Physiotherapy for Acute Back Pain

Do you know that feeling when you wake up in the morning and can’t turn your head? Have you ever felt a sharp pain in your lower back that prevented you from straightening up? Have you ever experienced a situation where, after a sudden movement, you felt as if an arrow had shot through your chest and you couldn’t even breathe? If so, I’m sure you’ll agree that, in that moment, you would do anything to make that unbearable pain stop so you could function normally and enjoy life again.

Acute pain of the musculoskeletal system affects a large part of the population. It may occur once in a lifetime, or repeatedly in regular cycles. Intense pain and limited movement restrict a person in most everyday activities. Suddenly, you find you’re unable to work, fully take care of your family, or engage in sports or other enjoyable activities. The only thing you want is for this unpleasant state to finally end.

Manifestations of Acute Problems

Pain

The most typical symptom is pain. Most often, this is sharp pain, usually localized in one spot, radiating into nearby parts of the body. In acute cervical spine problems, pain often radiates between the shoulder blades, into the shoulders, or to the head. Pain in the thoracic spine can travel under the shoulder blades or behind the rib cage. At the same time, rib movement when breathing may also be painful. Acute pain in the lumbar area is most often associated with radiating pain into one or both lower limbs.

Limited Movement

Acute back pain is often accompanied by limited mobility in the affected area. One component of movement may be limited (for example, only rotation to one side or forward bending), or several components at once (it’s impossible to bend forward or sideways).

Causes

Before listing the most common causes of acute back pain, it is important to mention that these problems are rarely caused by just one factor. Usually, several risk factors contribute to the development of the mentioned issues at the same time.

Major one-off load – typically lifting a heavy object

Unusual physical activity – sporadic activities (autumn garden maintenance, picking fruit from trees, moving house, home renovations…)

Sudden uncontrolled movement – unexpected situations such as quickly turning your head while driving, a dog suddenly pulling on its leash, or tripping or falling

Chilling – excessive cold acting on muscles leads to irritation of nerve endings and subsequent reflex muscle contraction (appropriate prevention is hardening/conditioning the body to cold)

Muscle imbalances and suboptimal posture

Chronic muscle overload – repetitive strain from sedentary or manual work

Psychological stress – increased mental tension leads to reflex muscle contraction

Mechanism of Onset

Great stress on muscles, joints, ligaments, but also nerve structures is potentially dangerous for our body, so the nervous system is set up to quickly prevent these situations. It does not necessarily have to be only extreme physical stress. If you have a sedentary job and chronically overload only certain muscle groups, even a seemingly small load can lead to significant overload. Exhausted muscles are no longer strong enough to keep joints in an ideal position, and our control system must react quickly before damage occurs to any of the structures.

In order for the nervous system to stop us, it has to use its strongest tool, which is pain and restricted movement. This is the only way it can let us know that something is wrong in a specific area and that we should rather leave it at rest. But not all rest is created equal. Although it may seem that complete bed rest helps the most, appearances can be deceiving. As soon as possible after the onset of acute problems (if the pain allows), physiotherapy should begin. Timely physiotherapeutic intervention significantly shortens overall recovery time and prevents acute problems from becoming chronic (more on chronic back pain here).

Physiotherapeutic Treatment

Acute problems in the spine area are treated by the physiotherapist mainly through gentle manual treatment of the affected muscles and targeted exercise. The exercise focuses on reducing the load on the muscles in the affected area and gradually restoring muscle balance. It is also important to educate the individual about lifestyle measures that must be taken to prevent recurrence of problems.

More information about my physiotherapy practice here.

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