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Help! My back is agony!

First things first – don’t panic!

We’ve all known someone who’s had severe lower back pain and been confined to bed or barely able to move. You may have had this yourself. It is frightening for you and those around you because the pain is so severe and the pain often comes on very quickly. It can result from lifting something or just getting in an awkward position – and it can be surprising sometimes how little it takes to provoke such severe pain!

The first thing to say is DON’T PANIC! There are reasons why your back has reacted like this and if you do the right things it will get better. We’ve put together some helpful advice on what to do if you have severe back pain that will get you moving in the right direction.

What is causing the pain?

The truth is, at this stage, no one can be sure of the exact mechanism and cause of your pain and it is pointless speculating because there are some important principles to deploy to start the road to recovery. Mechanical back pain is a term used to describe symptoms caused by injury to the spine – this can be a relatively trivial movement (like putting on a sock) or something more memorable (like lifting a heavy garden pot). The severity of pain can be related to how bad the original injury is – but not always. ‘Lumbago’ a word derived from Latin was the old term used to describe this condition but we now use a more descriptive label – hyper-acute back pain. More information about the cause of low back pain can be found here. Irrespective of the cause, the most important thing is follow our 10 steps to recovery.


10 steps to recovery

1. Initially, take the load off your spine. You have probably worked this one out already. Most back pain is mechanical in nature. This means that part of your spine has been irritated through injury or inflammation and it makes a whole lot of sense to try and reduce the stress on these sensitised tissues. For the first day or two you may have to find a position that takes the load off and our downloadable advice sheet shows you a couple of positions you are likely to find most comfortable.

2. Usually the most comfortable sleeping position will mirror the resting position you find during the day. Unfortunately, you will probably have plenty of time to work out what works best.

3. Make sure you have suitable medication to reduce the pain. When the pain is this bad, it really is not helping you at all and soon you will need to start moving – so it is really important that have good pain relief to allow you to do this. Some people resist this – but it is vital that you take all the steps necessary in order to ensure you make a good recovery. You can find some useful advice here about over the counter medication but if this proves to be insufficient, you will need to see your doctor or our prescribing physiotherapists (Johnny Cassidy or Paul Hattam) who are qualified to prescribe stronger painkillers.

4. As soon as you can, start moving. We know that moving as normally as possible helps to bring recovery and avoids stiffness of your spine developing (which can lead to more prolonged problems). You can potter around the house, have a shower and go downstairs. Avoid sudden movements if possible. You might need a bit of help to get going but this will help you to start feeling better.

5. Now you should be ready to start doing some exercises. We suggest you do some simple exercises that start to get your lower spine moving and a few of these can be found here.

6. If your pain won’t allow you to start moving more, you should seek help from a physiotherapist or your doctor. You shouldn’t be confined to bed for longer than 5 days.

7. If you develop numbness in the saddle area or you have any difficulties with your bladder or bowel (e.g. passing urine), you should seek medical help urgently. More information about this can be found here.

8. If you are on strong painkillers (e.g. Codeine Phosphate) do try to gradually reduce the stronger ones first as you start to improve, but do keep going with the simple analgesics (i.e. Paracetamol) and NSAIDs (i.e. Ibuprofen) so you don’t abruptly stop all medication in one go.

9. A good measure of recovery is to regain full, pain-free movement and return to all activities. Many people cut corners in their recovery leaving them with 80 or 90% improvement which, over time, causes an accumulation of pain and stiffness and a more chronic issue.

10. Our top piece of advice is to seek professional help as soon as possible. Physios are well equipped to manage acute back pain like this and will guide you back to full health however bad it might seem right now!


If you’re suffering from low back pain, especially if it’s not improving, click here to book an assessment with one of our experienced clinicians.