Issue link: http://www.wacmagazine.com/i/146896
" During the acute stage of an injury—the first three days—it's typically best to keep moving and mobilize yourself within your comfort zone." Normal pain When you see a physical therapist, what will they do? For starters, they'll assess the issue and request further testing or consultation if needed. They'll also: • Give you a treatment plan and an exercise regimen to help you regain your function and reduce your pain; • Guide you through the process of healing; and • Educate you on posture and prevention. The fact of the matter is that low back pain and musculoskeletal issues are normal parts of an active life. If I were to take an MRI of all of the WAC members who work out on the 4th Floor and don't complain of low back pain, I expect a quarter of them would have a herniated or bulging disc. This sort of anatomical deformity is normal. It's not always necessarily degeneration as much as it's a natural maturation of the system. (Yes, that means getting old.) The overriding message for those with low back pain and any musculoskeletal injury is to stay active. Several comprehensive literature reviews have been advocating this for many years. During the acute stage of an injury—the first three days—it's typically best to keep moving and mobilize yourself within your comfort zone. The worst thing you can do is sanction yourself to bed rest. This, however, does not speak to a serious situation where you have loss of sensation or strength in your limbs. Most low back stiffness or spasms are due to a disc event of some kind, such as a strain, bulge or herniation. These events are self-limiting and will usually last for three to seven days. Typically, a patient will describe bending forward and twisting—then feeling a pain or a pop. They will not feel particularly injured but will have difficulty getting out of bed the next morning. What actually happens here is the outer portion of the lumbar disc, called the annulus fibrosus, tears a bit and creates a pathway for chemicals in the inner portion, the nucleus pulposus, to leak into the body. These chemicals, called glycosaminoglycans, are very irritating to the tissue outside the disc and cause pain and swelling. The disc repairs itself quickly as the chemicals that were released dissipate. It's very important to get active as quickly as you can after this stage of healing, return to your normal activity, and stay consistent. It also may be time to focus on core exercises, weight management, and nutrition as part of your recovery. If symptoms persist or you feel stuck in your recovery, you should seek advice from a medical professional. That could be a general practitioner, a rehabilitation specialist, or a physical therapist. A state of therapy In Washington state you have direct access to any physical therapist. Many insurance plans don't even require a referral. This often means you can see a physical therapist faster and in turn experience a quicker recovery. So what do you do if an injury such as low back pain is keeping you down? First, modify your routine but stay active, ice yourself, and take anti-inflammatories as you feel necessary. Second, return to your normal activity and see if you can get back to 100 percent within a week. Third, if you are having trouble getting back to your previous functional level, seek medical care, preferably from a physical therapist. As a WAC member, you have access to a comprehensive Wellness Center that is focused on members' health and recovery. We're here to help. Persistent pain shouldn't be a part of life. for a better back Follow these tips when you experience a back injury: • Walk distances that don't increase your pain. • Use ice for pain relief. Five to 10 minutes on the area of pain at a time, several times a day. • Be careful with your sitting posture. • Stand up slowly from a sitting position. • Use a pillow to prop up your knees when sleeping on your back. Place the pillow between your legs when sleeping on your side. • Seek medical advice. Stuart Eivers, physical therapist at the WAC, can be reached at 206.839.4780 or wellness@wac.net. AUGUST 2013 | Washington Athletic Club Magazine | 29