» Blog
» Low Back Pain: Handle with Care!
Low Back Pain: Handle with Care!

Have you had back pain recently? It always seems to start with the same story:


“ I was doing yard work over the weekend and couldn’t move the next day. “

“ I bent over to pick up my son and I couldn’t stand up straight.”

“ I hurt my back and went to the emergency room.  The only thing they gave me was muscle relaxers and pain medications.”

“I hurt my back, but I wasn’t told to go to physical therapy.”

We believe that physical therapists should be the first point of contact with those experiencing low back pain. Statistics in the United States regarding low back pain are staggering.   28-40% of people in the U.S have experienced low back pain in the previous 3 months [1].  Between 12-15% of the US population will visit their physician with a complaint of low back pain [2].  Estimated annual direct medical costs for all spine related conditions for the years 2002-2004 were $193.9 billion[3].  Unfortunately, many of theses costs could be reduced if some basic rules to acute low pain were followed.

What are common symptoms of acute low back pain?

  • Severe back pain described as sharp, stabbing, locking, gripping or burning
  • Difficulty standing or sitting for any length of time.
  • Inability to complete normal daily tasks or job requirements.
  • Pain into the leg

How should I manage my symptoms in the first 24-48 hours?

Following these recommendations at the onset of low back pain for the first 24-48 hours, and patients can drastically reduce their recovery time.  While we make these recommendations, we still suggest seeking care from a qualified medical professional when you feel appropriate.

  • Ice for 10-15 minutes every hour for the first 24-48 hours.  Ice helps to reduce inflammation and pain.  Heat should not be used initially as it will cause swelling.
  • Positioning: Position yourself in the most PAIN-FREE position you can find.  Use ice in these positions.  Ideas include: On your back with feet elevated.  Pillows should be support your legs and hips fully.  On your stomach use pillows underneath your stomach and hips.  If you are on your side, pillow should run from your groin to your ankles. Use pillows, blankets, or towels to prop yourself if needed to make yourself more comfortable.  Body pillows are great options in this situation.
  • For the first 24 hours, when movement brings on pain, RETURN to your position of comfort until your pain-subsides again. This should be continued for the first 24 hours.
  • Call your physician to determine whether medication is recommended.  Anti-infllammatories, muscle relaxers, and prednisone dose packs are commonly prescribed in these situations.

GENTLE and PAIN-FREE movement can be effective to provide gentle stretching, relaxation and blood flow to injured and inflamed muscles, nerves and tissues.  Try these below:


Lower trunk Rotation: Try laying on your back with your knees bent and gently rocking knees side to side.

 Pelvic Tilts: Gently tighten and relax your stomach muscles.

  Gentle hamstring stretching: Slowly bend and straighten your knee.


  • Call your physical therapist!  A detailed evaluation and assessment can help get you back on your feet.  Skilled manual therapy techniques, trigger point dry needling and specific exercises can help get you back on your feet!

When is physical therapy not appropriate?

  • Should you have noticeable weakness in your legs, or feel like you are unable to control the use of your foot.
  • Should you have any loss of bowel or bladder dysfunction.
  • Extreme pain into your leg making it difficult to move.


[1] National Center for Health Statistics, National Health Interview Survey, 2006

[2] National Center for Health Statistics, National Health Interview Survey

[3] National Center for Health Statistics, 2010.

Check out Dr. Tamer Issa's book, Freedom From Neck & Back Pain- Learn to Live an Active Life Without Fear of Pain