What To Do When You Tweak Your Back

So you tweaked your back. It might have been from picking up something off the ground, in a workout, or getting out of a car. Some questions that might go through your mind are

“What do I do now? How bad is the ‘injury? Will I ever lift weights again?”

The good news is, it’s probably not nearly as bad as you think. Here’s how you can quickly get back to feeling 100%.

Enter competitive powerlifter and MD, Dr. Austin Baraki of Barbell Medicine

“In the absence of obvious acute injury or emergent medical conditions, how should we treat people’s nagging aches and pains? Unfortunately, there’s no single way, and going into detail on the topic would require an article (or book) even longer than this one. But, with the biopsychosocial model in mind, we can suggest a few important steps.

1) Managing stress, anxiety, and depression (much easier said than done)

2) Education about back pain to reduce the fear that your pain is reflective of constant “danger”

3) Getting adequate sleep

4) Avoiding use of opiate pain medications and “muscle relaxants” (although acetaminophen/NSAIDs may be helpful)

5) Exercising – or, even better, training – to move through previously “threatening” ranges of motion

6) Continuing to participate in normal activities (i.e, avoiding immobility!)

In addition to these steps, massage, a chiropractic adjustment, some physical therapy, or even seeing a physician might help as adjunctive measures and might be worth a shot. Still, some caution is warranted. If you encounter someone who describes their “one true cause” of pain or confidently offers relief through a single treatment modality, watch out. Additionally, depending on the practitioner, they might impart a harmful nocebo effect if they harp on your imaging findings or warn of imminent structural failure unless you get their treatment. Don’t get caught up in the mechanical doom-and-gloom mindset.

Although the current data does not show significant benefits of targeted “core” strengthening or specialized exercise prescription compared to “regular,” nonspecific exercise, our preference for physical intervention involves the application of gradual progressive overload through basic barbell training, for reasons described at length elsewhere. Our collective experience with this method has given us a clear idea of its effects in healthy populations, despite the lack of controlled trials. Even if it means starting with bodyweight or the 5-kilo aluminum training bar, it seems to build strength and the confidence that you are not broken more reliably than any other exercise model in existence. A competent, reassuring, and experienced coach can help guide gradual progress. But, depending on the nature of your pain, it may not be a cure-all, and the other factors we’ve discussed demand consideration as well.”

We want to highlight what we feel is most important from that excerpt. Once you rule out a serious structural problem (degenerative disc disorder doesn’t qualify), the best thing you can do is to believe that your tweak will heal (we want to play on the strong placebo effect). The second step is to start moving through previously “threatening” ranges of motion and slowly progressing the load. For example, if you tweaked your back and it hurts to deadlift heavy weight, grab a load you can handle without pain (perhaps an empty bar) and slowly work through the greatest range of motion you can without pain. Once you can handle the empty bar, slowly progress the load. This builds confidence and will give you the relief you seek. The worst thing you can do is to stop moving and believe you are broken. Instead, get moving and more often than not you will be back to your old self in a few days.

Need a referral? We highly recommend Discovery Health Centre for chiropractic and registered massage treatment and Mari Udarbe Han B.M.R.-P.T., B.Sc. for registered physiotherapy and acupuncture.

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