From Amanda's very early writing (1990s to early 2000s), shared as it was originally written.
Lots of things can go wrong with the back - and I’ll focus on the lower back this series. And there are 2 major mechanisms of injury. The first is sudden , jerky movements. Anything that jars our bodies is potentially harmful. Think about the times you have misjudged a gutter or step and your foot has jarred down - it can really trigger or stir up back problems. Where possible, try to avoid any sudden jerky movements - think about how you will tackle a task before you (literally ) fall into it and end up with permanent damage.
But by far the most common mechanism (a flash word meaning cause!) of back injury is accumulation of damage over a period of time.
And it’ s learning about how we accumulate this damage that puts us in control of whether we have back problems or not. I’ll be covering how we accumulate damage in this series.
First, lets look at what the most common injuries are in the back.
Facet joint sprains are the most common. (remember last week? Facet joints are those little joints at the side of the spine that allow a lot of our movements) These sprains are always associated with muscle spasm. Our spine is surrounded by small muscles that make it move and any time there is damage to our back, chemicals are released into the tissues around the back and the muscles immediately react with spasm. This is a flash word that means become very, very tense and tight.
This spasm sort of acts like a splint for the back. Our brain thinks that if we splint the spine with the muscles we can prevent more damage. It’s like splinting a broken leg or arm. The trouble is that many times the spasm is far more powerful than it needs to be. And BOY, does it hurt! Muscle spasm is really painful - when we are in the vice like grip of muscle spasm we would swear that every bone has been broken!
It’s also pretty common as a cause of back pain, much to people’s surprise. Stress and being under pressure contributes to this spasm. One of the most common reactions to stress is muscle tension. Everyone knows that. We can usually feel our muscles tightening up as we become more “uptight”. In fact, it’s hard to know sometimes which comes first - the tightness from tension that precipitates an injury or the injury which causes the spasm.
When you have significant back pain you must always seek the advice of an appropriate health professional for expert advice. This column is about giving you a better understanding of what might be happening and give you a sense of what to do to help yourself ‘until the doctor arrives’ so to speak!
Doctors will prescribe muscle relaxants if they perceive the spasm is really bad. These sometimes make you feel like a zombie - be warned! And the reason health professionals suggest we lie in bed for a couple of days (important in most cases it is a couple of days ONLY) initially is to allow the muscles to relax and release the spine - to stop splinting it. Some splinting is good but too much spasm for too long can inhibit blood flow and slow down the healing process. It’s finding the balance between enough spasm to protect initially and enough movement to encourage blood flow which heals.
If we lie in bed for too long (more than 2 days) , we start to have more pain from immobility than from the spasm! The best way to overcome spasm is gentle , consistent movement. No matter how small the movements are initially - any small movements are to the spine what oxygen is to a suffocating person.
So many people are frightened that if they move, they will damage something. Well, pain is nature’s warning. It’s her (or his) way of saying “you need to do this movement , but smaller”. So keep trying to move in smaller and smaller ranges so that you are encouraging blood flow into the area without harming the tissues. When I say smaller, I mean that sometimes the movement is so small that you are just gently rocking your hip one centimetre off the bed and back again. It really can be a very small movement and it will start releasing the spasm, which will then allow you to move a little more which releases more spasm etc.
It’s really important to understand that movement is lifeblood for the body. Use it or lose it is true! Movement brings blood to the area. Blood brings healing chemicals and oxygen. Movement releases spasm.
The best way to quickly eliminate spasm is to initially try gentle regular movements. And put cold compresses on the affected area. We only have to run our hands along the back to feel where the spasm is - it will feel like a ball of concrete! We can use commercially available cold packs or we can use ice. BUT, when we use ice, we must wet a towel thoroughly first, wring it out and then crush the ice cubes in the towel. Then put the ice pack on the affected area for about 10 - 15 minutes. After the first five minutes start very gently moving the area - small, rhythmical movements for a few seconds then rest then move again and continue with this cycle. This last part is really , really important.
Be careful that you use a wet towel and make sure you are comfortable while the ice is on - I don’t care what position you lie in but you must be comfortable and you must gently move during the ice process or you will get up after 15 minutes feeling worse than when you started. THESE THREE FACTORS ARE CRITICAL FOR YOU TO REMEMBER.
So, for severe muscle spasm, see a doctor; try lying in a comfortable position, with a wet towel and ice on the spasm and gently and rhythmically moving the affected ‘bits’ for a few seconds; relax and repeat; continue with this cycle until you free up your body. Listen to your body as you are doing this. You will know if you are overdoing it. Remember, you are searching for that fine balance between rest and movement. (In fact, this is pretty good advice for any episode (medical talk for situation) where you have back pain.
