Often a patient will say something along the lines of “I just bent down to pick up a piece of paper and my back went”.

And it can be really frustrating that a simple, every day action, can suddenly lead to so much pain.  In these cases the one comfort is that the actual injury may not be too severe.  With a little simple management we can often bring down the pain, and quickly get them back to work again.

Here are a few questions people often ask when this happens to them:

Should I try heat or cold? 

For a fresh injury, the area is inflamed, its hot and angry, so it’s generally best to cool the area down with an ice-pack or similar.  Try 5 minutes on, have 2-3 minutes rest, and then repeat.  Avoid direct or prolonged contact with ice and this can damage the skin.  Some people don’t like the cold in which case by all means try a heat pack to see if it works better.  For problems that have been with you for a longer time, heat is better.

Should I take a pain killer?

There’s no point in suffering for the sake of it, and if someone wants to try an over-the-counter medication such as paracetamol or ibuprofen I would encourage them.  If the pain is really severe a doctor can prescribe stronger medication once she or he has considered other health conditions or medication you may be taking.

Should I rest or exercise?

It’s about getting the right balance: the old advice to rest in bed has been thoroughly de-bunked, but advice to “carry on as normal” can seem a little cruel in the early stages of acute back pain.  It’s important to stay active, but how active depends on how much pain you are in.

When it’s really bad you should rest for short periods but try to do some activity every 30-45 minutes.  “Activity” could be just pottering around the house: making a cup of tea and clearing things up a little, or light exercise e.g. a walk around the block.  This is important because it keeps the muscles and joints moving at the site of injury.  It keeps the blood flowing- to bring in fresh resources needed for repair and to flush out pain-causing molecules.  Activity also helps stop the brain and nervous system from getting used to inactivity as the new normal, and starting to see any kind of movement as a threat.

What exercises should I do? 

I like exercises where you move gently in one direction and then back in the other.  These are good because they maintain the balance of muscle activity on both sides of the joint, and you don’t have to push too far if one direction is painful.

The following are good examples for low back pain:

Supine twist

Lie on your back with your knees bent.  Slowly lower the knees to one side, then roll them back up and over to the other side.

Cat – Camel

On your hands and knees, alternately curl your back up and down.  If going in one direction hurts: stop, and move the other way.  The next time, try to stop just before the point where the pain began.  With repetition, you may find that you can move further and further as the body gets used to movement again.

Wag your Tail

Still on your hands and knees, bend your back left and right, like a dog wagging its tail.


These three exercises cover all the basic spinal movements in a safe, controllable way.  When your back is bad I would recommend doing them several times throughout the day.  As you recover you can start to add in more challenging exercises and return to normal activity at a pace that suits you.

Please click on the video below to see how I do these exercises.

If you would like to see how I can help your back pain, please call 520714 to make an appointment.

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