is your Back really OUt?
Has your back ever “gone out?”
Have you ever bent over to pick something up or lifted something awkwardly and suddenly you have a sharp stabbing pain in your back? It can be so severe that you can’t move at all.
Does this mean you have “put your back out?”
This blog will explain what really happens when your back “goes out”, what you can do when this happens and how to prevent it happening again.
Do spines really go out of place?
Do you believe that you can actually put your back out? Many people do! The phrase “I put my back out” has become so common that many people genuinely believe that their spine can suddenly move out of place.
The truth is that your back or neck can’t go out of place, it’s not physically possible. What you have really done is injure your spine.
So before we explain what really happens, let’s look at how a spine moves and everything else will start to make sense.
How does a spine move?
Your spine is made up of 24 individual vertebrae (bones) and it is responsible for weightbearing, movement and the protection your spinal cord all at the same time.
The movement part is what we are interested in here.
What are the parts of a spinal joint?
The parts of the spinal movement segment are:
- Facet joints- Each vertebra has articular joints with the vertebra above and below. This is where most of the movement of your spine comes from.
- Discs– discs sit between each vertebra and provide some degree of movement. Their primary role is to act as a shock absorber.
- Ligaments- these structures are responsible for holding the spinal bones and joints together and preventing excessive movement that could damage your spinal cord.
- Muscles- small muscles that attach between two vertebra create movement between the individual spinal segment. Large muscles also work to move the spine as a whole.
All of these parts work together to create movement in your spine and each one of them can be damaged when you injure your spine and give you the feeling that you spine has “gone out”.
Overlaying all of this is your brain. It controls the movement of your spine by telling the muscles in the region what to do and when to do it. This happens on both a conscious level (think of bending over) and a subconscious level (like balancing your body/posture).
What happens when your spine “goes out?”
When you feel like your back’s “gone out”, what you have actually done is injure one or more parts of the spinal movement segments. Regardless of which part of your spine is injured, what happens can feel the same.
The muscles around your damaged joint, disc, nerve or strained muscle tighten up and spasm to restrict your movement. What your brain is doing is trying to prevent further damage. It’s like your brain saying “Stop, you’ve hurt yourself so I’m tightening everything up so you can heal and not do further damage!”
Its very similar to when you have a sore knee and you start limping. You don’t decide to limp, the subconscious part of your brain that controls movement changes to the way you walk. That is how your brain is wired, it automatically goes into protection mode when you are injured.
Why does it happen so suddenly?
In most instances when you back suddenly “goes out”, it’s because there has been underlying damage occurring for months or years that you didn’t know about. This damage has weakened your spine’s structure and left it prone to injury.
Over time your spine has lost its normal functional ability and movement range. There may even be degeneration (wear and tear) in the joints of the spine, bulging or damaged discs and weakened muscles present.
One day you ask your spine to do a normal movement or daily task, like bending or lifting, that you do every day with no issue, the next day it appears the same simple task has sent your spine into spasm. Unfortunately, at that moment your spine has reached a point where it can’t cope with this activity, and there is immediate damage to your spine. Whatever you did when the pain started, it was just the straw that broke the camel’s back.
Why does my back spasm up?
The pain and movement receptors in your spine immediately alert your brain that the damage has occurred. Your brain instantaneously tells the muscles in the area to spasm to try to stabilize and protect the injured area. At the same time the damaged part of your spine becomes acutely inflamed. By now any movement, even just weight bearing, can cause extreme pain.
All this happens in seconds without you even thinking about it!
Why does it feel better when it “goes back in”?
In some cases, the reason why your spine has gone into spasm is purely a biomechanical problem. Your spinal joints are locked up and altering your subconscious movement patterns, causing pain when your body tries to move. In this case, spinal manipulation (adjustments) can often provide immediate improvement in your joint movement and almost instantaneous pain relief. The truth is your spine hasn’t gone back in; it is just moving better.
When the disc, ligaments or muscles are damaged you will not get the same instantaneous relief from a chiropractic adjustment. This is because you’ve injured a part of the spine that needs time to heal. An adjustment gets your spine moving and puts you in a better position to heal, but until the injury heals and the inflammation settles, you will still feel pain.
Sometimes spinal manipulation is contraindicated when the damage to the spine is severe. That’s why an accurate diagnosis to find out what part of your back is injured is so important before you start any treatment.
What can I do when it “goes out”?
When you injure your spine these are the things that you can do immediately:
- Ice – use ice as discussed in our blog to help reduce localised pain and swelling
- Improve your spinal movement – Go to your chiropractor or other health professional to get your spine moving correctly as quickly as possible
- Exercises – Perform some specific stretching exercises to stimulate blood flow and movement.
- Drugs – Take over the counter (OTC) anti-inflammatory drugs such as Nurofen to help reduce the swelling. Also painkillers such as paracetamol may reduce your pain levels. If necessary speak to your doctor about which medications are most suitable for you.
- Use a Back Brace – get a back brace or crutches to reduce the load on your spine if the injury is severely limiting you
- Stay as active as possible – Movement is key to a faster recovery however, it’s important to not aggravate the injury so don’t do too much to fast. Consult your health care professional for the appropriate amount.
When should I go to hospital?
You should seek urgent medical attention if you have:
- Severe uncontrollable back pain
- Sudden loss of sensation in one or both legs, your groin and genital area or the anal region
- Sudden difficulty with balance and walking at the same time of pain episode
- Loss of control of either the bladder or bowels
- Fever or symptoms of illness
What are your treatment options when your back “goes out?”
There are several different treatment approaches available to you when your spine has been injured:
- Rest, ignore it and hope it goes away. Most acute back pain will settle with time and no treatment. Unfortunately, if you don’t correct the cause you are at high at risk for re-injury.
- Use over the counter anti-inflammatory drugs and prescription drugs such painkillers, non -steroidal anti-inflammatory and muscle relaxants which can reduce your symptoms
- Restore your normal spinal function with spinal adjustments from your chiropractor
- Massage techniques that are aimed at releasing tight muscles and increasing blood flow.
- Exercises to improve the movement and strength of your spine
- Epidural injections using steroids into the injured area to reduce the inflammation in the region.
- Surgery may be needed if the damage to your spine is beyond what your body can heal.
When should I go to the chiropractor?
Our advice is that you should go to your chiropractor as soon as you are mobile enough to get there. There are several different ways your chiropractor can help you. We will use specific chiropractic techniques, exercises and home advice that will get you moving as quickly as possible.
Then we can address the most important question of all “why did this happen in the first place?” We often say to patients “first we have to put the fire out then find out what caused it.”
How will the chiropractor find out what caused your injury?
Diagnosing what caused this sudden problem is the key to a long-term solution. You may have bulging or herniated discs, damage to the ligaments, joints between vertebra or muscle strains and tears.
We will do an accurate history, examination and if necessary arrange for x-rays, MRI’s or CT Scans to get a diagnosis.
Once we know exactly what the problem is, we will design a specific treatment program for you to manage and carefully monitor your progress. We will also help you with exercises to do and what modifications you need to make to your lifestyle while the injury heals.
What can I do to prevent my back ‘’going out” in the future?
There are many things that you can do to prevent re-injuring your spine:
- Restore your spinal function and strength with chiropractic care
- Have specific flexibility and strengthening exercises designed for you
- Start an exercise program designed to improve the muscular coordination of your body such as yoga or pilates
- Make lifestyle changes to ensure your weight is within a healthy range
- Lift with correct technique
- Improve your posture
- Have a good ergonomic environment both at work and home
Now you understand what really happens when you injure your spine. It hasn’t really gone out at all. If this happens to you, see our chiropractors or another health care professional as quickly as possible to get you relief but more importantly, find the cause and prevent this happening again.
If you have any questions or other topics you want to find out about pop them in the comments below.
Finally, we would like to know if you found this blog useful. Please leave a comment below we would love to hear your feedback.
References and further reading