Back pain is such a common experience that it is estimated up to 80% of adults will have at least one severe episode of back pain in their lifetime. 

For many people, the pain quickly resolves and things go back to normal. However the first time this happens to you it can be scary, particularly as very severe pain can occur suddenly and without warning. Statistics, however, are on your side. Most of the time, acute low back pain resolves without consequence and doesn’t recur. If you happen to be in the middle of an episode, here are a few tips to help you get through.

1. Avoid heavy lifting

While this may seem obvious, there are a few people who will always try to push through the pain. The expression “no pain, no gain” is in many cases outdated and if your work requires heavy lifting, it is more than reasonable to take a few days off.

2. Avoid too much rest.

On the other hand, lying in bed all day is bad for you as well. If you have severe back pain, gentle movement under the advice of a physiotherapist is much better for you than complete rest.

3. Avoid long car or plane trips

If possible, now is the time to avoid long distance travel. If you absolutely must travel, speak to your physiotherapist about how to manage your pain during the trip.

4. Avoid listening to horror stories

There are always stories about pain that never went away, requiring surgery, which only made it worse. While worst case scenarios do happen, being fearful is a negative factor in a healthy recovery. That terrible story is probably not going to happen to you and hearing these stories is only going to impact your recovery negatively.

5. Avoid delaying treatment

While your pain may go away on its own, it is important to have a professional assess your condition to screen for any serious injuries and advise you on how to best manage your pain while you are getting better. They can also help you recover as quickly as possible.

6. Don’t expect a miracle cure

Back pain is complicated, and a single treatment that works for everyone does not exist. It is important to follow the directions of your therapist and work with them to set reasonable and realistic goals for your recovery.

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Most of us are familiar with the post-exercise soreness that comes after a particularly strenuous exercise session. This pain, which is usually accompanied by stiffness and weakness, is often referred to as Delayed Onset Muscle Soreness. This is abbreviated to DOMS.

It is unclear exactly what the purpose of this pain is, as it is most intense 24-48 hours following an intense exercise session. However, we do know that muscles experiencing DOMS show signs of microtears throughout the tissues and the effects are worse following eccentric (controlled extension) exercises more than other types.

DOMS

While DOMS is not indicative of any serious injury and has no lasting side effects, it can be very uncomfortable and is problematic for anyone who needs to perform again quickly. This might apply to an athlete in a tournament stretching over a few days.

A person suffering from DOMS may also be at a higher risk of injury if they continue to play sport at their usual level. Understandably, many people are interested in how to avoid or reduce the effects of DOMS.

There is plenty of anecdotal evidence on how to reduce DOMS. However, high-quality research is limited and there is certainly no quick fix to this problem.

When it comes to avoiding DOMS, both a warm up before exercise and a cool down afterwards are important. Many experts also recommend using a foam roller on affected muscles following exercise. And while many people, particularly long-distance athletes are fond of using anti-inflammatory medication to reduce pain after exercise, the evidence shows that its effectiveness is limited and perhaps not worth the side effects of using the medication regularly.

Other Advice

Other advice includes gentle exercise, such as 20 minutes on a stationary bike, and mild stretching. Massage is not generally recommended, although some people may find it helpful. Staying hydrated during sports is always important, and keeping your fluid intake adequate while experiencing soreness afterwards can also help.  If you are particularly brave, ice baths have recently been shown to have mild benefits in pain reduction.

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Every profession has a unique perspective of life that can only be achieved from years of experience in that area. Here are three things that experience has taught your physio:

1. Problems that seem to arise for “no reason” are usually a result of disuse or lack of movement.

It’s common to want to know why pain has occurred; however it’s not always easy to identify a cause. What you come to learn as a physiotherapist is that pain and injury are just as likely to arise from disuse and inactivity as they are to develop from a direct trauma.

Our bodies are made to move and modern day life simply doesn’t allow for enough movement. We certainly shouldn’t be sitting as much as we are. This allows our joints to stiffen, muscles to shorten and weaken, and nerves to become extra sensitive.

There is also evidence that movement is essential for joint health, due to the movement of joint fluid that provides nutrients to the joint structures. The reason physiotherapists are always advocating for more movement is because we see the long-term effects of disuse on a daily basis.

2. Bad habits are hard to break, but the best time to make a change is today.

Today’s slightly stooped posture is tomorrow’s fixed hump back. It doesn’t happen overnight, but seeing every stage of the progression walk through your door is like seeing evolution in fast forward. It makes you want to address change early, when it is easiest to make a positive effect.

Other habits that should be formed early are incorporating as much exercise into your routine as possible. It’s harder to be fit and active in your 60s if you weren’t active in your 30s. Being active now is arguably one of the most important things you can do to ensure you have a comfortable and healthy later life.

3. Pain is affected by so much more than just tissue damage.

Your beliefs and attitudes about pain can have a huge impact on how you experience pain. Being fearful and anxious will amplify pain. The worst-case scenario is actually very unlikely and seeking the treatment of a physiotherapist can help to ensure the best outcomes possible.

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Many of us associate aging with a decline of skills and quality of life. However, the truth is not as black and white as this. While certain skills and functions do tend to suffer as we age, surprisingly there are many abilities that actually improve as we grow older.

Recent studies have shown that happiness is U-shaped, proving that the mid-life crisis is real. Ages between 40-60 tend to hold the highest amount of stress and responsibility for adults. It seems that happiness increases steadily after this period, with the average 80 year old reporting themselves to be as happy as the average 20 year old.

There is also evidence that your beliefs about ageing can act as a self-fulfilling prophecy. If you are positive about ageing, then your experience will be more positive than if you believe negatively about it.

It’s not only good news about your mental health though. Studies have also shown that while your short-term memory might decline, other skills such as creativity can actually increase. One of the biggest reasons for a decline in skill and function is the disuse that comes with retirement from work. Keeping active and mentally stimulated can be enough to keep your skills up to speed.

It has also been shown that confidence grows in both genders as we age. Making decisions becomes easier as we know ourselves better and have a wealth of experience to draw on when a tricky situation arises.

Certain physical skills such as strength and agility might decline, however it seems that other aspects of physical ability might increase, including endurance. There are many triathletes who are in their 70s, 80s, and unbelievably even in their 90s. In the absence of any serious disability, it might be the case that age is an excuse rather than an actual hindrance to being active.

Verbal ability and vocabulary are also skills that improve as we age, which may explain why crosswords are so popular with the elderly. Making the most of your abilities at every age is important. So try not to let age be a barrier to trying new things and keeping active.

Physiotherapists are dedicated to helping people stay active at any age and can help you with achieving your goals. Speak to your physiotherapist for more information.

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Sprains and strains are words that are used almost interchangeably when describing injuries, however they each actually have quite distinct meanings. The most straightforward explanation is that a “strain” refers to a tear in a muscle or tendon, while a “sprain” refers to a tear in ligament fibers. Below we briefly describe what that means and how we treat a sprain or strain differently.

Ligaments are fibrous tissues that connect and hold bones to other bones. These are very strong parts of your anatomy and, depending on the joint, provide large amounts of support and stability to the body.

Some ligaments are so strong, for example in the shoulder, that sometimes a bone will break before the ligament will tear. When ligament fibers do tear, the nearby joint can actually feel unstable.

Ligament tears will usually swell up and have a normal inflammatory reaction. Pain will be worse with movement or if the ligament is placed under more stress. Occasionally, if a ligament has torn all the way through, there is much less pain than with a less severe injury.

Your physiotherapist is able to grade the severity of a ligament sprain. This will help guide treatment and expected recovery times.

Muscle strains are easy to confuse with ligament sprains, however there are a few telltale differences.  Following a muscle tear, it is more likely that you’ll feel weakness rather than instability. The pain will also be isolated over the muscle or tendon body. An injury to a ligament will be tender over the site of the ligament and special tests can be done to show a laxity due to the injury.

Treatment is also slightly different as sprains will need more support and will sometimes even need to be braced. Muscle strains however will benefit from gentle movements earlier.

In both cases, following the basic principles of rest, ice, compression and elevation is great advice in the early stages of any injury. Heat is not recommended until at least two days after the injury.

It is important to seek professional opinion when recovering from both a strain and a sprain. It is very easy to re-injure an area while it is healing if undertaking strenuous activity too early and without correct rehabilitation. Speak to your physiotherapist for more information.

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