How to help yourself during acute blockage of the lumbar spine - first aid and exercise tutorial

Have you ever woken up and you couldn’t straighten up? Did you want to lift something heavy, and since then you feel pain in the lumbar area? Did you just spend several hours in your car or you got cold by an open window and now your feel pain in your back? Do you feel pain in the lumbar spine going to the side, buttocks and down into the legs? You don’t know how to help yourself? We have several tips and tricks how you can help yourself and achieve relief.

WARMTH

The best and most safe option is heating pad, which is producing heat constantly after being plugged into electricity. The intensity of heat can be regulated by a remote. This way of warming up is the most safe for the skin and there is no risk of getting burned. If you don’t have the heating pad home yet, i strongly recommend you to get one, you never know when you may use it.

Handling the heating pad is very simple and safe, you only need to place the heated pad on your lumbar area. In case you would want to lie down, we recommend to lie on the stomach and place the pad on the back. In this position are vertebrae in a better position, and you would be able to exercise while warming up the muscles.

Some of your probably have at home gel packs, which you can warm up in a water or in a microwave oven. Warm them up to a temperature which will warm up your muscles to the depth (between 40 - 60°C). You have to feel that you are well warmed up, but the temperature can’t be too high, so that it wouldn’t cause you burns. We recommend you to use cotton cloth which you could place between the skin and the gel pack, so that the textile would create a protective layer against the formation of burn.

If you don’t have any gel packs, we recommend you to place aluminium foil into a folded towel (size at least 70 - 40 cm) and iron it. Place this warmed up towel on your back. Aluminium foil produces consistent warmth for longer period of time. If you do not have an aluminium foil, you can just warm up the towel, but the warmth will quickly run out.

The least safe option, but very effective alternative is using towel in size of approximately 70 x 40 cm. Fold the towel to 70 x 20 cm. Roll the towel tightly into a roll of a height at least 20 cm. Boil water in a kettle, and prepare the hot water to be carefully and slowly poured into the rolled towel into the height of 10 cm (you will be holding the remaining part of the towel). Pour the water slowly, because tightly rolled towel would not absorb the water fast enough if you would pour the water too quickly and you could end up burning yourself. Then slowly unwind the towel and apply it into the lumbar area, lower thoracic spine, sacrum bone and on the surrounding muscles. Thoroughly keep in mind that you wouldn’t burn yourself. If the soaked water is too hot, wait a little while, until the temperature would be bearable. The goal is again to warm up the skin, subcutaneous tissues and muscles to the depth.

 Hot towel rollHot towel on the lumbar area

MANUAL TECHNIQUE FOR RELIEVING THE MUSCLE TENSION

Lay on your stomach and ask your relative or friend, to press his hands on your back, thorax etc. and to gently press his hands and at the same time moving the skins and muscles around the spine. The pressure should be areal, with the whole palms and fingers. The intensity of the pressure should not cause any pain, it should be very pleasant. The pressure of the hands responds its own weight.

Stretching the thoracolumbar fasciaRelaxing thorakolumbar spine

Try to find exactly where in the muscles you feel the pain (it may feel as hard small balls, which are very painful). This is a so called trigger point, which has to be massaged. Press against the trigger point with your thumb or finger either consistently, or press for a while and then relieve the pressure. Another thing that may be pleasant is when you turn the skin around the trigger points in circles, by rotating your finger or thumb and increasing or decreasing the pressure involved.

EXERCISING

The most frequent movement, during which the lumbar spine gets blocked is permanent bending (for example: slouching back in front of computer) or combination of rotation and bending of the spine (for example lifting up a heavy object from the ground). In this case it leads to blockage of the lumbar spine or herniation of the intervertebral disc.

The most effective exercises are in the position where you bend your back backwards or when you bend the back backwards and rotate the pelvis or lumbar spine. Little bit lower are mentioned combinations of exercises from yoga, McKenzie method, method according to Roswitha Brunkow and DNS according to Kolář.

Plank on the stomach with stretching and rotation

McKenzie pain in the back

Lying on the stomach

Lay down on your stomach on a warm but firm mat (carpet, sleeping pad etc.), lean against your forearms as if you are reading a book on a beach (position of „cobra” from yoga). You can stay in this position to read books, work on a notebook etc., or switch laying on the stomach with resting on the forearms. When you exhale, stretch out your arms, and with inhale slowly go back down.

If you are able to manage the position on the forearms, you can try to stretch out against your palms (stretching out the elbow joints - „high cobra” position).

It is important to note that stretching out has to always come out of the arms (arm muscles are working). The muscles alongside the spine, buttocks and thighs have to be 100% relaxed.

Combination of bending and light rotation while laying on the stomach

This position is very ideal, if you feel pain on one side. In order to explain the position, we will describe position if you feel pain in the left side of the lumbar area or left leg. Those of you who feel pain on the right side, just do the exercise the same way for the right side.

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Plank McKenzie

Lay down on your stomach on a warm but firm mat (sleeping sheet, carpet etc.) and turn your head to the left side. Place your arms horizontally (position in which Jesus Christ was crucified) and bend the left leg in the knee and try to place that leg as close as possible towards your chest or waist - according to how much you are able and whether you are comfortable. This is the so called „frog” position, (biathletes often use this prone position when they are in a shooting range). Stay in this position for as long as you want. For someone it may be relaxing, and they may choose it unconsciously as a position for falling asleep.

Sitting

Sit straight on a firm chair. The hips should be in the same height as knees. Try to straighten or even bend in the lumbar spine and straighten in the thoracic and cervical spine. Try to breathe in this position into the lower part of the stomach.

If you will be able, you can try the position in which you keep straight spine and breathe into the pelvic floor (as if you’re straining on the toilet), breathe into the side of the lower ribs and lumbar spine.

Those who will be able to bear such difficulty, you can place your palms on your thighs, and press them against the thighs. If you are able to hold your lumbar, thoracic and cervical spine straight and at the same time you are also able to manage well enough the coordination of breathing against the pelvic floor, you should feel the abdomen to get firmer - as one firm unit.

Standing

Stand up and straighten your spine as you would while sitting. Place your palms on your buttocks - wrists are on the pelvic bones and fingers are directing across the buttocks towards the ground. With slow movement try to bend in the lumbar spine, but keep your cervical and thoracic spine as straight as possible. The goal is to the bend in the lumbar spine with the help of the hands being placed on the back, and rotating the rib cage towards the ceiling. Again you can stay in this position or you can with exhale bend backwards and with inhale slowly straighten your trunk.

If you will be in one of these positions (lying on the stomach, sitting, standing) feeling relief, stay in the position. With inhale think about the pain, the intensity and area, and with exhale „blow away” the pain, and try to relax even more. This psycho-relaxing technique has a big significance in physiotherapy.

If you feel that the exercise doesn’t help, or your condition is even worse, don’t continue.

There is a rule that the pain is stronger in the morning than in the evening, and that with movement the intensity get lower. However the pain is sometimes so strong that it will paralyze you. In such case stay at home and relax, daily and work duties won’t go anywhere. It is important that you would get back into condition as soon as possible, which you will certainly not achieve under stress!

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Extension While Standing

HOW CAN PHYSIOTHERAPY HELP YOU?

If you feel that your muscles are not getting relieved and the condition is only getting worse or that it is stagnating, we recommend you to visit a physiotherapist. We have developed for such acute cases very effective procedure called Physiotherapy All-Inclusive, which uses techniques of classical physiotherapy and also options of treatment with radial shock wave. By a damage of soft tissues (intervertebral disc, joint capsule etc.) we have the option of using focused shock wave therapy, which is in combination with physiotherapy called FOKUS All-Inclusive. Our flexibility enables a short ordering time for acute cases, sometimes even the same day, or the second day.

HOW CAN A DOCTOR HELP YOU?

Orthopedists, neurologists, doctors etc. will send you to a standard X-ray examination. This examination may reveal rotation and shift in the single vertebrae against each other or against the skull bones - it will prove whether there is a blockage in the cervical spine, but the X-ray does not have any responding value by the possible damage of the soft tissues (for example intervertebral discs). It is therefore worthless to undergo X-ray examination.

Doctor will prescribe you drugs against headaches and pain in the nape, as well as drugs relieving the muscle tension in form of tablets, ointments and gels. Alternatively the neurologist may use an injection to relieve the affected area. It is in doctors competence to recommend you also peaceful regime and give you FT coupon for outpatient physiotherapy (applicable only in Czech republic). In case of serious blockage of the damaged soft tissues (for example: result of recent injury or overload), you may be recommended with hospitalization.

More exercise tutorials:



Author:
 FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

Source: Clinical experience from a private practice in physiotherapeutic field, FYZIOklinika

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