Lower Back Pain Help Page:
Position #1 on elbows. You can lie flat if it is too painful to be up on elbows.
If you have lower back pain and even butte and leg pain and need help now, this page is for you. I will take you through a series of "examination" maneuvers and test positions to hopefully lessen your pain. Most back pain is from painfully stiff and poorly functioning structures. The following maneuvers are modeled after the McKenzie approach, one that I am highly trained in. They will guide you back to some form of recovery or buy you time until you can schedule a visit with me. I will present this in a cookbook approach, giving you very basic instructions. Please read them first and follow along.
Essentially we want to avoid any positions or movements that increase leg pain, or any pain that goes away from the spine. We want to use positions and movements that decrease pain that is off to the side of the spine or in the leg. If your pain is centrally located in the lower back, we simply want to reduce it.
Try position one first. If it lessens your pain and it stays in the midline, progress to position THREE. If the pain does not centralize, then go to position TWO. The word "centralize" means to lessen or move any pain that is off to the side of the spine (or into the butt, hip, thigh, or leg) back to the center or midline after trying a position or movement. If the pain off to the side is lessened with a certain movement or position, even while the central lower back pain increases, is also a sign of centralization. We want the pain to recede back to the midline or lessen altogether. These are the positions or movements we will use for treatment.
1. Assessment:
a. Note WHERE your pain is: is it in the middle of your lower back? Off to the right or left side? Does it spread into your butt, thigh, leg, or foot?
b. Note what your pain level is on a 1-10 pain scale. A value of 10 is so bad you can not move and are being carried to the hospital! Zero is no pain at all. Five is moderate pain.
2. TEST POSITION #1
Lie on your belly, either on the floor or your bed, and prop yourself up on your elbows. If that is too painful, then just lie flat on your chest with your head turned. If that is too painful, put a small pillow under your belly at your belt line and lie on it. Try to relax in this position and note what happens to your pain. Assess it in a bout 3-5 minutes.
Does it increase, decrease, or is there no change?
Does it move from the right or left side of your back to the center?
Does it move away from the spine? Into the butt, thigh, or leg?
If your back hurts BUT THE PAIN STAYS IN THE MIDLINE, it is a good sign and it should slowly lessen. Remain in the position for another 3 minutes but try to get to your elbows if you were at first flat on your chest. It may hurt again but usually it gets better.
If it hurts or the pain even lessens, BUT THE PAIN TRAVELS AWAY FROM THE SPINE and into the butt or leg, this is a possible sign of nerve irritation and that this position is not good for you. Especially if you experience numbness or pins and needles in your legs and feet. If so, get yourself out of this position and end the assessment. Call the office for help: 508-835-2271.
3. TEST POSITION #2: SIDE SHIFT!
If your PAIN IS OFF TO ONE SIDE OR DOWN ONE LEG, while you are in test position #1, slide your hips AWAY from the side of your pain to see if the PAIN CENTRALIZES. This means:
Does your pain shift from the right or left side and go toward the center of your lower back? Or,
Does it go from your foot/leg and only extend to you knee, or thigh? Or,
Does it go from your thigh to your butt?
Does your pain centralize to your back?
If the pain centralizes in any way, stay in the shifted position for another 3 minutes to see if the pain lessens.
If the pain essens, then progress to position THREE.
If the pain gets worse with shifting away from the pain, then slide shift your hips TOWARDS the side of pain.
Essentially we want to avoid any positions or movements that increase leg pain, or any pain that goes away from the spine. We want to use positions and movements that decrease pain that is off to the side of the spine or in the leg. If your pain is centrally located in the lower back, we simply want to reduce it.
Try position one first. If it lessens your pain and it stays in the midline, progress to position THREE. If the pain does not centralize, then go to position TWO. The word "centralize" means to lessen or move any pain that is off to the side of the spine (or into the butt, hip, thigh, or leg) back to the center or midline after trying a position or movement. If the pain off to the side is lessened with a certain movement or position, even while the central lower back pain increases, is also a sign of centralization. We want the pain to recede back to the midline or lessen altogether. These are the positions or movements we will use for treatment.
1. Assessment:
a. Note WHERE your pain is: is it in the middle of your lower back? Off to the right or left side? Does it spread into your butt, thigh, leg, or foot?
b. Note what your pain level is on a 1-10 pain scale. A value of 10 is so bad you can not move and are being carried to the hospital! Zero is no pain at all. Five is moderate pain.
2. TEST POSITION #1
Lie on your belly, either on the floor or your bed, and prop yourself up on your elbows. If that is too painful, then just lie flat on your chest with your head turned. If that is too painful, put a small pillow under your belly at your belt line and lie on it. Try to relax in this position and note what happens to your pain. Assess it in a bout 3-5 minutes.
Does it increase, decrease, or is there no change?
Does it move from the right or left side of your back to the center?
Does it move away from the spine? Into the butt, thigh, or leg?
If your back hurts BUT THE PAIN STAYS IN THE MIDLINE, it is a good sign and it should slowly lessen. Remain in the position for another 3 minutes but try to get to your elbows if you were at first flat on your chest. It may hurt again but usually it gets better.
If it hurts or the pain even lessens, BUT THE PAIN TRAVELS AWAY FROM THE SPINE and into the butt or leg, this is a possible sign of nerve irritation and that this position is not good for you. Especially if you experience numbness or pins and needles in your legs and feet. If so, get yourself out of this position and end the assessment. Call the office for help: 508-835-2271.
3. TEST POSITION #2: SIDE SHIFT!
If your PAIN IS OFF TO ONE SIDE OR DOWN ONE LEG, while you are in test position #1, slide your hips AWAY from the side of your pain to see if the PAIN CENTRALIZES. This means:
Does your pain shift from the right or left side and go toward the center of your lower back? Or,
Does it go from your foot/leg and only extend to you knee, or thigh? Or,
Does it go from your thigh to your butt?
Does your pain centralize to your back?
If the pain centralizes in any way, stay in the shifted position for another 3 minutes to see if the pain lessens.
If the pain essens, then progress to position THREE.
If the pain gets worse with shifting away from the pain, then slide shift your hips TOWARDS the side of pain.
Position #2. Shifting hips away from a right sided pain. Slide hips to the left.
4. TEST POSITION #3: McKenzie extension, yoga cobra, or upper body push-up!
After trying either of the above positions, get your hands under your shoulders as if you are going to do a push-up on the floor, and push your upper body only up with your arms so that your hips and legs remain on the floor. Breath in as you push-up, LOCK your arms and keep them locked, breath out and SLOWLY let your hips and lower back stretch to the floor. After you are totally stretched, descend SLOWLY back to the floor. Repeat 10 times.
All along self-assess your pain LOCATION and intensity. The goal is to lessen or centralize any pain that goes away from the spine midline or is into the butte/leg.
You can substitute with the standing backward bending position using the above sequences. It might be easier but can me more difficult to use.
5. TEST POSITION #3: McKenzie extension, yoga cobra, or upper body push-up!
After trying either of the above positions, get your hands under your shoulders as if you are going to do a push-up on the floor, and push your upper body only up with your arms so that your hips and legs remain on the floor. Breath in as you push-up, LOCK your arms and keep them locked, breath out and SLOWLY let your hips and lower back stretch to the floor. After you are totally stretched, descend SLOWLY back to the floor. Repeat 10 times.
All along self-assess your pain LOCATION and intensity. The goal is to lessen or centralize any pain that is off to one or both sides of the spine or is into the butt/leg.
You can substitute the standing position also. It might be easier but can me more difficult to use.
Position #3.