An Osteopath’s Guide to (Non-Specific Low Back Pain) AKA Back Strain

Back strain

Patients often comment on the sheer physicality required as I move them around on the treatment table and manipulate them often using my body weight or core strength. Although it feels like a thorough workout for them we’re trained to protect our own bodies as well as patients’ when applying osteopathic techniques. Meaning that we don’t get back pain as a result of our work (and no your partner really shouldn’t do some of this stuff – you’re both at risk of injury!).

So for osteopaths, work is generally a pretty nice workout as we’re not sitting all day, we’re using our muscles, and very rarely strain our own bodies at work. In my experience, it’s much more common for osteopaths to strain their back at the gym or exercising, which always carries a bit of risk along with the enormous benefits.

So when I strained my low back for the first time three days ago (and woke up with a mild spasm two days ago) it was during a week when I wasn’t working. Of course!

Not being a regular gym-goer my own back strain is the commonest type of injury among my patient group – triggered not by one memorable event, but a combination of three minor ones.

These events (or ‘loads’) were: lots of driving – three longish drives over 5 days; lots of stress; and then lifting and carrying my toddler around in her backpack, which I hadn’t done for some time, and she’s now heavier. I didn’t feel it go, click or pop. I just felt, “hmmm…. I seem to have done something to my back” -ish.

I sort of knew there might be a problem brewing when several days earlier after the first drive, I felt the need to do a yoga/pilates workout at home, BUT DIDN’T GET ROUND TO IT.

My symptoms are classic back strain – sharp, stretching pain in the small muscles at the bottom of my back (but not reaching up to my waist as when additional muscles spasm) and aggravated by standing from sitting and letting my spine relax into a c-shape.

And for pain relief? I could definitely alleviate the pain with NSAID and paracetamol, but it’s not that bad, and movement (ie working) actually helps. I did try some Ibuleve gel I found in the bathroom cupboard (who put that there??) one morning (it’s worse in the morning before I’ve moved around) but that had literally no effect so I binned it.

I’m expecting it to resolve over the next few days. I’m going to do an online class (probably the Pilates class I recommend to many clients to reduce the spasm that I can feel there constantly and possibly a gentle yoga class a couple of days later. If it gets any worse (it averages a 3/10 currently, reducing to 0 when I’m standing and walking to a very transient 5/10 when I catch it) I’ll see a colleague for some manipulation.

The main pointers both from a personal and a professional perspective then are:

  1. If you feel your back tightening up, GET ROUND TO EXERCISE to release it. This is a sign that you are now at risk.
  2. Long drives are always challenging. Take lots of breaks, and try to exercise to irrigate and relax your muscles and ligaments between drives.
  3. NSAIDS and paracetamol and/or codeine are the best combinations of pain relief over the counter. On prescription, you may also benefit from Diazepam for the muscle spasm.
  4. Osteopathic manipulation will help.
  5. Keep moving regularly during the day (walking is often best) to irrigate the tissues and allow inflammatory cells to get to and drain away from the site of the strain
  6. Get enough rest (finding pain free positions that will allow the muscles to completely relax)
  7. If you haven’t got any leg symptoms and the spasm isn’t reaching your waist, it’s probably ok to wait a few days before calling the osteopath to see if the symptoms resolve. But if you’ve been in pain for more than a few days and are experiencing leg pain or upper back pain as well, get in touch!

Written by Andrea Rippe