How Do We Go About Treating Back Pain?

When you injure your back, the pain can be intense and surprising. Simple movements can feel like sharp, stabbing jolts. The first step—for both you and your therapist—is don’t panic. With the right diagnosis, guidance, and treatment, most back injuries improve well. Below are the key principles we follow when managing acute back pain.

1. Avoid Aggravating Activities

Avoid movements that reproduce your pain, especially in the early stages. For many people, the painful movement is spinal flexion (bending forward). This is often how the injury occurred—picking something up, tying shoes, making a bed, etc.

Think of it like a sprained ankle: you wouldn’t walk on uneven ground immediately after the injury. The same logic applies to your spine—avoiding the painful direction gives the discs and joints time to settle.

What makes the spine tricky is that flexion may not hurt at the time, but the pain often appears minutes or hours later. Dr. Stuart McGill, a leading spine biomechanist, has demonstrated in his research that spinal discs can only tolerate a limited number of flexion cycles before becoming irritated or injured. The spine tolerates compression well, but repeated bending is what often causes problems. This also can be low load over a prologed period such as sitting. I know full well sitting and driving can aggravate symptoms. So early on, avoid unnecessary bending to reduce mechanical load.

2. Learn the Hip Hinge

The hip hinge teaches you to bend forward from the hips rather than the spine. This allows the torso to move without flexing the lower back, reducing the load on irritated discs and joints.

Dr. McGill’s measurements show that a proper hip hinge can reduce spinal bending forces by 30–40%. This is extremely helpful in the early phase of recovery when the goal is to calm the area down.

3. Limit Bending and Prolonged Flexed Postures

This is reinforcing tip number one. Avoid long periods of sitting or sustained forward-leaning tasks such as:

• Mopping or sweeping

• Ironing

• Preparing food

• Repetitive manual tasks

• Sitting at a computer for long hours

There is no one perfect posture, but staying in one position for too long increases mechanical load. Think of sitting on a hard wooden chair—you eventually need to move. The trick is to change positions before pain begins, not after.

4. Use Pain Relief and Anti-inflammatories When Appropriate Short-term use of NSAIDs (e.g., Nurofen, Voltaren) and simple pain relief can help reduce inflammation and allow you to move more comfortably. Always check with your pharmacist or GP to ensure these medications are safe for you, especially if you take other medications or have health conditions.

Medication won’t “fix” the problem, but it can reduce irritation, improve sleep, and help you tolerate movement and therapy.

5. What Exercises Should I Do?

If bending forward increases your pain but arching backward only feels stiff, you may benefit from gentle extension-based exercises. These help reverse the constant flexion many of us live in:

• Sitting at breakfast

• Driving

• Working at a computer

• Cycling or sitting for exercise

Standing lumbar extensions can often be easier for people to fit into daily life. However—not all disc injuries respond to extension. If your nerve pain or back pain worsens with these movements, stop and consult your therapist.

6. Go for a Walk

I have found personally something as simple as walking around the block helps loosen you up. I started just walking around the kitchen then progressed to walking around the block. Start with 5 to 10 minutes and see how you feel. You can also do this multiple times a day because it’s only a short time. As the days go on you can increase the time as symptoms permit

7. Massage and Heat

After a back injury, the surrounding muscles often go into spasm as the body tries to “splint” the area. These tight tissues can be a major source of pain and can restrict movement.

Massage and heat help to:

• Decrease muscle spasm

• Improve blood flow

• Reduce pain

• Restore normal movement patterns

8. Your Mental Wellbeing Matters

Back pain can be frustrating, draining, and worrying. It may affect your sleep, mood, and daily confidence. This is completely normal. Keeping moving within your limits, getting reassurance from your therapist, and sticking to the plan can help you stay calm and in control.

• Stay patient

• Stay positive

• Your back will improve with time and the right guidance

Recovery isn’t always a straight line—but following these steps helps you move in the right direction.