What to do if you have severe low back pain

Disclaimer: This “home remedy” section applies only to current patients who have seen Dr. Priestman for the specific condition indicated.  If you have not seen Dr. Priestman for your current condition, do not try this at home!

If you have severe lower back pain or pain that radiates down your leg, you want to try to avoid those big ouches. That’s like picking at a scab—it just takes longer to heal. 

First thing in the morning is the most important time
The disc is like a sponge; it swells with water during the night. This causes it to put more pressure on nerves and cause more pain. Fifty percent of the swelling is gone in the first half-hour that you are up and on your feet. For most people, after a few hours they can get away with all kinds of activities, which were impossible when they got out of bed. Here is a recipe to speed that up to improve things before you head off to work.

Wake up a half-hour early. Before you get out of bed, do a half-dozen cat/camel stretches. Then get up, get a cup of coffee or tea, look at the paper, walk around and avoid bending forward or sitting, for about a half-hour. Then have a hot shower, go back to your bed, throw away your pride, and lie on your back to put on underwear, socks, pants, shoes, etc. Avoid sitting and, especially, avoid sitting and bending forward to put on socks and tie shoes. (Get on your back!)

For relief of Sciatic Pain:
If you have pain running down your leg, you have pressure on a nerve. If you can find a position that takes the pressure off the nerve, the pain/numbness will go less distance down the leg. Don’t worry if the back hurts a little more to start with. That will recover; the nerve pain/numbness is the priority.

Eighty percent of people will benefit from lying on their stomachs and raising themselves up on their elbows. This called the cobra stretch in yoga and is very popular in back pain classes because for 80 percent of people it works. If it makes the pain or numbness radiate more strongly in your leg, stop immediately, and do the knee to chest exercise covered next.

Start by only raising up a little bit, 7 or 8 times for about 10 seconds at a time. Do this about 6 times per day. Over several days, try raising up a little higher (but never to the point of pain).

The other 20 percent of you will do better with lying on your back and flexing your knees to your chest. Start with a half-dozen on each side, holding for 10 seconds each. If this diminishes the extent of the pain/numbness in the leg, continue. If not, try the cobra exercise, mentioned above.

If you have to sit for more than a half-hour or stay in one position for too long, do a half-dozen repetitions of the cat/camel stretch.

Ice:
Twenty minutes to half an hour at a shot. Use a gel pack or a bag of frozen vegetables. If you’re at a hotel, use a zip lock bag with ice from the ice machine in it. Wrap the ice, vegetables or gel pack in a light towel to keep from frost-burning the skin.

The skin should be numb in three or four minutes, but not painfully cold. If it’s not numb, you have too much clothing on. If it’s painfully cold you do not have enough material between you and the ice; put some more on!

Driving:
If you have any distance to drive, take a cooler and put ice packs in it. Put gel packs on the ice packs. Keep a cold gel pack on your back while the others chill on the ice packs in the cooler.

Try to keep the ice on your back the entire time you are in the car. If possible, get someone else to drive so that you can recline in the passenger seat (so that you are not folded as much). Stop and walk around the car every half-hour, and every hour take a five-minute walk.

Lumbar supports for the car:
I am not crazy about the “Obus Form” back support cushions. They cost a hundred dollars and most people end up slouching anyway. I recommend taking a mid-sized towel (between a hand towel and bath towel) and rolling it up with a string through the middle, and duct taping the towel closed. Run the string over the headrest of the seat and adjust it up and down so that it fits like your forearm would, at a right angle behind your back. It should be the same thickness and height as the forearm.

Going to work:
Most people are far less concerned with the pain in their back than with how it will affect their schedule. You have to understand that pain is the body’s way of telling you to take it easy. If you don’t listen, it can get much, much worse.

Culturally, we tend to live to work; even the people who think that they don’t. The U.S. is the only country in the western world without legislated mandatory time off! The average worker gets 12 days off, and most only take nine. The next lowest is Canada, where vacations start at 20 days per year. That is one nine-day vacation per quarter. France gives 39 days a year!

If you can move about at work and don’t have to do any heavy lifting, fine, go ahead; daytime TV will make you crazy!