ACUTE SPINE INJURY
Did you know…?
- In the United States, despite steady increases in the use of imaging, prescription pain medications, injections and surgery, there is no clear correlation between these “advances in medicine” and improved functional status or reduced work disability related to back pain
- Many patients with neck or back pain following injury improve naturally in two to three weeks, two-thirds are better after seven weeks.
- Recurrences are common; however, similar to the initial episode, most recurrences have a favorable outcome.
- Symptom improvement from sciatic pain is typically slower, but about a third are much improved in two weeks, and 75% after three months.
- Only about 10% of patients seen for sciatica go on to have surgery. Natural reduction of the herniated part of the disc is seen on repeat MRI in about two-thirds of patients without intervention
- Even with successful surgery resulting in symptomatic and functional improvement, patients with herniated discs don’t return to work any earlier than those who receive non-surgical treatment.
FOLLOWING A STRAIN
Activity reduction should generally be minimal. Return to normal daily activities as soon as possible and return to work as soon as feasible is the best advice. Those who rest in bed actually experience slightly more pain and less functional recovery than those who remain mobile. Use of cervical collars should be avoided; regular use may actually delay improvement. There is also little evidence to suggest that corsets or braces for the low back have therapeutic value.
Maintaining proper posture is an integral part of recovery. This includes sitting straight, with the normal lumbar curve supported and head balanced over the shoulders. Avoid prolonged sitting. Be especially aware of your posture if you sit in a reclining chair; it’s much more difficult to maintain a “neutral spine” if your legs are extended, and the back of the chair is reclined. Make an effort to break up prolonged sitting by standing and walking every 15 to 30 minutes. Sleep position is also important: the head and neck should be aligned with the body, best accomplished with a small pillow under the neck. A helpful sleep position is to lie flat on your back with thighs slightly elevated on pillows. If you lie on your side, try placing a pillow between your knees.
COLD AND HEAT
Neither heat nor cold applied superficially penetrates very far below the skin. However, if application of heat or cold provides you with some relief, it is not wrong to use either, so long as you monitor your skin for burning or frostbite.
Traction provides no significant benefit in either the short or long-term for neck pain or low back pain patients with or without sciatica. The role of mattresses has not been studied in acute (recent onset) low back pain. Studies involving people with chronic low back pain found that they did better sleeping on medium-firm mattresses. Responses to various mattresses are likely to be highly individualized.
Back pain often leads to atrophy (shrinking) of spinal muscles. Early studies have reported atrophy and abnormalities of the spinal muscles in up to 60% of people with chronic back pain. More recent research suggests atrophy may occur in as little as 24 hours after the onset of a recent back strain. If you have been dealing with recurrent or chronic neck or back pain and/or strains, you may be an excellent candidate for our medically proven spinal strengthening program here at Results Neck & Back Therapy.
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