It's Sunday morning and yesterday your husband was the weekend warrior at the church picnic, the hero of the softball game.  But this morning, he is in agony!  In fact, the lower back pain is so great at every movement that the poor man is immobilized, unable to get himself off the floor.  And he is crying out to his wonderful wife to help him in this hour of crisis and help get him off this floor.  Your mind is reeling, not knowing how to help him. Get the heating pad?  Or should it be ice?  Call the doctor?  But it's Sunday morning and even if the office were open, how to get him there?  Call the Rescue Squad? 

 What to do?
      Just how should one handle such an emergency?  Well, first of all.  Don't Panic.  Granted he is in severe pain and this is a serious moment.  But don't lose your head.  Stay rational.  This is not cardiac arrest. His pain is lower back, not chest and shoulder.   His life is not in any danger.  This is an acute pain event caused by powerful lower back muscles in spasm.  These muscles are reacting to his attempted movements and are "splinting" trying to protect an inflamed joint from yesterday's ball game.  In such cases, delayed symptoms are not unusual.  You can go to bed fine and wake up in misery.  Usually the patient can find one position where he is somewhat comfortable.  Have him very slowly search for a position that will ease the pain. Side position with a pillow between the knees often will relieve it or on the back with legs drawn up or lifted across a chair seat. (Kidney stone pain can cause terrific back pain, but the pain from kidney stone is not positional.  Position does not effect  the pain.  The pain is just as great standing, sitting or flat out on the floor.  With a kidney stone, he should not be immobilized by the pain. In fact, he won't be able to stay in any one position. In this case, put him in the car and transport him yourself to the ER.)  

Don't Move Him.   
      Assuming that he was able to find some measure of relief from a particular down position, what can be done now for him?  (If no position can be found to relieve the pain, you have two options: call the rescue squad or try some of the procedures now to be discussed.)  One thing you don't want to do at this point is to make any attempt to get him on his feet and move him (unless you have a definite plan of where you are going once he's up).    Any attempt at this point will rarely be successful.  His screaming will also hurt your ears.  He will most likely plead with you to help him up. But explain to him that he is for now better off where he is.   And besides, where is the man going once he's up still in dreadful pain?  No where, certainly not to church or to the golf course. Now if where he is lying is wet or dirty, a move can be undertaken to get him to a carpeted dry area, which may be better than his bed and much batter than a sofa (usually too soft).  

Use Ice.  
      If you do not have a Col Pac in the freezer, take out a frozen bag of peas.  Place the bag on the outside of the shirt in the small of his back over the involved joints.  The purpose of the ice is to reduce swelling in the joint and to bring a measure of pain reduction.  You may also use some heat over the muscles of the thoracic spine between the shoulders. The heat is designed to relax the paraspinal muscles that run all the way from the lower back to the neck. 
    
Find a Supportive Garment. 
     An elasticized back support is just perfect.  Don't have one?  Ok, look for a wide belt like a motorcycle belt or lifting belt.  Don't have that either?  Then, use one or two of his widest belts and strap the frozen peas around the waist.  Just as a sprained ankle is soothed and stabilized by the compression of an ace bandage, so the joints and muscles of the low back are given support by this belt.  The muscles will not feel the need to splint as violently if the back is supported.  If you can find nothing, get resourceful. Something is better than nothing.  Fold a beach towel lengthwise a few times and tie it around his back as snug as you can.
     
Gentle stretch and traction. 
     After an hour on ice and heat, re-evaluate the situation.  If he can move now with considerably less pain, a stand up may be attempted.   But if motion is still very painful, he may try a second round of ice/heat,  while you try to buy or borrow a lumbar support from the nearby store or friend.  With the support now in place, a stand up can be attempted.  If it is still a no go, some traction  to his back may be helpful.  The simplest way to get traction is with a pair of crutches.  Standing, he places the weight of his body on his hands and shoulders, lifting his torso up so that the upper torso weight is removed from his back, holding 10 or 15 seconds and repeating the traction as he stands in place or moves about.  Without crutches, he may try bringing a chair in front of him in the kneeling position and proceed with arms on the seat of the chair, lifting his torso upward to put traction on the back.

 Repeat the process.  
     Every thing you have done can be repeated 3 or 4 times through the day until the following day when his condition can be assessed in the office.  He is certainly not ready to run a race, but he is no longer, hopefully in screaming pain either and he is able to move slowly on his own.  Keep in mind that after a night in bed, the muscles will tighten by morning and a similar process may be required the following morning.

He's No Better. 
      If all the above procedures fail to bring some measure of help, it is time to consider calling the rescue squad for transport to the ER. 

What about Muscle Relaxants?
     Since it is the muscles that are splinting to protect the injured joint, it would seem that muscle relaxants would be helpful.  That is sound reasoning and it is true.  The lumbar support's role is to decrease the need for the muscles to splint.  The herb Valerian root is a good natural muscle relaxant and along with magnesium is very much indicated for this problem. We usually recommend that the patient combine Valerian and Magnesium with SAMe or 2 or 3 Advil (Ibuprofen) which is an anti-inflammatory.  While we do not recommend Advil for long term use, it does have good application in the short term, provided the stomach is protected with a fatty food, since Advil  (and all NSAIDS) can cause GI side effects far worse than the back problem. 
       However, occasionally the injury is so severe that prescription muscle relaxants are required.  These will pretty well knock you out, so prepare to sleep.  Chiropractor's licenses do not cover writing prescriptions, so this is something that your primary care or ER physician will order.

                                  Call 825-8867 For An Appointment