How to manage acute low back pain

A sudden onset of intense low back pain is horrible. The pain may be sharp, stabbing pain that can take your breath away. You may feel like your legs will collapse underneath you. In fact, 80% of the population will experience some form of back pain in their lifetime. This blog will focus on the, "never knew something could feel this bad" sort of back pain. You may not be able to stand up straight, sit or stand for long periods of time. You may have trouble with everyday activities like rolling over in bed and getting in and out of a car. The back pain may start after a very simple activity. Sometimes people report they were leaning forward to clean their teeth. Sometimes back pain may start after doing something more vigorous than usual. Some common jobs like gardening or moving home may result in back pain afterward. Some symptoms that can come with severe back pain are radiating pain to your buttocks or legs. In some cases, you may have numbness and tingling in your leg and foot, and/or weakness in one of your legs.


Why does it hurt so much?

People often compare the severity of their pain to their worst experience of pain. Some examples of strong pain are childbirth and kidney or gallstones. So why does it hurt so much? The possible pain causing structures in the low back are very close to your spinal cord. Your brain is very sensitive to any pain signals coming from this area and your nervous system wants to prevent any further damage to protect the spinal cord. One of the defence mechanisms is muscles spasm. With your muscles in spasm, it becomes very difficult to move.

The low back is in the middle of your body and is important for moving your trunk and limbs. When picking up an object whilst sitting the muscles around your spine will need to activate. When walking, the muscles around your spine and torso need to activate. As you roll over in bed, your core muscles need to activate. This muscle activation leads to movement of the pain-sensitive structures. This reminds your brain that moving hurts.

Signs and symptoms to be aware of with low back pain are:

  •  any numbness in both your legs, feet or saddle region (the part of your body that touches a saddle when sitting on one),
  •  inability to control your bladder or bowel function, or
  •  weakness in both your legs and feet,

If you experience the above signs or symptoms you need to see a medical professional. You should consider calling an ambulance.

When the pain is more manageable you may try a more conservative approach. The short-term management of low back pain is to rest and move.


Things to do in the short term:

Usually, back pain does not need hospital admission. You may consult your GP or a qualified health professional, like an osteopath, who can assess, examine and diagnose your back pain. Often back pain will settle in a few days. Here are a couple of things you can try in those first days to help you get through:


  • Rest and move.

Alternate between sitting and lying down. Try to change your position at least every 20 minutes. Use supportive chairs which keep you sitting at a right angle. No soft couches. Try a reclining chair. Stand for short periods of time. Try lying on the ground with your knees bent up. Don't stay in one of these positions for too long, that will lead to your muscles tightening up. Changing your position often will make that transition easier.


  • Support the spine.

Try using a lumbar brace or taping the low back to make moving easier.


  • Move around, but not too much.

Try short 10-minute walks at a slow pace. Or, try low impact exercise like walking in a pool or using a stationary bike for gentle exercise. Find that middle ground by using a less is more approach.


  • Apply heat or ice, or switch between the two.

Try heat on your low back using a wheat bag or heat patch. Sometimes a cool pack feels better and sometimes using neither is helpful. Try out each one and see what feels the best.


  • Try and get restful sleep. During sleep is our body regenerates and heals itself. Try sleeping on your side with a pillow between your knees. Or, lying on your back with a pillow underneath your knees. Whatever you do, avoid sleeping on your stomach.


  • Appropriate pain relief medication. Talk to your GP and or pharmacist about possible pain relief medications.


Things to do in the medium to long-term:

Often, the significant discomfort will become less intense after the first few days. As the pain subsides your movement starts to improve more each day. Your back pain can get better. Understanding what is wrong and what you can do to manage and improve your condition helps.

How might I prevent an episode of strong low back pain?

Consider how fit you are before doing a vigorous work task. Ask for some help with the lifting. Consider your posture and lifting techniques. Take regular breaks.

Look after your health and your body. Consider stretching before an unaccustomed task or add this to your daily routine. Consider your exercise routine. Have you been walking, cycling or swimming lately? Have you been thinking about that pilates or yoga class, go on book in!


Our Osteopaths enjoy helping you prevent or improve after an episode of low back pain.

Contact the team at Alliance Health Clinics to help get you moving again.