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Lower back pain: Extra advice

Lower back pain: Extra advice

In previous articles we have discussed active rest , safe reactivation exercises and pain management strategies. Today will we go over a few more important topics for lower back pain recovery…

 

Sparing the spine

 

Moving in the wrong way can place increased stress on the back, exacerbating pain and limiting recovery.  The most common source of injury to the low back occurs when bending.  Similarly to repeatedly picking a scab, repetitive bending of the spine during recovery will result in irritation.   It’s therefore important to spare the spine when bending by hinging from the hips instead of the back and keeping your chest tall. This ‘hip hinge’ can be applied to a variety of daily activities to help protect the back and avoid re-injury.

  1. Getting out of a chair
  2. Lifting
  3. Brushing teeth
  4. Putting on shoes
  5. Getting out of bed
  6. Getting up and down from the floor

 

 

Sleep

 

Sleep timing

Sleep is extremely important, especially when recovery from injury. When tissues have been damaged, the rate of healing is greatest during sleep, whatever time of day the injury occurred [1].  Sleep also effects pain tolerance, with sleep disruption having been found to reduce pressure pain thresholds by 24% the next day [3].

It’s therefore important to ensure you are getting enough sleep when recovering from back problems.  However, unfortunately, staying in bed for excessive periods (more than 8 hours) can also cause problems:

When you lie down the discs between your vertebrae attract water and swell. This swelling increases disc bending stresses by up to 300% and ligament stresses by 80%! This is why you are taller in the mornings and often most stiff. More time in bed, leads to more swelling.  So, while 8 hours in bed is healthy, much longer than that can exacerbate back pain due to increased disc swelling.

 

 

Sleeping Position

For many back pain patients just trying to get to sleep can be a nightmare. Unfortunately, when it comes to what is the best sleeping positon there is no definitive answer. Listed below are positions that are generally well tolerated but every patient is different. Use pain as guide and be prepared to switch positions regularly throughout the night in order to remain somewhat comfortable.   

 

  1. Fetal position with a pillow between knees
  2. Supine (on your back) with a pillow under knees.
  3. Prone (Stomach sleeping) – although this not a generally recommended long term sleeping position, it can b comfortable in the short term for many patients with disc pain.  Another alternative for those with disc pain is to sleep supine with a pillow under the lower back to prevent it flexing into the mattress.

 

 

Nutritionnutrition fruit and vegetables, chiropractor jersey

 

Pro-inflammatory diets (increased sugar, increased refined oils & decreased fruit & veg) & nutrient deficiencies can decrease tissue repair exacerbating current pains and predisposing to future injury. For more information, take a look at ‘6 nutrition tips for injury recovery’  

 

 

Images

Liebenson. C., Journal of Bodywork and Movement Therapies

 

 

References

  1. Adam, K., & Oswald, I. (1984). Sleep helps healing. British medical journal (Clinical research ed.), 289(6456), 1400-1401.
  2. Dattilo, M., Antunes, H.K.M., Medeiros, A. (2011) Sleep and muscle recovery. Medical Hypotheses, 77: 2, 220-222, 2011
  3. Lentz, M. J., Landis, C. A., Rothermel, J., & Shaver, J. L. (1999). Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. The Journal of rheumatology, 26(7), 1586-1592

 

 

 

 


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.


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I first attended due to pain in my lower back that I had had for over a year. It was my last resource, as I had tried a lot of things before but it was definitely the best thing for me. I felt listened to and taken seriously and I’m now more or less pain free. I can now do all the things I like again, like dancing and walking. That’s just great!

Karen Mackel