Video Transcript: Help! What to Do when your Back Goes Out

Hi, everyone! Dr. Orit Hickman here from Pain Science Physical Therapy.

And I wanted to put together a really quick video to give you some guidance on what to do if your back suddenly “locks up” or “goes out” on you. Now, there are many of you out there who experience back pain on a regular basis, but there are also some of you who have just episodes of back pain that come and go.  

And, our understanding of why this happens is much better than it was ten, fifteen, twenty years ago when I first started — you know — as a new grad physical therapist. But, there are some things that we know really, really help with an acute episode of back pain, and they’re not what we used to think. So, we used to say that if you’re having an acute episode of back pain, you need to lay down, not move, rest your back, protect your back. And then, once you feel better, start some gentle exercises with a physical therapist, especially working on strengthening your core muscles. We now know that that is not the best way to treat an acute episode of back pain. 

So, if you're listening to this, potentially you're in the middle of SOS. You’ve got a really severe episode, and you’re like. “I don’t know what to do and how to take care of myself.” 

So, the first thing you want to do is don’t panic. It’s really hard, but as soon as your panic goes up, your muscles get tighter, and everything gets tighter, and pain levels go up as a result of it. So, actually taking some gentle, deep breaths in through the nose, out through the mouth, and trying to repeat this five or ten times will help to relax your muscles and relax your nervous system. So, that’s one.

Number two, believe it or not, keep moving. As scary and as awful as this feels, if the episode came on without you doing anything really obvious, then it’s probably the nervous system freaking out over something. So, your nerves get really irritated. Your muscles get really flared up, and everything feels like it goes out of whack. So, keep moving, but your movement probably needs to be a little bit more gentle. So, try to go out for a gentle walk. Try to continue to do your normal, daily activities. The worst thing that you can do is lay down and do nothing and protect your back. That actually makes things tend to get stiffer, more tight, can take longer for the flare-up to recover. 

So, first thing: don’t panic, breathe. Second thing: keep moving. Third thing: meditation. Believe it or not, it’s very, very effective at calming the nervous system down. So, that should also help kind of bring things back down, relax the muscles so that they let go. 

Number four: heat or ice. Pick which one of those things feels better. I would recommend that you start with ice rather than heat because, believe it or not, if the nerves are really sensitive, nerves really like ice. Heat might feel good in the moment, but if you’re having some inflammation in there, that will keep things a little bit more sensitive. So, I would go with ice first, then try heat if you feel like it's not helping. You could also — also alternate between ice and heat. No more than ten to fifteen minutes at a time and make sure to get up and move around between. And then, at the end of that, see how you feel. 

You could definitely give your — give a call to your doctor. There might be some medication that the doctor recommends that you take in the moment to help calm things down. But, not panicking, breathing, meditating, keep moving, these are all really, really important. There are a lot more things that we typically give patients when we start to deal with — you know — an acute episode of back pain. But, I think this — you know— hopefully this will kind of help you understand that movement is good. And, it’s the last thing you want to do is rest and protect your back. 

So, I hope this helps. Let me know. I really appreciate any kind of feedback. And, if you guys want to have more specific videos on what to do during a — an emergency episode of back pain, let me know. I’ll put some more together for you. Thanks. Have a good one!