Lower Back Injuries are both debilitating and painful and unfortunately very common. There is a common misconception that immediate treatment of a lower back injury is similar to soft tissue injury such as a ligament sprain. The structure of the spine responds vastly different to heat and cold and should be respected as such. Common injuries of the lower back include spasm of the Quadratus Lumborum, Slipped Disc of Lumbar region L3-L4 which may impinge on the Sciatic Nerve. The latter is extremely common and is well known for obvious reasons as it’s very painful. To add insult to injury these can cause secondary issues such as lateral curvature of the lumbar spine and increased flexion in the spine.
In immediate treatment of these injuries, they have to be treated as equally and independently as each other. A huge common issue that many people have when immediately treating lower back issues are that they stay immediately immobile and retreat to their beds. I implore you to re think and look at alternate methods. With muscle spasm in particular the brain has excreted a chemical causing muscle tension, to provide a form of defence mechanism which brings its own level of pain and fluctuating discomfort. Heat can provide effective relief due to its ability to dilate the blood vessels and flow oxygen and nutrients into the muscle and just as importantly it flushes out any unwanted chemicals in the muscle. This can provide relaxation of the muscle and increased flexibility, application of heat packs and hot baths can help relive spasm and provide immediate relief of discomfort. However a word of caution it is not always the answer as spasm is a secondary issue and masks more severe problems such as slipped disc or degenerating disc.
To myth bust the claim of immediate bed rest after lower back injury which stakes its claim to the dark ages, I will provide my take on it. The joints in the spine are lubricated by synovial fluid which contains valuable nutrients and minerals that are vital to the healing of tissue, and also to allowing the joint to freely move and not get locked into position. This fluid is excreted upon the act of movement therefore staying in bed immobile will only continue the joints in the spine to stay locked and unable to heal the surrounding tissue. However extreme movements can affect tissue damage and only inflame other tissue, so a modest approach must be taken. I often encourage my clients to resume normal daily activity where possible with caution.
Just to touch on the issue of the slipped disc it commonly occurs from impact injury or excessive loading of the spine, forcing the small sack of fluid to stick out of the joint and impinge surrounding structures such as Sciatic Nerve. This in turn often causes the muscle in the lower back to contract to provide a defence mechanism, often referred to as a lateral curve. This can be treated through physical therapy and our earlier method of heat application. However a word of caution as with a slipped disc it may bring inflammation of tissue and heat is not its friend. So I would advise immediate referral to a therapist as they can provide physical therapy to treat the disc. As with any nerve related injury, I can’t promote caution enough when dealing with nerve injuries and if you are not appropriately qualified you must refer your client to a therapist or appropriate health professional.
I hope this can provide you with an insight into the use of heat to a lower back injury as this can provide immediate relief to the muscle, but a word of caution to severe nerve pain as this is always what we call a red flag and will need further investigation.