Dealing with an acute low back pain attack

People always ask what to do when they have acute back pain. There are many answers depending on the exact nature of your problem but one thing people forget about is that pain is a perception and not a thing.

One common way of looking at how you perceive pain is to visualize your nervous system being like a telephone exchange. When a signal comes into the spinal cord it is prioritised according to the speed it comes in at, it’s intensity and what other competing signals are arriving at in roughly the same time period. Sensations , such as temperature(hot or cold),vibration, auditory information etc, arrive on insulated nerves and move at a fairly quick pace. Pain travels on uninsulated fibres and thus tends to arrive less quickly and can be blocked out by the faster signals that arrive first. A perfect example is a toothache that you hardly notice all day as you are bombarded by other information yet it is felt as a pounding toothache once you get into bed. Once the other signals are absent your nervous system becomes focused on what is left and you perceive the remaining pain as much stronger than you might have during the day. This is one reason why so many treatments have a short term effect that reduces what you feel yet don’t really get rid of the underlying problem. If you put on a heat rub/ice pack, have a massage, use a TNS machine then you will have some relief but only as long as the effect of the treatment remains. If there is still an underlying irritation it will all come back until you have dealt with the thing that is irritating your body in the first place.

The simple answer is when you first have an attack of back pain the best thing is to find a comfortable neutral position (usually lying on your back with your legs up on a stool/couch or on your stomach with a couple of pillows underneath) and apply any form of treatment that provides an alternative sensation to help settle down how much your nervous system is focusing on your back pain. Once you have had a day or so to let things settle then you have a wide choice of treatments that might help depending on what has gone wrong. With acute attacks many things will help including manipulation, massage, exercises and possibly other treatments such as acupuncture.

In the long run, you are best to calm your back down, have some form of treatment to settle your back further and then go back and focus on the things that really matter. Most back pain occurs because of bad habits, poor posture, trauma or working too long at something your body does not tolerate well. If you learn to take care of yourself better in your day to day activities you will find you have less (or maybe no) attacks and be better prepared to get on with your life.

Best of luck with taking care of yourself!!


What about sex?


Everyone talks about it but no one talks about what happens when you have a bad back…

Sometimes, even if you are in pain, you want to please yourself or your partner. For the person with a bad back this can seem like a difficult, if not potentially disabling activity. Actually this is far from the truth is you are aware of what you are suffering from and follow a few rules.

Most peoples pain is actually a combination of the pain they have from an injury (new or old) and the bodies attempts to compensate or protect them from further irritation. Most pain can be broken down into 3 categories and there are rules on what is potentially possible in each category.

Generalisations (pinch of salt please)

– Pain that worsens with bending or sitting movements may originate
in some sort of disc problem.

– Pain that is one sided and worsens
with walking and standing up tends towards more of a facet type

– Pain that goes down your leg when you bend forward and may
have some concurrent pins and needles sensation tends towards a nerve
root origin.

Given that these are only generalisations you can still use the information to help you accomplish your goals :’ ).

First if your pain is more likely disc based then you need to avoid being bent/twisted so any approach where the active partner is behind while the other person is face down. This would work for the more passive partner this would also avoid any bending as well although a pillow under the tummy might help to avoid too extreme a position.

If your pain is is more likely facet based then a variation on a seated position might be useful for either partner as there are no backward pressures. Traditional positions like the missionary position might work for the more passive partner or the more active partner can switch to a more submissive position on their back(knees bent) and let the other partner position themselves appropriately.

If you experience leg symptoms then sideways foetal positions offer an opportunity to be active with no stretch to the nerve roots for either partner.

 This is just a quick list of possibilities to give you some ideas but necessity being the mother of invention it may help you to determine what might work for you.

There are lots of variations that can be tried. I do have a set of descriptions with diagrams that can be sent to you if sent me a note at my e-mail address :

Best of luck in all of your endeavours!!