What Does Throwing Out Your Back Mean
What Does Throwing Out Your Back Mean
- What Does It Mean?
- What's Really Happening?
- Common Misconceptions
- Treatment
Jay Leno once did a monologue where he said in his 30s he had a motorcycle accident, got checked out, and was back at work the next day, but in his 60s he sneezed wrong and threw out his back for a week. You know what he means by "threw out his back": It's that sharp, stabbing pain that can make every movement agony, your constant companion for a couple of weeks.
You know what throwing out your back feels like, but what does that actually mean?
But what is throwing out your back,really?
What Do You Mean, You Threw your Back Out?
Most of the time when you talk about throwing your back out it's a result of when you twist, turn, cough, sneeze, or lift wrong, says David Hanscom, MD, an orthopedic complex spinal deformity surgeon and author ofDo you Really Need Spine Surgery?
Dr. Hanscom says the medical equivalent of throwing out your back is spraining your ankle. "It's very painful; you may not necessarily see a tear, but you've injured ligaments and it hurts a lot. The same thing can happen in the back."
Most likely you've experienced acute pain in the lumbar spine or lower region of your back. You can throw out your back at any age doing any number of activities from gardening to bending over to picking something up. But it is more common as you age, which is why Leno notices he once took a walloping and walked away, but now something minor like a big sneeze can take a toll on the back.
When you sprain your ankle, you immobilize it, but you don't have large muscles around it as you do in the back. "What happens in any part of the body is any time you injure tissue, your muscles automatically spasm to act like a splint," says Dr. Hanscom.
Crueler, those spasms tend to be the worst part of the back pain because back muscles are large, and seriously scream when they spasm. In addition to pain, the back often feels stuck, with significantly decreased range of motion. All this can take a couple of days to calm down and probably a good two to six weeks to get back to normal.
What's Really Happening in your Back?
Most of the time when you throw out your back, you're likely to have a small ligament strain or an annular tear, a tear in the ligament that connects your vertebra to the disc. When you're standing upright and lifting properly, the disc works like a hydraulic.
"As soon as you bend over not using your legs, the back part of the spine opens a lot, and now instead of having a hydraulic effect you have a cantilever shearing across a disc," says Hanscom. Then if you bendandtwist, you magnify the pressure across the disc by 400%. It's a deadly combination.
"The way you prevent it is simply using your legs and keeping your back straight and letting the hydraulic tissue do its work," Hanscom says.
Lifting with just your spine increases shear force on your vertebrae and discs, which makes injury much more likely.
Common Misconceptions About Throwing Out Your Back
Jordan Duncan, chiropractor and owner of Silverdale Sport & Spine—a clinic specializing in difficult to treat musculoskeletal pain conditions outside of Seattle—says he's not sure where the origin of the term throwing your back out comes from, but it can be misleading.
"You didn't throw your back anywhere." It's sort of like saying you blew out your knee. "The terminology can be fairly harmful to some people because of the fear associated with it," says Duncan. And fear can be significant when it comes to back issues.
When people come in with back pain, they can have a lot of fear around it. What have I done to my back? Will it get better? Will I walk normally again? "What we know now is fear is inflammatory," says Dr. Hanscom. So, when people are afraid and their immune system fires up, they can feel the pain even more.
Treatment for Throwing Out Your Back
If you've lifted, bent, or twisted wrong and are in pain, there's a few things that work well and will most likely happen if you see your doctor:
- Ice or heat. It depends on your preference. Dr. Hanscom thinks either is appropriate and he likes ice slightly better but says whichever one gives the most comfort is OK.
- Abdominal corset.Go to the drugstore and pick up an abdominal corset, a wide stretchy band that you wear around your lower mid-section. Your ab muscles supply about 40% of the support for your lower body so the corset can help unweigh the spine a little bit and ease your discomfort.
- Anti-inflammatories.Whether it's Advil or a prescription Ibuprophen with a high milligram count from your physician, these are better than narcotics. Hansom warns, if you do need a narcotic, it should be for a very short time, a few days to a week, and you must be careful because they can cause constipation, which makes back pain even worse.
- Tricyclic antidepressant.To help you sleep and rest your back in the first few days, Dr. Hanscom likes to prescribe a tricyclic antidepressant like cyclobenzaprine (Flexeril). "Not a fan of muscle relaxers since they don't relax back muscles specifically," he says. Flexeril is a short-term solution to relieving nerve pain and back spasms. If your pain is severe, he may prescribe Ambien because getting sleep is important to helping you heal.
- Physical Therapy .Oftentimes seeing a physical therapist who uses modalities like heat and ice, ultrasound, massage, and other techniques including exercises to strengthen the muscles is a good idea as well.
You won't typically get imaging right off the bat when you throw out your back unless there are other red flags, like numbness, fever, or incontinence, since it likely won't change the treatment plan. Hanscom says he wouldn't X-ray on the first visit nor do an MRI the first month because most people have some degree of degenerative disc changes in their backs and this won't tell him anything. Plus, you can't see always see a tear on MRI.
You will likely heal up well in two to six weeks. If something is amiss after that, you should follow up with your doctor. Dr. Hanscom says you should still be able to do most things after an incidence of throwing out your back heals. However, a few sports that can be hard on the back need more caution like snowboarding, squash, and racquetball.
Keeping back muscles strong with regular exercise, lifting correctly from the legs, and not twisting when you lift are the all-important elements to prevent throwing your back out.
Source: https://www.spineuniverse.com/wellness/what-thrown-out-back-means
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