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We have previously talked about the importance of active rest and reactivation exercise for recovery from lower back pain. Today we will go over some pain relief strategies you can employ for short term lower back pain relief.
In severe cases of low back pain just finding a comfortable position can be difficult. The ‘dead bug’ position places the spine in a neutral position and brings the pelvic floor and diaphragm into good alignment. This reduces excessive tension in the low back and eases pain for most low back pain sufferers.
- Lay on your back next to a chair – If needed, place a pillow under your head and/or under your lower back to maintain its natural curve. There should be a slight arch of the lower back – it should not round into the floor.
- Lift your legs one at a time onto the chair. Your hips should be at a 90 degree angle.
- Rest your hands on your stomach.
- Relax and breathe into your stomach and the sides of your lower ribs. Try not to breathe into your upper chest.
- Do not stay in this position for longer than 30 minutes without getting up and gently moving.
Cobra rest position
In patients with sciatica, or a back problem that is aggravated in the morning time, after sitting or driving, or worse when bending forward, the cobra position is generally recommended.
- Lay face down, resting on your forearms, with palms turned down.
- Push through your elbows to lift your chest and shoulders and slightly arch the low back.
- Completely relax your stomach and buttocks.
- Breathe into your stomach and sides of your lower ribs – with each exhalation think about letting your back sink further into the floor.
- Hold this position for 2-5 minutes.
- If lifting to your elbows is aggravating, start instead by placing one fist on top of the other and then resting your chin on top. This produces less extension in the lower back and can be more comfortable in very acute complaints.
Anti-inflammatory medication (NSAIDs) can be an effective option for short term pain relief in cases of muscle and joint injury, however research suggests that they should be used with caution.
Inflammation is commonly seen as “bad” and something that needs to be eliminated as quickly as possible. However, the reality is that acute inflammation is a vital first step in the healing process. When any tissue of the body is injured healing occurs in three phases:
- The Inflammatory phase
- The Repair phase
- The Remodelling phase
Each phase of healing is necessary for the subsequent phase. In fact it has been said that “Inflammation can occur without healing, but healing cannot occur without inflammation”.
Research shows that minimising the inflammatory stage of healing with the use of anti-inflammatory medication likely has some negative long term consequences:
- “ the use of these medications [NSAIDs] inhibits ligament healing, and thus, leads to impaired mechanical strength” 
- “NSAIDS appear to have a positive effect on the evolution of an acute ligament injury… However, in the long term, this rapid return is likely to be at the detriment of good healing ”
- “We do not recommend their [NSAIDs] use for muscle injuries, bone fractures (also stress fractures) or chronic tendinopathy.” 
In summary, anti-inflammatory medication will likely decrease pain in the short-term but they may do so at a cost to complete tissue healing. If you do choose to take NSAIDs, you should take the minimum effective dose for the shortest possible time.
Look out for next weeks post where we go over more pain relief strategies for lower back pain.
- Hauser, R. A., Dolan, E. E., Phillips, H. J., Newlin, A. C., Moore, R. E., & Woldin, B. A. (2013). Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. Open Rehabilitation Journal, 6. 1-20
- Ziltener, J. L., Leal, S., & Fournier, P. E. (2010). Non-steroidal anti-inflammatory drugs for athletes: an update. Annals of physical and rehabilitation medicine, 53(4), 278-288.
Liebenson. C., Journal of Bodywork and Movement Therapies
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.