5 Top Tips for Relieving Back Pain
Everyone’s unique, and back pain can have many different causes.
But if you want quick relief for low back pain, then most people need to start with these basic fundamentals.
So think of these top tips as the equivalent of your dentist telling you to eat less sugar and brush twice a day, or a personal trainer saying to start a food diary and make an exercise plan.
1. Use ice not heat
I give this advice to almost everyone who walks into my office.
It’s by far the most common mistake people make when dealing with back pain, and oftentimes they’ve actually made the pain worse by continually applying heat.
Use a cold pack, not heat.
Heat feels nice. It’s comforting, and there’s something instinctive about reaching for the hot water bottle or wheat bag.
And sometimes it’s the right thing to do. Like if your back’s just a bit stiff, or in some cases of muscle spasm.
But if you’re actually in pain, like if it’s more than a 4/10, then it’s almost always the wrong thing to do.
Pain often means inflammation.
Inflammation in the muscles, joints or ligaments. Whether that’s acute (recent) inflammation that comes from an injury or aggravation, or more long term (chronic) inflammation, which is often the case with ongoing back pain.
If you add heat to inflammation… you get more inflammation.
Or you end up making it last longer than it otherwise would have.
So if in doubt, I always recommend starting with a cold pack.
How to use a cold pack
You can always use bag of frozen peas, but the best option is a proper gel cold pack (like these ones) that you keep in the freezer.
They bend to fit the area of the body nicely even when frozen, and you can use them over and over again.
But Instant gel cold packs (12x29cm) are great for keeping at work, in the car, or taking on holiday, where you may not have access to a freezer.
And you can even get compact gel cold packs (15x15cm) which are more convenient for the handbag, laptop bag or coat pocket, if you’re concerned about your back ‘going’ when you’re out and about.
Either way, wrap it in a tea-towel so it doesn’t touch the skin directly.
- Apply it to the sore area for 15-20 minutes
- Put it back in the freezer (unless it’s a disposable one) for at least an hour
- Then repeat if necessary (I usually recommend doing it 3-4 times a day)
2. Stay active and mobile
Bed rest is almost never the best idea.
And most of the time staying reasonably active is an important factor in a quick recovery.
Two reasons for this:
A) Keeping still for too long makes you stiffen up even more.
If you’ve ever been sore from the gym, then you’ll know this already. A day or two after a leg session, and you’re getting up off the couch with gritted teeth. But if you keep moving about it’s not so bad.
The same goes when your back is playing up, especially when there’s muscle spasm. Sitting still for too long just makes it harder to get moving again.
And you also want to keep the blood flowing around your muscles, and the fluid around your joints, because that’s what brings healing chemicals and new cells to the area.
‘Motion is lotion’.
Your body will let you know which movements or positions it doesn’t like, and it’s wise to listen to your body (see no. 3: ‘Don’t overdo the painkillers’).
But unless certain movements are really painful, it’s usually ok to move through it, gently.
B) Keeping active stops the PAIN-FEAR cycle
The mind plays a big role in both pain and recovery.
‘Fear-avoidance’, when you get anxious or nervous about certain movements or activities, is a trap you want to avoid.
There’s a difference between being sensibly cautious of certain movements (for example being mindful about forward bending movements first thing in the morning), and being afraid of doing them.
It’s important to feel like you’re still in control, even if your body is telling you to take it easy for now.
Anxiety and fear amplify pain, they literally make the pain feel more intense.
And a lot of people with chronic pain also live with fear and anxiety.
That’s a whole other subject, which we’ll cover in a different article, but the simple message is to try and keep active as much as you can. Keep doing normal everyday things.
3. Don’t Overdo The Painkillers
Painkillers can be helpful for getting you through the day, if they work for you.
But every medication has side effects and risks, and a lot of people assume that over-the-counter drugs are safe because you can buy them in a supermarket or petrol station.
The most common way doctors recommend using painkillers is with a STEPWISE APPROACH, which means:
- Starting with paracetamol, up to 4g (8 tablets) per day.
- Then trying NSAIDs like ibuprofen or aspirin (not on an empty stomach).
- You can combine paracetamol with ibuprofen.
- And for anything stronger like codeine-based medication you need to speak to your doctor.
As the two most commonly used pain medications are paracetamol/tylenol (acetaminophen) and NSAIDs (non-steroidal anti-inflammatory drugs) like ibupfofen, naproxen, aspirin and diclofenac, here’s a quick overview of them and some general recommendations.
To quote a paper from the British Journal of General Practice: “NSAIDs may be slightly more effective than placebo for the treatment of low back pain but at the cost of significantly more side effects. Paracetamol has not been shown to be effective in low back pain”.
And you can find more information on the uses and side-effects of both drugs here.
- Don’t take more than 4g (usually 8 tablets) of paracetamol per day
- Check any other medication you’re taking (e.g. cough mixture) to see if it also contains paracetamol. Because that’s how young and otherwise healthy people overdose on it, because they don’t realise how much they’re taking over several days. Overdose causes liver failure and potentially death.
- Be aware that paracetamol depletes your glutathione levels. Glutathione is the ‘master antioxidant’ and the most important immune system chemical in your body. I’ll write in another article how to increase your glutathione, but for now just be aware that you need it.
NSAIDs (like ibuprofen)
- The main risks with taking NSAIDs are stomach bleeds, heart and kidney problems. The risks increase with age (especially over 65) and how long you take them for.
- Never take NSAIDs on an empty stomach. They block certain enzymes (COX-1 and COX-2), which are also responsible (COX-1) for producing the stomach lining. When you inhibit that it can lead to stomach ulcers and possibly bleeding.
- Ask your doctor for a review every 3 months if you are taking them regularly. Depending on your situatiton, they may not be a safe long-term drug.
The US Food and Drug Administration issued a public health advisory stating that “NSAIDs should be administered at the lowest effective dose for the shortest duration consistent with individual patient treatment goals.”
But the reality is that many people take them every day, for months or even years. So be cautious of taking too much of either of them, or of taking them for longer than really necessary.
4. Try the Cat exercise
The Cat is my Number One back exercise of all time.
After injuring my own back, I did this every morning for over ten years. Not that I needed to for all that time, it just became a habit like brushing my teeth.
I still do it any time my back feels stiff, or if I’ve been sitting down for long periods – like on a flight – and I recommend it to all my patients with back pain.
- Start on all fours, in a square shape with your shoulder above your hands, and your hips above your knees.
- Gently arch your back down, breathing in, just as far as you can comfortably go.
- Then reverse it, breathing out and arching your back up towards the ceiling. Again, just as far as is comfortable.
- Do this (up & down) 10 times.
* The best time to do this is before you get out of bed in the morning.
5. Do Some Deep Abdominal Breathing
If you’re reading this and thinking “None of that yoga stuff!”, I highly recommend you keep reading, and keep an open mind.
Pain and suffering are two different things.
Pain is the physical sensation you’re feeling, suffering is the emotional response you have to that pain.
And that emotional response (and also the intensity of the pain you’re feeling) is strongly influenced by what ‘mode’ your nervous system is in.
Fight or Flight vs. Rest & Digest
Fight or flight (the sympathetic nervous system) always wins out, because getting away from an immediate danger is more important for survival than deep healing and digesting food.
But if you’re always in that mode, you don’t ever get into the proper deep healing that’s necessary to change your situation.
The problem is that the immediate danger (Oh look there’s a tiger, run away) has been replaced by the constant background stress of mortgages, jobs, politics, the news, and everything else that’s designed to provoke an emotional spike in you, that makes you want to read that article/buy that paper/watch that clip, etc.
But there’s a hack.
To get out of the fight or flight mode, the simplest way to do it is just by controlling your breath.
Because when you breathe deeply through your abdomen (instructions to follow) you stimulate the vagus nerve, that calms everything down and stimulates you autonomis nervous system.
How to do deep abdominal breathing:
- Go to a place where you won’t be disturbed for 5 minutes
- Sit with your back upright and your hands on your tummy
- Breathe in deeply, and feel the breath going down into your stomach, and your tummy expand (your shoulders should not raise up at all… which might take a couple of goes to practice)
- Hold for a second, then slowly let it out
- Keep doing this for about a minute
Do this twice a day and you’ll feel so much better, in body and mind.
These 5 tips will likely make a big difference to you if you’re suffering with back pain.
They are the foundation for your relief and recovery.
Whether you are just starting to look for ways to reduce back pain, or you’re already having treatment, following these tips will help you get the results that you are looking for.
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