First Aid for Back Pain

by Christina Lasich, MD Health Professional

Many would argue that back pain is inevitable and for some it becomes a sudden reality. Bending over to pick up a piece of paper, moving furniture, or reaching for something in the car's back seat; one of these scenarios may sound familiar to you. At home or at work, you need to know what to do when a sudden attack of back pain occurs. Fortunately, most back pain will get better naturally. But in order to improve your chances of recovery and to save yourself a trip to your doctor's office, you need to learn some first aid for back pain.

Those of you familiar with life-saving first aid remember the ABC's (Airway, Breathing, and Circulation). Let's apply the ABC's to your back; "A" for arrest the offending activity, "B" for balance the pressure, "C" for control the inflammation. With the ABC's for sudden back pain, you can quickly recover from a sudden back pain attack.

A rrest

Let's go back to the scenarios: bending, lifting, and twisting (the BLT's). All of these activities can trigger back pain. Now, it makes no sense to keep pulling that trigger when your body is screaming "ENOUGH" Sometimes you become so focused on finishing a task that you push past the discomfort. When you are in pain, you need to focus on some first aid for pain.

Start with "A" and arrest the activity that is causing the pain. In other words, take a break and let your body recover. Remember, most back pain goes away naturally, unless you continue to push beyond what you can physically tolerate. As a general rule, give your back a 24 hour period of recovery before attempting to gradually resume your BLT's. Recovery does not mean bed rest; therefore, stay as active as possible. Recovery is not doing the laundry, lifting boxes, and pulling weeds in the yard. Those all require too much bending, lifting and twisting. Try life at half speed without BLT's until your back feels better. "Arrest" is the first step for quick relief.

B alance

What else should you do while you have halted the painful activity? Now, it is time for "B"-balance the pressure. Most sudden back pain attacks are caused by the discs which, like balloons or tires, are sensitive to pressure. Sudden loads of abnormal pressure by bending, lifting, or twisting leads to back pain. The best way to balance the pressure is by unloading the spine with comfortable positions. The fetal position (lying on your side with your knees pulled toward your chest) relieves pressure in your back. You can also relieve pressure by lying face down on a bed, exercise ball, or high counter top so that your chest and tummy are supported and your legs are dangling towards the ground. Try this for 20 minutes every 2 hours for the first 24 hours and then three times daily until the pain goes away.

Ultimately, the sudden load that caused your back pain needs to be balanced out with a pressure relieving activity. In fact, unloading your back throughout the day helps to prevent sudden relapses of pain. You cannot load, load, load your lumbar discs all day long without unloading once and a while. That unbalanced lifestyle is like making withdrawals from your bank account without making deposits. Eventually, your bank account (your back) runs out of money. Balancing your "back account" not only helps you at the first sign of trouble, but also keeps you out of trouble.

C ontrol

Finally, your first aid is not complete without controlling the inflammation-the "C" is for control. That's right, grab the ice pack because ice is the best natural anti-inflammatory that can cool the fire of a new injury in a hurry. If you do not extinguish fires, they tend to grow out of control. But be careful not to burn your skin. So use the ice for just 20 minutes at a time throughout the day until the back pain is relieved. Now, if the ice is just not enough and you are able to use anti-inflammatory medications (check with your doctor first), the over-the-counter anti-inflammatory medications like ibuprofen, aspirin, and naproxen sodium are all equally effective at subduing the fire of back pain. Gaining "control" over the inflammation is essential to good first aid for back pain.

Some of you may be wondering about heat at this point which is great because heat controls muscles spasms. Well, go ahead and try it. See what works best for you because some back pain is caused by inflammation, other pain is caused by muscle spasms, and some is caused by both. Ice for the first 24 hours, then heat, then alternate; all combinations work. The main point is for you to be proactive in controlling your pain. Don't panic. And stay in control during a sudden episode of back pain.

To the Rescue

Back attacks can occur at anytime, but you don't have to panic as long as you know what to do. The first 24 hours are critical for starting this first aid process-the ABC's of back pain. If you arrest the offending activity, balance the pressure, and control the inflammation, you will be on the road to recovery. Back pain has become a battlefield full of victims who did not use first aid. Some ignored the pain, some pushed beyond limits, and some didn't put fires out fast enough. These casualties of back pain are not inevitable; they are preventable with some good sense. First aid for sudden back pain is as simple as remembering your ABC's-arrest, balance, and control.

So when do you need to call for the rescue team (emergency personnel or health care providers)? I remember one episode as a firefighter. We were called to assist a man who was in so much pain that he could not move from being wedged between the toilet and the bath tub. Obviously, some situations may require some assistance like being stuck in the bathroom or falling off a ladder. Most importantly you should know that a true back pain emergency is when the nerves suddenly stop working. Sudden, uncontrollable urges to urinate or defecate and sudden paralysis (legs or arms stop working); both are signs that the nerves might be damaged. These examples are all times when you want to remember "D" for dial 911.

Back pain happens, the responsibility for care and for deciding when to seek medical attention is yours. If you don't have an emergency situation, then first aid is a great place to start. Remember, you are your body's keeper.

Christina Lasich, MD
Meet Our Writer
Christina Lasich, MD

Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.