Troubleshooting Acute Back Pain

If you’ve ever bent over to tie your shoe and couldn’t get up, you know about back pain. One moment you’re fine, the next you’re not. The most common question I get from my patients:

“Why did this happen?”

Typically, acute back pain results from of a combination of weakness and tightness. The large muscles of the low back are chronically tight (and sometimes weak) causing the small postural muscles to take on extra work. That’s when a seemingly benign effort to pick up the paper or tie your shoes leads to an acute low back spasm.

Many of us exercise irregularly (this means you weekend warriors) so our bodies are not equipped to handle a sudden increase in demand. Driving or sitting at your desk for long periods tightens your hip flexors, making it difficult to stand up after an extended period of time.

What Happens if Your Back Goes Out?

First things, first. You’ll need to get rid of the spasm. Acupuncture and cupping are excellent for this, but sometimes medication is necessary. In this case muscle relaxants can be helpful, but will leaving you feeling groggy.

Controlling Inflammation Can Reduce Pain.

Inflammation is marked by pain and discomfort that is worse than a simple spasm. In this case, short term anti-inflammatories like Advil and Aleve may do the trick. If not, your doctor may prescribe a short, tapered course of oral prednisone- typically 5, 7, or 10 days. Buyer beware, steroid medications can also have unwanted side effects like insomnia, agitation, and excitability.

When to see an M.D.

If your pain is unremitting or you lose feeling in your feet, you could have significant nerve impingement. It doesn’t necessarily mean you need surgery, but you’ll need to see your primary care doctor to get a referral to a physiatrist (pain management doctor). Your doctor will order and x-ray and MRI to get a good view of what’s going on in your back. From that point they may recommend medications, local steroid injections, or a referral to a neurosurgeon. While this may feel scary to you, physiatrists see this condition on a daily basis and are well-equipped to triage the situation.

Rehabilitation: Staying the Course

Once you get out of acute pain and back to functioning normally, there’s still more work to do. In my practice, I see patients over several months to deal with the residual inflammation and pain. Then I work with them to support their rehab efforts with a good physical therapist (link), massage therapist, or chiropractor. No matter what, you’ll need both strength and flexibility to prevent a recurrence.

Need Help with your Back Pain?

If you’re suffering with back pain, it’s likely I can help. I am Board-certified in acupuncture orthopedics, a designation held by fewer than 1% of acupuncturists in the U.S. I also have a tremendous referral network of other M.D.s and alternative care practitioners who can support you.