Arrgh! So you bent over, and while trying to put on your shoes, you felt a twinge in your back. Over the next twenty minutes it just gets worse, to the point where you know you’ve really hurt yourself. What should you do? Try and ignore it, and suffer through work? Or ring in sick and lie down all day? The latter, while sounding like the better option (and isn’t that why we have sick leave), is almost the very worst thing you could do.
Why is this? The main reason is due to the body trying (a little too earnestly) to protect itself and causing a heap of muscle spasm. Because the spine is regarded by the brain and the body as a fairly delicate and important area, it overreacts to tissue damage and creates significant muscle spasm to splint and stiffen the spine. With immobility this spasm builds and builds, creating more lactic acid and metabolic by-products resulting in more pain.
Secondly, a highly common component in an acute injury is the presence of inflammation, and this is true in the case of back pain. When sitting still, this fiery soup of noxious chemicals effectively “pools” – explaining why you are often sore and stiff when you first rise after sitting down for a long time. Movement allows blood flow and can stop this build up, resulting in a less painful experience for the individual.
There is growing evidence to support “early movement management”, even in cases where it seems counter-intuitive (e.g. ankle sprains), and it’s becoming a best practice principle in Physiotherapy and Sports Medicine. Movement helps to avoid the above problems, but more importantly, and most effectively is if is non-aggravating, it let’s the brain and the body know it’s not in danger. This breaks the pain-danger cycle and lessens the pain experience.
So what do I do then? Can’t I have a bit of a rest?
Definitely. I can’t expect one to constantly pace the hallway all day, but it is of vital importance to avoid static postures for extended periods, particularly at work where you may spend hours at a time stuck at your desk. My general suggestion for office workers is to try and get up for a short walk (1-2min) every half an hour, or try a stretch or back movement that doesn’t make the pain worse. Yes, this will result in a slight reduction in time at your desk; however, with pain reduction there is less distraction and likely more productivity. Pain relief (particularly in this acute stage) is of benefit and allows this normal movement to occur, and it helps a good night sleep.
So I can run a marathon? Thankfully we can fall back on commonsense here and understand that while a bit of movement is good, too much (particularly in aggravating positions) will likely hurt. Also, if you are in a situation where you are unable to walk, have shooting leg pain/pins and needles/numbness, or cannot find a movement that doesn’t hurt, speak to your Physiotherapist as professional help is definitely indicated. Your Physio can identify the problem, assist with pain relief and get you back on the path towards normal movement.