12-Minute, Do-It-Yourself First Aid for Back Pain

CATEGORY 1: The most common advice is, "Lie down and don't move." This is the category for a trip to the Emergency Room.

Do the video for Category 1. Once you've given yourself relief, you can seek longer-term measures.

CATEGORY 2: The most common advice is, "Get a massage or see your chiropractor or physical therapist."

Do the video for Category 2. Your pain will decrease with each repetition until, after a few days, you may be entirely pain-free.

Pain meds and muscle relaxants are commonly prescribed for both categories.

NOTE: If you have numbness or tingling in your extremities, do only the CATEGORY 1 movement sequence and get professional help immediately. You may do the sequence repeatedly.

Unless you have had a violent accident, your back pain, whether sudden or chronic, has been coming for a very long time. Muscular tension builds up for a long time before crossing the point of no return and becoming a back spasm. Then, like the proverbial "straw that broke the camel's back," a small movement can trigger a crisis: muscle spasm.

What causes back spasms? What controls muscular tension?

The answer may be obvious to you: your brain, the master control center for your muscles; your brain causes your muscles to go into spasm.

Why?

Here, the answer may not seem so obvious -- until you understand it: conditioning. Your brain controls your muscles. Your brain gets conditioned through repetition: repeated overuse, repeated overstrain, repeated stress. Your brain learns to hold muscles tight until you can no longer relax them. It's what is meant by "nervous tension." At that point, your tight back no longer comes from bending or lifting, but from a tension habit stored in your brain. You're always tight, on the verge of spasm or in spasm. The problem isn't exactly "all in your head" -- but it is in your brain.

With tingling or numbness, the muscles of your back are so tight that they are pulling your vertebrae (the bones of your spine) so close that they trap and pinch nerves.

So the problem is simpler than you might expect. You probably do not have a medical problem; you probably have a conditioning problem. By relaxing those muscles, you end the pain of spasms. You also free the nerves from pressure and end the symptomes of a pinched nerve.

Fortunately for those using the right methods, a muscular conditioning problem can often be cleared up fairly quickly -- past experience notwithstanding.

The view of most therapeutic methods holds that back pain comes from weak muscles. They therefore prescribe or practice "strengthening and stretching."

This view is understandable. Tight muscles are tired muscles, and tired muscles feel weak and seem to need strengthening. Tight muscles are shortened muscles, and shortened muscles seem to need stretching. Tight muscles cause postural changes, and postural changes imply the need for strengthening and stretching.

But the problem isn't weakness or muscles in need of stretching; it's muscular overactivity and muscle fatigue (tiredness and soreness).

In that way, common therapeutic methods -- psychological, manipulative, many surgeries, therapeutic exercises in general -- use models of understanding that misunderstand (or miss a part of) the situation. They concentrate on muscles instead of on the brain-level control of muscles.

It's simple: When muscles relax, they rest and get refreshed (feel stronger); they lengthen out (no longer seem to need stretching). With normalized muscular functioning, alignment improves, movement normalizes, comfort returns.

A more direct approach, then, is to improve muscular control. People with back pain generally need a brain-muscle approach -- either to avoid surgery or after surgery.

Muscular control has two parts: the ability to regulate muscular tension (regulate strength and relaxation) and the ability to sense muscular tension. Both abilities are needed.

Therapeutic methods typically neglect the sensory awareness part of control. Too often, people are given therapeutic exercises with only primitive instructions in how to do them. They are told only what to do (e.g., do abdominal strengthening exercises, i.e., crunches) but not how to do them (e.g., slowly or maintaining awareness of the sensations of movement); they're told, "These are strengthening exercises," so people go for strength or force instead of for graded control; they go for effort (measured by numbers) without cultivating sensory awareness (experienced by feeling). That's why many therapeutic methods don't produce definitive outcomes. To the extent that they do work, they do so through inadvertent gains of muscular control at the brain level.

If you can't feel how to control your muscles, you can't feel how to relax them. You need to improve your ability to control your muscles and that involves your ability to feel your muscles working under your control (not merely the pain of muscles in spasm).

As you do, you recover comfortable freedom of movement; you recover your ability to relax and you stay more relaxed without thinking about it. You experience a long-term alleviation of muscular spasticity and pain; you gain the ability to care for yourself, as needed.