You know the situation. You reach down to pick up a shoe or other small object and upon standing upright, your back seizes and you yelp in pain. What happened?

Why would something so simple, like picking up a pencil from the floor, cause such an injury?

No matter what you tried to pick up, it’s usually not the weight of the object, but rather, how you picked it up. Discovering the reason for your pain is usually not the most immediate thing on your mind. All you want to do is figure out how to stand up and get rid of this terrible pain.

Depending on your symptoms, level of pain, and mechanism of injury, there are steps you need to take after sustaining an Acute Low Back Injury. If the pain or symptoms do not subside within seven days, or if you experience any neurological symptoms, such as sciatica, numbness, loss of strength, or unrelenting pain, contact your local Therapeutic Associates Physical Therapist (PT) and/or Primary Care Physician (PCP) for specific guidance.

Commonly referred to as “throwing your back out” when reaching for something, bending over improperly, or even sneezing, there are some simple steps you can take to reduce the inflammatory reaction and get movement going again. (If you cannot perform these steps, we recommend you contact your PT and/or PCP for specific guidance.)

Try to stand up, if possible, and walk around a bit. It may be uncomfortable, but if you can manage, it will help to loosen your lower back muscles. Try light walking for five minutes and prepare for step two, below. If you are unable to walk around, move straight to step two.

Obtain a cold pack, wet towel with very cold water, or bag of frozen peas. Find a position of comfort, such as lying on your back with your legs up on an ottoman or pillows. Place the cold pack under your lower back or area of pain for 15–20 minutes. If unable to lie on your back, or if your cold pack is too big, try lying on your stomach with a few pillows under your abdomen and the cold pack on the sore area. Avoid using heat if you are in acute pain (this can be like gasoline on a fire), but you may use heat if you are a bit sore or just feeling tight. If unsure, use cold.

After 15–20 minutes of using cold, attempt to stand up properly and walk around. Make sure to roll to your side, bring knees to chest, then push up into a sitting position once your feet go off the bed. It may be painful, but this is a much less painful way of standing up than trying to sit straight up. You will want to let your back thaw out for at least 90 minutes before applying a cold pack again.

Make sure you avoid prolonged computer use, sitting in one place, or driving during this acute phase, as these activities can aggravate your symptoms.

When lying down, utilize proper sleeping positions. Lie on your side with one pillow under your head, one between your knees, and one to hug onto; OR, lie on your back with pillows under the back of your knees.

Use proper body mechanics when reaching for objects on the floor. Bend at your knees and squat down rather than bending at your back.

There are some basic movements/exercises you can use to work on early mobility and decrease muscle spasms. Try lying on your back with knees bent up and feet flat on ground. Pull one knee to your chest using your hands. Hold for five seconds, and then repeat with other knee. Do 10–20 repetitions three different times throughout the day. An alteration of this exercise is to try the same exercise by pulling both knees to your chest. If these cause too much pain or worsen your condition, cease and contact your PT/PCP.

Using a combination of gentle movements, light walking, positions of comfort and cold/heat applications may dramatically improve the next 24 to 48 hours. If you are not in acute pain, but sense that it is just tightness/soreness, it is ok to try 15–20 minutes of heat. If symptoms worsen after using heat, immediately put cold applications on as specified above.

Attempt to slowly work back into normal activity as tolerated over the next couple of weeks. If you are unable to return to normal activity, feel like your condition is worsening, or you experience any neurological signs/symptoms as described above, contact your Therapeutic Associates Physical Therapist or PCP immediately.