Lower Back Pain
Muscle Strain or Disc Injury
Ethan Goodfellow
Why does my back hurt?
There could be many reasons for your back pain, however we are going to focus on just two; Muscle strains and disc injuries.
Potential Disc Injury
Your back feels like it's about to "go" or give way.
Your back is sensitive to compression, such as going over bumps in a car.
You feel it is difficult to lift your leg from the floor when seated.
This is because the discs in your back act like springs. When injured, anything that puts pressure on the "spring" can cause discomfort.
Disc injuries can also cause nerve root compression, sciatic pain being an example. You may feel pain, numbness, and reduced muscle function in your hip, thigh and leg.
Potential Muscle Strain
Your back feels tight and swollen.
Your muscles are sore and may spasm if used for too long.
You can lift your leg from the floor when seated without increasing your symptoms
This is because the muscles in your back will swell and tighten when damaged. They will be sensitive to stretching and get tired quickly when doing normal daily activities.
You may also get nerve compression with muscle strains due to the inflammation caused by your injury. Generally it is much milder, and recovers more quickly than a disc injury.
What is a Lower Back Disc Injury?
As mentioned above, a lower back disc injury, slipped disc, or disc herniation are injuries to the tissue between the bones of the spine. You may have done this by;
Overstressing your disc on a regular basis + not allowing sufficient time for recovery + not doing any self care work.
Overstressing your disc on 1-2 occasions. This can mean doing simple things such as;
Sneezing or coughing
Stepping or jumping from a high to low surface
Twisting or bending suddenly
Lifting a heavy object, or lifting awkwardly
Falling over/jolting your back
If you have lost bladder control, or have severely reduced function in your legs, you must seek medical assistance. This may indicate severe nerve impingement.
But don't despair, the good news is that they can get better!
Lower Back Disc Injuries and Inflammation
Inflammation sounds bad doesn't it?
Actually inflammation is normally a good thing! It is your bodies way of repairing damaged tissue, including in your back. It works by slowly reinforcing the bulge or weakness in your disc.
You may have noticed when you first injured your back it wasn't too bad. Then you sat down or laid down for a while, and the pain is so much worse now! Thats down to inflammation. Your body has recognised the damage done to it and started to get to work on repairing it.
But why is it more painful now? Your brain can recognise that there is now more inflammation in the area and now gives you more pain to protect the injury from further damage! It's definitely working right?
While inflammation is good to repair your injury, it is not good to remain at rest for long periods of time. As you have probably experienced, the pain and stiffness increase the longer you are sedentary. Therefore, mobilisation exercises are needed to reduce stiffness and aid the repair process.
What can you do to help your lower back get better?
Methods of offloading injury. Support, activity adaptation, resting position. Things to purchase. (1)
The importance of rest and sleep. Sleeping position. resting position.
Protect your Lumbar Disc Injury
Protective mechanisms in your body
Once injured, your body will try to protect the injury from further damage by giving you warning signals. You must listen to the warning signals from your body.
Pain
You may have a constant level of pain, or it may increase when you perform certain movements. If your pain increases and does not return to pre-activity levels, it means that the activity was too much for your injury. Do not perform movements that increase your pain levels on a regular basis as this may slow or stop your recovery.
Stretch
Stretch is a pulling/tightness sensation when you move your body. It helps to protect your injury from damage by overstretching. If you repeatedly stretch too far and too often, you may be doing more damage to your injury than is repairable. Limit your range of motion based on your stretch response.
Fatigue
Fatigue is a slight burning sensation that occurs when your injury has been working for a period of time. It may also feel like a weakness or heavyness of the injured area. It means that you need to rest the injured area.
Stiffness
Stiffness is normally a sign of inflammation, and increases with inactivity. It may become worse with long periods of inactivity, such as when sleeping, and you may wake up in pain. The best course of action is to mobilise the area until the stiffness improves.
Mobilisation exercises for lower back disc injuries
Mobilisation exercises should NOT increase your pain or discomfort. If they do, it means that the movement is too difficult for you and that you should either make the movement easier, or try another mobilisation exercise. The following movements are ordered in level of difficulty; 1 being the easiest. If you feel no symptoms at all during a movement, then you can progress to the next one.
The goal is to reduce stiffness in your lower back over time.
(1) Deep Breaths
Perform 4-5 slow deep breaths at a time, so as not to hyper-ventilate. Then rest for at least 30 seconds.
Repeat regularly throughout the day to help reduce stiffness, and relax your body.
(2) Laying Twists
(3) Cat-Camels
(4) Seated leg lifts
(6) Assisted Bends
(4) Assisted Squats
(7) Walking
Strengthening
Once you are no longer feeling sore all the time, you may want to start strengthening your back.
This serves a few purposes
Measuring the strength of your injury
Specifically strengthening your injury
Allowing you to train specifically for daily activities or sports.