How To Treat Back Pain At Home

Throwing your back out is a painful scenario that is actually quite common. It is typical for someone with an acute episode of back pain to tell me:

"I bent down to..., but I could not stand back up."

"I stood up after bending down, but immediately I knew something was wrong with my back." 

"I twisted my back and quickly felt severe back pain."

"My back has been hurting since I was moving a lot of stuff around recently."

What To Do For Acute Back Pain:

Step 1. Decide if it is serious enough to see a doctor immediately.

Reasons To See a Doctor Immediately For A New Back Injury:

1. You can barely walk.

2. Your pain is so severe that no over-the-counter medicine is helping.

3. You experienced major trauma to your back.

4. The injury caused you to lose sensation in your pelvis or legs.

5. The injury has changed your ability to control your bowel/bladder function.
6. You have noticeable weakness in one or both legs as a result of your injury.

Home Treatments For A New Back Injury:

1. Ice. Ice down your back or the painful area for 10-20 minutes at a time, throughout the day.

2. Over-the-counter Pain Medicine, preferably an anti-inflammatory (Advil, Aleve, Ibuprofen).

3. Rest. Find the most comfortable positions and avoid aggravating movements.

4. Time. If it is not a major injury, it should progressively improve over the next few weeks.

Should You Immediately See a Chiropractor For a New Back Injury?
Seeing a chiropractor may be a good option if you have one that you know and trust. Ideally, go to one that has successfully treated you in the past. They can rule out red flags and tell you if/when to see a physician. If your pain is not improving with chiropractic treatment, do not continue for more than 3-4 weeks.

Should You See a Physical Therapist For a New Back Injury?
Yes! However, most Physical Therapists require a doctor's prescription before beginning treatment, so be sure to ask your doctor for this. In my experience, most patients with a new back injury will significantly improve within 1-2 weeks of PT, and many patients will get immediate pain relief within the first visit. If your pain is not improving within a month of PT, follow up with your doctor for further testing or treatment options.

What To Do for Sciatica in my Leg

Photo: John Ragal

There are multiple causes of sciatica or back pain that radiates down the leg(s). The most serious cause of sciatica is when a nerve root in the spine is being pinched by a bulging disc or by arthritis-type changes in the spine itself. Not only can this cause shooting pain into the leg(s) but also weakness in the leg and changes in the sensation in the leg (for example numbness or tingling in a portion of the leg or foot). If this is the case, it would be diagnosed through MRI and treatment options would be recommended by your doctor. 

Physical Therapists treat many patients with such sciatica. The key to relieving this type of sciatica is to stop the compression of the nerve root in the spine where it is being pinched. This can be done through positioning and exercises. If you are completely compliant with Physical Therapy and get no relief from any sciatica symptoms, then your doctor may try injections (usually with Cortisone) to provide some pain relief. This is a steroid, which provides an anti-inflammatory response. If you do not want injections, you may be prescribed oral medications for pain relief and/or anti-inflammation. 

Other conservative treatments for sciatica are going to a chiropractor, mechanical lumbar traction (requires a MD prescription) or getting acupuncture. Also some people get relief from inversion tables. Aquatic Physical Therapy (doing therapy inside a swimming pool) is another helpful tool for patients with sciatica.

Pregnancy, Exercise, and Eating

Photo: Takis Markopoulos

You may be tempted to decrease or stop exercising while pregnant. Or you may be tempted to eat whatever you crave--no matter how unhealthy. But doctors recommend you continue to exercise throughout any normal pregnancy. And, of course, eating right is more important now than ever, both for your health and your baby's.

Pregnancy and Exercise:
If you normally exercise at very high intensity, you will need to decrease to moderate intensity during pregnancy. Your guideline is to keep your heart rate below 140 beats per minute. So if you usually run at 6.5 or 7.0 miles per hour, you will likely decrease your pace to 4-5 miles per hour now. This is difficult for women like me who like hard and sweat-pouring workouts. But you can still do most of your usual workout activities as long as you slow them down or modify them.

Exercise Appropriate During Pregnancy:
Treadmill or walking/light jogging
Elliptical machine
Stair Climber
Stationary bike
Swimming
Yoga/Pilates
Weight training

Exercise Not Recommended During Pregnancy:
Fast Jogging/Running
High Intensity Cardio
Plyometrics
High Impact Aerobics

Pregnancy and Eating:
In the past 9 years I have been pregnant five times, so I understand cravings of all sorts: potato chips, chicken soup, fudge, popcorn, chocolate frosties, and even cheese grits. Most foods can be eaten in moderation during pregnancy. But here is a brief list of unsafe foods: fish high in mercury (including tuna), cold cuts, caffeine, alcohol, unpasteurized cheese, raw sprouts, raw sushi, smoked fish, raw or rare meat, foods prepared with raw eggs. Some of these are allowed in small amounts, such a serving of tuna per week. The book referenced below is very comprehensive about all types of foods and the recommended amounts during pregnancy. Generally, try to eat a wide variety of nutritious foods. Find foods full of iron and folic acid. Eat a lot of fruits and veggies! Drink a ton of water! All of these are great habits to start now and should continue when you are breastfeeding.

References: Murkoff, Heidi and Mazel, Sharon. Eating Well When You're Expecting. Chapter 7: "Eating Safely When You're Expecting."