Low Back Pain and Sciatica - Inflammatory Pain, the Worst Pain of All

We have nearly all been there. You do something which seems quite innocuous, such as putting you shoes/socks on, picking something up, getting out of a chair and BANG your back 'goes'.

The next thing you know, you cannot move due to the searing low back pain or sciatica you are feeling. What should you do now...?

Inflammatory Pain - There's nothing worse

Unfortunately, you are now experiencing inflammatory pain, where the structures responsible are inflamed and consequently the pain is constant. Even the slightest of movements, cough or sneeze will exacerbate the pain no end.

At this stage, the best thing you can do is rest. By rest, I do not mean put yourself in bed for a few days, rather find the most comfortable position you can for your pain. This usually involves lying down, be it on your back, stomach or side lying with a couple of pillows supporting your top leg.

When you find the most comfortable position, ideally you should either stand up and take a few steps or at least change position every 30-60 minutes, as it is also important to keep as active as possible. However, if your low back pain/sciatica is extremely inflamed, complete rest can sometimes be indicated for 24-36 hours. All of the time though, the emphasis will be on becoming more active as you feel appropriate.

I often use the analogy here of hitting you thumb with a hammer, At first everything hurts, the pain is constant and you only have to brush your thumb against something and the pain increases dramatically and the inflammation flares up again. If however, you can avoid aggravating your thumb, the inflammation will settle down and you will find you can do more and more with your thumb without aggravating the pain.

This is very similar to what is happening with your low back pain or sciatica. Every time you perform an activity which significantly increases your pain, you are further encouraging inflammation to take place. However, if you can avoid unnecessarily aggravating it, it will begin to settle down and you will find you can become more active.

That is why it is so important to give yourself 'relative rest' in the early days (by relative rest, I mean if you are able to be a little active, even if it involves just a few steps, I encourage it). As your low back pain/sciatica then begins to settle, and it will, you will then need to slowly but surely encourage more activity.

As the pain moves away from its initial inflammatory state and you become more active, you should then consider an appropriate gentle exercise programme. The likelihood is you have some muscle imbalance present which has caused you to suffer this attack of pain in the first place i.e. tight and weak muscles.

If you wish to resolve your low back pain/sciatica as soon as possible, as well as dramatically reduce the chances of suffering another attack in the future, addressing the cause of your current episode of pain is essential.