David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Wednesday, February 20, 2013

HOW (AND HOW NOT) TO CRACK YOUR BACK

Everyone has acute low back pain from time to time. Most of the time it will get better on its own and be due to a muscle strain with or without joint pain, which is safe to treat with self-administered manipulation. Sometimes, however, it is better to be evaluated before home treatment:



See a health professional if your low back pain is:
  • right after a fall or accident
  • present for more than a month
  • making it hard to stand or walk
  • causing leg weakness
  • causing loss of urinary or bowel control
  • associated with unintentional weight loss
  • associated with fever, chills, or sweating
  • worse during or right after an exercise
  • no better after a week of home exercises



For safe self treatment it's best to do the exercises in the sequence they are listed. If no relief with a position of ease, stop the sequence and try a different low back pain routine (see subsequent posts). If pain is worse with a myofascial stretch, stop the treatment before attempting a joint mobilization and try again later. Some lower back problems are better treated with more specific routines that will be provided in subsequent posts.




LUMBAR POSITION OF EASE

Lumbar position of ease (WVSOM)

  1. Lie face down with a pillow or two under your pelvis on the side of back pain;
  2. If comfortable, take a few deep breaths and rest in this position for 2-5 minutes. If no relief with this position, move the pillows down to in front of the lower thigh just above the knee and rest for another 2-5 minutes;
  3. Proceed to a lumbar extensor stretch or slowly roll to one side before getting up;
  4. Use this position of ease 2-4 times a day or as needed for pain relief.



 LUMBAR EXTENSOR STRETCH
  1. Lie on your back and grasp both knees with your hands. If knee pain occurs, instead grasp the back of the thighs just above the knees;
    Lumbar extensor stretch (WVSOM)
  2. Use your arms to slowly pull the knees toward the chest as far as they will comfortably go;
  3. Take a few deep breaths and stretch for 10-20 seconds;
  4. Proceed to a lumbar self-mobilization or slowly roll to one side before getting up;
  5. Do this stretch 2-4 times a day.




LUMBAR MOBILIZATION
    
    Lumbar mobilization (WVSOM)
  1. Lie on your back with knees bent, feet on the floor, and arms outstretched;
  2. Drape one knee over the other and allow the legs to fall to the floor while keeping the shoulders down;
  3. Repeat to the other side;
  4. Do up to twice a day if helpful.




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