Living with back pain is difficult stuff. I know because I’ve been managing it since 18 years of age thanks to genetics and certain decisions – more on that in another post. As a Physiotherapist, I hear patients report not only physical pain but in a lot of cases financial and mental stress as result. Back pain can be especially impactful to your true or normal self. Changes in everyday activities range from how you get out of bed in the morning to how many hours of physical work or past times you can do. After living it and having hundreds of conversations with patients over the years, this is what both my colleagues and I repeat over and over and what patients say they wish they knew all along. So here goes: (as always this is not to replace your medical recommendations – see our disclaimer at the end):
1.Trust that your pain will get better
There is really something good that comes with a positive outlook and belief in a good future. Research is showing us that those who dwell on the negative aspects, like the limitations, impacts and pain, often do worse. The vast majority of low back pain episodes improve over time and if you tend to keep moving ahead and think positive thoughts then this goes a long way toward maximizing recovery. In Western Newfoundland, our long winter months and lack of sunshine can get folks down and this issue can add to negative thinking surrounding back pain. Seeking enjoyable winter activities outside is key to survival in my humble opinion (speaking as an individual who has grown up in Labrador and raised a family here on the West Coast). However, for clinical issues like depression, anxiety and mood disorders we need to seek professional help. These services should be adapted as easily as you would seek a doctor for your physical health. Combining counselling with Physiotherapy/Massage/Chiropractic is often an effective multi-disciplinary approach.
2. Walk as if you were normal; walk more often
I am certainly not saying everyone with back pain should keep doing usual activities and ignore the pain. However, long term change in walking patterns is highly problematic. When you suffer low back pain in the first 24 hours then by all means I recommend you limit strenuous activity. In more severe cases, you may find yourself limping for a few days adopting a forward leaning posture in order to tolerate short walks to the washroom. Sometimes, fear of what might happen if you stand up straight weighs on the mind and a shortened leg stride with short arm swing results. A key message here is that edging yourself back toward a normal walking pattern as soon as possible is key to preventing further problems. This is where a good therapist assessment comes in – often people need help with reassurance that everything is okay and guidance on what normal walking is. Yes – folks need help returning to normal walking. Its a fact.
We often hear from patients especially in the Corner Brook area that the hills and unsafe slippery conditions prevent walking. Here are some solutions other patients have found:
- Civic Centre walking track
- Gym membership to use the treadmill (CounterBalance, Forever Young, YMCA)
- Buy a used treadmill just to get you going (Facebook classifieds, Kijiji, NLbuyandsell)
- Corner Brook waterfront is flat
- Steady Brook access road is flat
3. Keep moving the back
Do you remember bedrest as a treatment for back pain? This has fallen out of favor in light of medical research but people often tend to adopt a low activity “because activity hurts” approach. My alert here is that stiffening your back (think moving like you have a cast around your waist) is detrimental to the majority of simple low back pain sufferers. So, combining a strange walking pattern (see #2) with a stiffened back is a recipe for prolonging recovery time. Common sense is needed here. If you bull forward to a degree that your back pain increases, sleep is worsening, and your movement reduces then you should realize something isn’t quite right. Maybe you are overdoing a particular “type of motion” that you should be limiting like excessing bending or twisting. The point is that limiting “all” bending and twisting is as bad for you as excessing bending/twisting. Perhaps you simply need some of the tissues around the back relaxed or inflammation around a back joint reduced to allow those movements. For instance, in one case a patient ignored the pain and kept slugging on but it was the angle of how they performed their work resulted in ongoing pain. The solution was simply education on what to avoid and take tension from the back with a treatment. Maybe you need an evaluation and adjustment that allows free movement at a particular area. Again, this is where professional consultation is helpful.
This list isn’t exhaustive. I have not covered the topic of snow clearing which is a significant concern in our unique part of the world. An idea for another post could be a video reviewing proper use of the snow blower with back pain. That said, if you are interested in the topic please scroll through past posts where we did cover the shovel issue!
In clinical practice we focus on educating people on specific exercises and treatments that are helpful for their specific “type” of back pain. Research on benefits of movement and exercise for lower back pain is clear. However, a good approach to management of persistent lower back pain is not cookie-cutter but rather each person should receive an individualized evaluation and specific recommendations. Our staff of Physiotherapists, Chiropractor, Massage, and Physicians believe in treating the individual in a positive and goal focused environment. We help you achieve your goals from summiting mountains and running the Boston to picking up a grandchild and being able to clean the house. Stay active!
Video Link for helpful background on the research: VIEW VIDEO
Thanks for reading!