My back hurts : What should I do?

The title is really generic but back pain is generally what I hear the most about and treat the most so I figured it to be the most appropriate title.  But back could have been substituted for any body part.  After more than a decade of being a physical therapist, one of the things I have come to realize is that if people understood acute management of injuries, there would be far less major injuries to deal with.  In other words, if people understood and followed how to treat an injury in the first 24-48 hours, there would be less injuries that balloon into chronic pain or even injuries that require physical therapy.

The subject for this article dawned on me as people repeatedly ask me, \”Who fixes you when you get hurt?\”   The answer is no one really.  I do get hurt, all the time.  I have a very physical job and three extremely active children.  I get hurt, pretty much on a weekly basis.  It wasn\’t until I realized that it was my management of these injuries from the onset that helps me not to need any treatment.  And I will caveat this by saying that I do know that I do know advanced treatment techniques, that is my job, but most of what I do in the first 24-48 hours is nothing special, nothing that required vast amounts of school, just things that require attention and understanding.  Things that anyone can do that will help them avoid coming to see me or any other medical profession for that matter.

The worst phrase ever invented was no pain, no gain.  People have applied this to every part of their life, when in reality it applies to very little.  Yes in the last mile of a grueling 10 mile mud run, no pain no gain applies suck it up and finish.  Or if you are doing a high intensity workout and just running out of gas, put your head down and finish, suck it up. However, these are really the only 2 scenarios that come to mind where you can really tell yourself no pain, no gain.  It is not a mantra that should be applied on a daily basis and one that should be used with caution and skepticism.

Most of us feel pain on a weekly basis, we tweak something here or there, wake up with a sore neck, go into back spasm or just feel some pain in our knee.  Pain comes in many different forms and many different intensities.  The bottom line is you need to take note as you feel pain.  Sometimes, within a few hours the pain has gone away, yet most people don\’t take note how.  It is usually something you and your body did that allowed that pain to subside.  For example, many people tell me that they wake up with neck and/or back pain.  Most people upon waking get out of bed, get into a nice hot shower, slowly get dressed, have a cup of coffee and ease into their morning.  By that time the pain has subsided and you feel great again.  I have not heard of anyone who wakes up with significant back pain, hopping out of bed lacing up their shoes and running 10 miles.  But yet with most injuries that occur in our body, we do just this, we push them and exacerbate them to the point where we blow them up into giant problems and need to compensate for them to get them to stop.  The truth is, if we treated every injury like we do a sore neck in the morning, most injuries would heal on their own and not require any medical intervention.

Fear is a powerful thing, a powerful thing.  It is the thing that causes us to injure ourselves to the point of needing medical attention.  For example, let\’s take a sprained ankle.  If you trip and sprain your ankle and it is a mild sprain it can very easily heal on its own.  Yet a lot of people require medical attention after days later because they sprained it and then they injured it.  After someone were to sprain his/her ankle everyone\’s first reaction is to test it out, evaluate the damage, which is correct.  But then stop.  Once you have determined that there is no bone protruding and you don\’t feel  that you need to call an ambulance stop testing it, stop pushing it.  People feel the inherent need to test an injured body part out excessively, to \’see\’ how it is doing.  I will tell you how it is doing, you hurt it, let it go for awhile.  It needs time to rest.  Now does this mean lay down and rest, absolutely not.  It does not mean limp either.  It means get ice on it, as soon as humanly possible.  Then walk slower, concentrating on not limping.  Just go slow, allow it to figure out how to put weight on it again.  It is in pain, it does not want to work normally, don\’t force it to, you will start to form compensation patterns that will then require physical therapy.

That is the most important thing – is not to form compensation strategies.  And the part that is the double edge sword is your body will form them for you without you even knowing it.  That is why it is important not to push to hard to fast, because your body will form compensation strategies that will protect the joint.  These strategies will begin to form immediately if you let them.  So it is imperative that you make sure you function the same after an injury and not limp or not shrug your shoulder to guard, etc.  You have to slow down when you are injured, the quicker you put the breaks on, the faster you heal.  I know we hate to slow down, I hate it, but I know if I don\’t, I will wind up with a more severe injury than I already have.

If you injure yourself and you don\’t know what to do, call and get into your physical therapist that day.  Allow them to help you avoid what you should be.  Have them tell you what to limit.  Laying flat on your back, is not the answer.  Completely stopping activity is not the answer.  Slowing down, concentrating on performing correct movement patterns will allow you to spend only 1 visit in physical therapy as opposed to 3 months in physical therapy.  And the most important thing to remember – if it hurts don\’t do it!  For more information on physical therapy go to

Call Total Performance Physical Therapy today to schedule your appointment!

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