While there is no cookie-cutter treatment for pain, this recent article in the Guardian is full of important things to understand and put into practice for anyone who experiences back (neck or hip) pain.
Below are the points I found most helpful and important, both in terms of prevention. Understanding what pain means (see below) is critical for being able to manage, treat and resolve pain, whether acute or chronic.
1. Avoid triggers
“Prevention is better than cure,” says John Corfield, an osteopath who runs a clinic in Wilmslow, Cheshire. “There are things you can do to help avoid the common causes of back pain, such as swimming, engaging the core and not sitting for prolonged periods.” Pay attention to postures or activities that aggravate your body and find ways to adjust your ergonomics, such as holding a phone against your shoulder—use headphones instead.
2. Get up and move around as much as possible
“The best thing you can do is move regularly,” says Emma Hayward, a Kent-based osteopath. “Even if that is just to get a glass of water and sit back down. It is about regular, small movements, so that your body is not in one static position for several hours.”
Consider a sit/stand desk if you work at a computer. “People sit at desks for way too long,” says Corfield. “You should be up and about every 20 minutes for five minutes or so. In Scandinavian countries, they are big on standup desks. We seem to be so far behind, considering there are more work days lost to lower back pain than any other injury in the UK.” Equally, you don’t want to be standing for a whole day, says Hayward: “Being able to change the position your body is in regularly is probably the best way you can prevent pain.”
3. Address stress
“I rarely see someone with an injured back who hasn’t also got very stressful things going on in their life,” says Hayward. “I think that primes our body to be more vulnerable to injury.” The osteopath James Davies, who is the author of Body, agrees on the significance of stress as a factor. When injured, “managing stress and ensuring you have a calm, balanced state of mind is integral to recovery”, he says.
4. Build up core strength
There are a range of exercises you can use to do this, says the osteopath Anisha Joshi, who runs clinics in London and Hitchin, Hertfordshire. She recommends focusing on strengthening the glutes by doing glute bridges: “This can be really effective at helping to support the lower back. Also, thread-the-needles (which involve kneeling on all fours then stretching one arm under the other) are good to get your mid-back moving, while planks gently engage your core to help the deeper pelvic floor muscles support your lower back from the inside.”
5. Slouch (occasionally)
Posture is not as important as people think, says Joshi. “There is no evidence to show that posture predisposes you to getting back pain. There is this common saying that we practitioners use, which is ‘the best posture is your next posture’, because it is all about moving. Even if you’re sitting up straight, you are still going to get back pain, so I’d encourage slouching a bit.” That said, adds Davies, “incorrect posture can lead to various problems, affecting everything from blood flow to muscle strain. It is essential to be conscious of how we sit, stand and move throughout the day.”
6. Treat back pain like getting a cold
Joshi points to the statistic that up to 80% of people will experience back pain at some point. “There is a lot of fear around back pain,” she says. “I try to get my patients to reframe it as almost like having a cold, because it is that fear that makes people panic.”
It is also difficult to avoid. Corfield had his last episode six months ago: “I was going to the gym, doing everything right – I was in great shape.” He was getting a chopping board out of a cupboard when he felt his back go.
7. Understand the meaning of pain
Try not to be afraid of pain, says Hayward, as hard as that may be. Understand what the body is doing when it sends out pain signals. “Pain can be really frightening,” she says. “People think that pain equals terrible damage. Often the pain is the body protecting against damage. So if someone strains a joint or a disc in their back, the body will very quickly create a muscle spasm, which restricts movement, but what that does is protect against further injury. But the muscle spasm itself is incredibly painful. So a big message for people is not to be frightened that they’ve damaged something. Actually, pain levels and damage don’t correlate.”
Nick Potter, an osteopath who works for the Centre for Physical Medicine and is the author of The Meaning of Pain, says: “It sabotages you deliberately, because the brain’s perception is something is harmed or dangerous and therefore it stops you. If you can learn to breathe and relax your muscles, the pain instantly improves.”
8. On feeling pain, act quickly
“Some people will say it will correct itself in six weeks,” says Corfield. “The issue is, if it doesn’t correct itself in six weeks, you’ve gone from it being an acute problem to becoming chronic. So it’s the flip of a coin. It could turn into a bigger problem than it would have been if it were dealt with sooner.” Joshi adds: “If you’re experiencing any pain or discomfort for longer than three days, you should get it checked.”
What to do when having a painful episode?
9. Use ice (anti-inflammatory) and heat (flush and keep things moving), alternating 20 minutes of each.
10. Painkillers can be useful, but can mask the problem
11. Keep moving... unless you are in severe pain. "Generally, movement helps and being sedentary can make things more painful and stiff.” Often, people will feel stiffer in the morning, as inflammation builds when you are still, but Hayward advises getting the spine moving as much as possible.
12. Adapt fitness regimes accordingly and diversify activities. “Regular [and varied] activity is a cornerstone of recovery and overall health,” says Davies. “It is not about intense workouts, but rather consistent, moderate exercise that suits your condition and lifestyle. The key is to start slowly, especially after an injury, and gradually build up to your previous level of activity, ensuring you don’t overdo it and cause further harm.” If you were very active before back pain, says Hayward, “it might have to be a staggered return”.
13. Get more sleep. “There is evidence to show that lack of sleep affects back pain more than back pain affects sleep,” says Joshi. “Focus on your sleep as one of the key areas of trying to heal your back through sleep hygiene and relaxing before bed. If you have to take painkillers to get off to sleep, do it.” Hayward says: “If you’re waking up very uncomfortable in the morning and you’ve got a mattress that is quite old, that could be something to look at.”
14. Relax on your back: What is the one thing we should all be doing to promote better back health? “Lie down on a flat surface,” says Davies. “Ensure your back is comfortably straight. Elevate your legs by placing them on a chair or sofa, forming a gentle angle. This position naturally aligns your spine and reduces the stress and pressure often exerted on your back muscles and spinal discs. As you lie in this restorative pose, allow your entire body to relax completely. This not only alleviates the tension in your back, but also promotes overall relaxation.
Click here to read the full article with even more (20 total!) comprehensive tips, above is just a selection.
