Over the years, I have worked with literally thousands of people who suffer from mechanical lower back pain. During that time, I have identified several self management tips that are worth knowing. These tips fall into the category of “management of biomechanics” during activities of daily living.

First of all, most people who suffer lower back pain experience the pain episodically. Each episode is worse, last longer and over time, starts to come on more frequently. This is typical, and is the main reason why management of lower back pain is worthwhile.

My tips are these:

1. The pain is worse in the morning, and there is more risk in the morning. It is important then, to take care of the back first thing out of bed. This is true because during the night, the disc imbibes water creating increased intradiscal pressure in the disc before you get out of bed. You are indeed taller when you wake up than when you go to bed! So the first tip is to be cautious in the morning. I have advised people who have significant morning pain to actually get up in the middle of the night and walk around for several minutes as a way to mitigate the morning pain.
2. Walking is great medicine. The literature points out that maintaining your activity is of no harm, and I believe necessary to overcome episodic back pain. Sub maximal exercise gets your blood circulating, relaxes your muscles and generally promotes good health. The weight bearing also compresses the disc and squeezes some of the water out, meaning less pressure on the nerves. So a good walk every day is helpful.
3. Biomechanics is key. Be thoughtful about what you do. Face the things you do, keep lifting to a minimum, but when you do lift, keep the object as close to your center of gravity (around your belly button) as possible.
4. Avoid prolonged sitting. And when you do sit, a firm chair with back support and arm rests is ideal. Try to use lumbar support when you sit. For instance, when getting on an airplane, put one of those little pillows behind your back.
5. Use prolonged ice daily. I mean ice plus water in a plastic bag right on the skin for at least 30 minutes. The cold penetrates at about one cm every 10 minutes. It takes a half hour to numb the muscles and dull the pain. Be careful not to use gel ice packs because they tend to be too cold (if your freezer is below freezing) and not stay cold for long enough.
6. Finally, get fit. Fit people have a much lower incidence of lower back pain than the population at large. This is more of a long term strategy, but if you are stronger, your muscles do a lot to support you. Along with this of course goes flexibility and core stability. Develop your core and don’t forget your back side when you do so. Core exercises include hamstring exercises, and back muscle exercises as well.

Back pain tends to be episodic, the episodes tend to be more frequent over time, they tend to last longer each time and also to be more severe each time. Reversing these trends is the goal of managing your back pain. Follow my advice and you will be able to do so!

Good luck

Neil