines chronic back pain as “pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated.” Around 20% of those who experience acute low back pain will go on to develop chronic low back pain with more persistent symptoms within a year. Low back pain is one of the most common causes for missed work days and adults with back pain spend almost 200 million days in bed each year!
When speaking to people who have experienced that “pulled my back, can’t stand up straight” feeling, they often describe their experience as scary and "very worrying". One minute you are fine, the next you can’t walk or stand up straight. A simple round of golf or a weekend workout that normally doesn't cause any issues can suddenly leave you wondering what went wrong? Back pain can range from an acute, sharp type of pain, to feelings of numbness in your legs, which can be quite disconcerting.
Often we can think that the more serious the pain, the more serious the injury. Interestingly enough, this is actually not generally the case with low back pain. With this belief in our minds it isn't really a surprise to hear that people still believe in the old advice to lie down on the couch and rest. The most excruciating back pain can actually end up resolving on its own, while more serious conditions,, like degenerative disc disease, are more sneaky and chip away at your spine over months and years.
And it’s not just older folk that experience low back pain. While back pain affects men and women of all ages, it is believed that adults of working age are the most vulnerable. Data from the South Manchester Back Pain Study and the Southampton Back Pain Survey suggest that the prevalence of back pain actually decreases sometime in our 60s, although more research is still needed to confirm this. This means that we are most likely to experience back pain during our 30s, 40s and 50s. It is theorized that older patients tend to suffer more from joint pain and osteoarthritis rather than nonspecific low back pain.
When Should I Be Worried About My Back Pain?
There are some sensations that can indicate something more serious than just a pulled back.
Radiating pain - this is pain that moves towards your legs and/or glutes. It is sometimes described as a “shooting pain”. This type of pain could indicate a compressed/pinched nerve.
A sudden weakness in your legs - conditions like sciatica or spinal stenosis can be caused by compressed nerves in the spine, leading to weakness in your limbs. If you are experiencing a sudden weakness in your legs this could also be an indication of a stroke, even though this is pretty rare.
Sharp pain - pain that is sharp versus pain that is dull and achy can indicate the presence of a torn ligament or muscle. Sharp pain can also indicate an issue with internal organs located towards the back or side of your body.
Numbness / pins and needles - if you are experiencing numbness in the area around your glutes or groin you should seek immediate medical attention. This type of pain is referred to as “saddle anesthesia” and it can be a sign of a serious spine or nerve condition.
Incontinence - if you have a loss of control over your bladder or bowels, combined with low back pain, you might have a spine infection such as discitis. It could also be a sign of a serious nerve compression.
If you have weakness, numbness, and incontinence all together, you could have a condition known as cauda equina syndrome - a serious illness that is a medical emergency and usually requires immediate surgery to prevent permanent spinal cord nerve damage.
What Can I Do To Help My Back Pain Get Better Fast?
For chronic low back pain there are some things that you can do to speed up the healing process.
Do NOT rest for too long. This advice is very much outdated and the new international guidelines for treating low back pain recommend that you maintain mild to moderate activity levels after a back pain episode.
Gentle stretching. Stretching to the point of gentle tension - not to the point of pain - can help to warm up the muscles and gently help you improve your flexibility again.
Exercise therapy. Activities such as yoga, tai chi, and Pilates are recommended as activities that can help to strengthen muscles, improve flexibility, and reduce pain.
Psychosocial interventions. Stress plays a huge role in low back pain injuries. When we are stressed and rushed our muscles are more tense and are more susceptible to injury. Taking time each day to engage in mindfulness activities, deep breathing, or meditation, can make a big difference to your back health.
Back pain is often painful and scary and yes, it can hurt so bad that you can't stand up. It is very important, though, not to give in to any temptation to lie down and rest for too long. Guidelines recommend trying to maintain a moderate level of your usual activities as long as it doesn't cause more pain. If you are concerned about your pain you should definitely consult with your healthcare provider to make sure that there are no red flags or anything more serious going on.
Studies have shown the importance of maintaining activity levels to ensure that your back pain heals as quickly as possible. A recent publication from Harvard Medical School stated that “we now know that an extended period of bed rest isn’t helpful for moderate back strain at any stage of therapy”. If you are looking for ideas on how to stay active and exercises that you can do that won't make your back pain worse, check out our article on Best Exercises For Low Back Pain.