If you have ever injured your back at work, you are not alone. It’s happened to the best of us. You started the day hunched over a too-low medication cart sorting out pills. You faithfully followed the “no lift” policy during a patient transfer, but the equipment failed at just the wrong moment. The gentleman in room 230 started to stumble on the way to the toilet and it was only your spectacular off-kilter catch that prevented his fall. Congratulations. You just injured your back.
Research indicates that the highly demanding work of healthcare providers, especially nurses, is associated with 9-12x the odds of musculoskeletal injury to the neck, back, or shoulder. The triggering events may be variable, but the result is too often the same: the sudden onset of acute pain. You have just been initiated into a club with thousands of unhappy members. Now what?
First, do a quick assessment. Most musculoskeletal back pain is not serious and will disappear spontaneously or after a bout of short-term conservative management. However, if you have low back pain coupled with a loss of bowel or bladder control or any loss in sensation in the inner thigh or groin region, all bets are off. It’s time for an immediate trip to the doctor to assess what is causing the nerves at the terminal end of the spinal cord to be compressed. Loss of motor control in the legs is also a red flag that something serious may be afoot. This loss of control is often experienced as clumsiness or a new tendency to trip over your own feet. Such signs and symptoms should never be ignored or self-treated.
But there are many times when an injured back at work is just a pulled muscle or ligament and, as such, it can be addressed immediately. Here are four quick fixes for injured backs for when you still have a few hours left on your shift.
1 – Compensate for Your Mistake. Quickly.
Often, an acute musculoskeletal injury occurs when the back is flexed and placed under an unexpected load. This is why transfers are so potentially dangerous to perform and a “no lift” policy is the norm in so many health facilities. The good news is that the body is very forgiving of awkward postures and poses if you quickly and repeatedly correct for the error. For most back injuries, this means performing spinal extension. It only makes sense. You got injured in a flexed position. Place the body into some gentle and repeated extension. Note: If extension increases your pain or causes neurological symptoms, use common sense. Stop and seek medical help.
2 – Bounce (Gently) or Rock
The peripheral nervous system functions much like a series of roadways. Sensations such as temperature, pain, weight-bearing, and pressure travel from the periphery to the central processor on nerve fibers, but not all nerves are created equal. Much of pain travels on the slowest of all “roadways”; unmyelinated C-fibers. If you can distract the brain with another kind of input, say a rhythmic loading and unloading, pain sensations can get lost in the traffic. (Want a quick demo of this principle? Cut your finger. What do you automatically do? You shake it violently and pop it in your mouth. In other words, you self-prescribe movement, temperature, and pressure sensations to dull your finger pain).
So how do you self-prescribe movement for your injured back? Look for a well-inflated physioball (also known as a Swiss ball) and sit squarely on top of it. Hold onto the desk or another surface for safety and perform very gentle bounces in a rhythmic fashion. Think gentle! Your buttocks never leave the ball—concentrate on how low you can bounce and yet keep the rhythm going. Can’t find a physioball? You can perform a repetitive rocking sensation back in forth in an office chair. Make sure you are sitting upright on the edge of the seat so that your lower back gently flexes and extends. Can’t do that? Stand with your legs in a stagger and rock back and forth in a predictable pattern.
3 – Laugh. Smile. Move.
Yes, laugh. Smile. Keep moving. Eat with your colleagues. If you need to go to Occupational Health, by all means, go. But know that research shows that minor musculoskeletal pain follows your lead. If you shut down, complain, and isolate yourself, plan on your pain ramping upwards. The body’s natural pain-relieving system, endorphins, is empowered by the things that bring you joy: laughter, your favorite music, socialisation, physical touch, and best of all, dark chocolate.
Lastly, when you get home, don’t consider curling up in bed. Even in cases of moderate musculoskeletal injury, a single day of bed rest has been shown to increase, not decrease, the pain.
4 – Think Ice & NSAIDs
One of the first acts you should take after a minor musculoskeletal injury is to apply cryotherapy. Immediately. It is difficult to overstate the benefits of cold therapy, especially in the early hours after an injury. The cold provides three clear benefits:
- It retards the inflammatory response and it slows down nerve conduction velocity, in essence, acting as a regional anesthetic. It also produces a rebound effect when removed.
- Once the cold application is removed, blood vessels quickly vasodilate in a spectacular overcompensation. This rushes oxygen and nutrients to the region and removes waste products.
- Cold therapy can be applied with a gel pack, a bag of ice from the cafeteria, or even an ice cube wrapped in a hand towel and used to perform an ice massage (you’ll need a partner for this one).
But ice need not stand alone to provide analgesia. Nonsteroidal anti-inflammatory drugs (such as ibuprofen and diclofenac) can provide an immediate analgesic effect, which allows the body to move without pain, thus reducing the likelihood of a pain cycle. Obviously, if there is a medical reason to avoid NSAIDS, you should avoid them. Otherwise, consider taking them responsibly and following these other ideas as a first-line tool in your fight to alleviate an acute back injury at work.
Andrea Salzman, MS, PT graduated from the University of Alabama at Birmingham with a Master’s degree in physical therapy in 1992. Over the last two decades, she has held numerous prominent leadership roles in the physical therapy field, with a heavy emphasis on academic writing and administrative functions. Between 1995 and 1998, Salzman served as the Editor-in-Chief of an American Physical Therapy Association (APTA) journal. In 2010, Salzman received one of the highest honors given to a physical therapist from the American Physical Therapy Association, the Judy Cirullo Leadership Award. Between 2012 and the present, Salzman has written 12 physical therapy courses for Care2Learn, Relias Learning and reviewed over 100 other course offerings. Currently, Salzman continues in her writing, leadership and administrative roles at Aquatic Therapy University and 10K Health.