[Closed] Help! Just put my back out. ARGHHHHHHH!

Fire a hot water bottle onto it. Take pain killers. Get it moving.

Bath? Lie down now. Don't take pain killers.

First the ticker, now this - you're not having a good few weeks.

Keep moving, co codamol and alcohol are your friends.

If it hurts take painkillers, it's that simple.

Then seek a GP appointment next week or minor injuries unit over the weekend.

http://www.nhs.uk/Conditions/Back-pain/Pages/Introduction.aspx

Heat. As mentioned above - a hot water bottle. As hot as possible. And keep moving if you can.

I should know - I've had 2 lumbar microdistectomies to repair prolapsed discs! Good luck.

Frozen peas wrapped in a teatowel & try a few gentle stretches.

here, let me summarise:

ice, heat, painkillers, no painkillers, lie still and keep moving. Booze.

Hope this helps 🙂

Ignore everything that disagrees with the physio who posted. 😀

Ibuprofen, ice, painkiller, if it hurts don't do it, but try to keep active, but not if it hurts. Diazapan if things go really wrong, to stop the spazam,..

Beer so helps at least short term. Long term its all about the abs.

Ignore everything that disagrees with the physio who posted.

Oh, that reminds me!

*sets reminder to compose email about knee issue tomorrow*

😀

^ oh FFS, is that George?

*goes to check recent driving threads*

As said above, stay as active as possible. Alternate hot and cold. Try not to lie on your back. Lying on your side with a pillow between your knees much better for spinal alignment.

If it really hurts and you don't get on with codeine then diclofenac (Volterol) is good. If all else fails tramadol or gabapentin of it's long term.

Good luck!

If its muscle spasms then like Twinw4ll says cocodamol is your friend

Keep it moving, flex it, if it hurts, take pain killers.

It will work its way back.

Whatever you do, don't lay there trying to keep it still. Movement is the key.

^ oh FFS, is that George?

No. My name is Joe.

Jamie, I sent you an email.

Like someone said ignore the physio - cocodamol and ibruprofen and lie still no running about bollocks! If this is not doing the job head down to A and E and ask for Tramadol and Diclofenac (great stuff) and do not entertain going near a chiropractor

Don't go to A&E with a sore back. I'm sure you have more sense than that of course.

I would advise going to a chiropractor. But only if you want your back to get better and not suffer horribly with debilitating pain.

If you enjoy the above then avoid at all costs.

If I have back problems, I curl up in a ball mushroom style on the floor, stay that way for a few minutes.

I guess we were made that way.

It works for me, to stretch things back out to where they should be.

I would go with Drac's advice 🙂
In the longer term, Pilates might be a good way of strengthening your core. I started Pilates last year and the exercises are great.

Depends what you've done as to the best medicine.

I have a herniated disc ad L5/S1 (basically lower back) and although when it went the first time I had to have interesting x-ray guided injections, if I tweak it now I use diclofenac and co-codamol.

When mine 'goes' I have no option but to lie down as I just can't move otherwise. But it is normally only for an hour or so then I get downstairs to take some tablets. After that usually walk round the house trying to keep my back straight and stretching occasionally before it frees up some hours later.

After a few days on the diclofenac it is usually ok again. I try not to take co-codamol for more than a day or so as it is nasty.

However different people need different remedies so if yours still hurts or gives you pain get down to the docs.

After a few days on the diclofenac it is usually ok again. I try not to take co-codamol for more than a day or so as it is nasty.

Diclofenac is awful too it works but it's pretty nasty stuff.

Avoid NSAIDS (anti inflammatory medication) for first 48 hours. Pain killers and move as pain allows. Any loss of control of bladder or bowel go to A&E, otherwise G.P, walk in centre or Physio if it doesn't improve over the next 7 days.

What's the thinking behind avoiding NSAIDs and/or other painkillers?

If decide to go down the NSAID route, you can get diclofenac over the counter in lower doses - Boots do a generic version. But as Drac said it is nasty - follow the instructions - My dad got a stomach ulcer that was attributed to not properly using diclofenac - it is effective but be wary.

Why avoid anti-inflammatories for 48 hours?

I had heard from some demo reputable source the theory that it might be disadvantageous to take pain killers because you will then move around and possibly further hurt whatever it is. I will defer to the more knowledgeable here though.

This video changed my life about 3/4 years ago!
Every time my back went (4/5 times a year) I'd go to chiro and he'd pretty much do what's in the vid but charge me £35.
I've been doing this once a week and the first flare up in 4 years was last Saturday.
Got home, done what's on the vid and was instantly mobile but the muscles were sore for about 4 days.
Got out cycling on Tuesday night without any pain.

Taking pain relief allows you to move more which is good for back pain. Follow the advice on the NHS link I gave above to make sure you're not serious, posting straight away on a forum suggests it's probably not, and you'll be ok. There is absolutely no sense in being in pain when you don't have to be.

I love how back pain advice from the lay person is stuck in the 19th century. It keeps me in a job. 😀

Thought it was NICE guidelines unless it's changed.

Recent thinking recommends that NSAIDs are withheld in the immediate post-injury phase when the inflammatory process is at its peak (Braund and Abbott, 2011; Stovitz and Johnston, 2003). The inflammatory phase has important healing properties, stimulating and facili- tating soft-tissue repair, regeneration and growth. It therefore follows that reducing this integral process may impair healing, and delay overall healing time (McGriff- Lee, 2003; Mishra et al, 1995).

Can't find the NICE stuff but pretty sure that's the current advice. Painkillers are fine obviously to help promote movement as mentioned previously.

I've just realised who you are Kurt.

You sorted my physio out when I knackered my scaphoid a few years back.

And my knee.

The NICE guideline is being updated, but the old one said this:

http://www.nice.org.uk/guidance/cg88/chapter/guidance#pharmacological-therapies

Kurt took his paragraph from this article http://www.nursingtimes.net/Journals/2012/11/01/g/z/e/061112-Evidence-on-NSAID-use-in-soft-tissue-injuries.pdf. That article goes on a hell of a lot about RICE. There is very little evidence to support RICE, that's why it has been replace with POLICER. Protect, Optimal Loading, Ice, Compression, Elevation and Rehab. But there's not a lot of evidence for that either.

Personally, I'd stick with taking the NSAIDs as laid out in the NICE guidelines as opposed to listening the a junior charge nurse such as the author in the paper Kurt linked to.

Wanmankylung, have you read the papers he has referenced? I haven't either but it does give a good summary of plenty of the literature out there. Like anything you can argue the toss either way. To be fair there are more nurse prescribers than there are physios....

POLICER is more relevant for peripheral joints?

The BJSM podcast has a good one on NSAIDS for any one that is interested.

Hey Bregante, hope you are well, did I treat you?

You did mate. Must be 4 years or so now. At Sedgeley.

The papers used in the construction of that article are upto 20 years old. I wonder if they chose those papers because they are the only ones which support their argument or if there is no newer evidence.

Just to clarify, I'm not saying that NSAIDS shouldn't be used at all, just that in the initial inflammatory phase they may possibly hinder the healing process so may be worth considering holding off for a short period of time (48hours) if the pain can be controlled using other methods.

on the iPad now but will have a look for some current stuff tomorrow if you like when I can get Journal access. I am sure there will be stuff to support either approach, just my personal preference would be to hang fire on the NSAIDs initially if possible. Generally post surgery consultants seem to avoid anti inflammatory medication with the same justification, which I think is not a bad acid test..

Cheers

Kurt

Bregante,

Hi mate, I am sure I would recognise you by face but not sure from your forum name. No doubt I will bump into you at sedgley at some point. You must be back riding if you are on here.

Cheers mate,

Kurt.

Generally post surgery consultants seem to avoid anti inflammatory medication with the same justification, which I think is not a bad acid test..

The limiting of NSAIDs post surgery is more to do with decreased clotting/increased bleeding rather than inflammation.

I hope I don't get any one with lower back pain today if I prescribe dicolfenac I might be breaking no NICE guideline.

Wanmankylung, is that not relevant when considering healing following an acute muscle injury?

This podcast is a discussion between the editor of the British Journal of Sports Medicine and Professor Lars Nordsletten a Sports Physician supports the consideration for avoiding NSAIDS immediately post injury.

Professor Lars Nordsletten on NSAIDs and COX-2 inhibitors in sports medicine: A cautionary tale by BMJ talk medicine https://soundcloud.com/bmjpodcasts/professor-lars-nordsletten-on on #SoundCloud

and another one from the BJSM with discussion on NSAIDS

“Mythbuster” on NSAIDs in sports medicine, challenging nutrition dogma, and evidence-based practice by BMJ talk medicine https://soundcloud.com/bmjpodcasts/mythbuster-on-nsaids-in-sports on #SoundCloud

I had a spinal fusion 2 months ago and the surgeon told me to avoid NSAIDS because they inhibit the heing process as well as increase the risk of bleeding.

Surgery is different vickypea.

Wanmankylung, is that not relevant when considering healing following an acute muscle injury?

That would depend on the nature of the injury. But for back ache there's not likely to be a hell of a lot of bleeding.

Dunno? Only basing my opinion on the use of NSAIDs immediately post injury on current literature and experts in the field. Obviously we would give different advice, which is fine everyone can have their opinion on how to best manage an injury depending on the evidence we choose to influence our practice.

We have no or very littke evidence here and can't do an assessment so best that the OP follows NHS advice, which mentions NSAIDS, until they can seek help. Me if he fits the acute back injury criteria without any of the complications then I'd be prestibing codeine, paracetamol, diclofenic and possibly diazepam if they're were no contraindications.

Drac - is that so that the constipation takes their mind off the back ache?

Something like that.

I'd be prescribing codeine, paracetamol, diclofenic and possibly diazepam

That is exactly what I was given after I was hit by a minicab on the club run and left with a couple of stable spine fractures. It helped deal with the pain and I dealt with the constipation later. I did end up in the land of the fairies mind.

EDIT : No, I've just remembered, it wasn't diclofenic that I was given to take with codeine, paracetamol, and diazepam, it was tramadol, that's what sent me to the land of the fairies.

I know surgery is different to the OP's situation, but wanmankylung said above that limiting NSAIDS post-surgery is more to do with increased bleeding. But surely that is most relevant in the short term, whilst longer-term avoidance of them post surgery is related to inhibition of healing?

Yeah tramadol is supposed to be wonderful. I'll add that I wouldn't necessarily prescribe all those that's the options I have.

No Vickypea they avoid them post surgery for increased bleeding, they're used long term post surgery to reduce inflammation to allow healing and aid pain relief. Even Paracetamol is a pretty good antiinflamatorty. Current guidelines for acute back pain is to consider NSAIDs. If I didn't consider using them I'd have to give a good reason not to, reading an article wouldn't really be any good for me as I'm not a practitioner.