In this article we will look at the best practices for optimizing back pain recovery. Despite the fact that back pain can cause a significant amount of pain and discomfort, it usually recovers spontaneously on its own. The speed of recovery depends on many variables. There is no one single magic remedy to speed up the recovery process.  However there are certain strategies that can be used for optimizing back pain recovery to help you recover faster. Understanding that you may not have control over certain aspects of your recovery process, will also allow you to create more realistic expectations and avoid undue frustrations.

Physical fitness and age Individuals who are more physically fit and do not have other major medical conditions, generally tend to recover much faster. The body can fully focus on the healing of the injury when there are no other chronic conditions that also require attention, energy, and resources. The smaller the number of raging fires present at the time of injury, the faster and more efficient the recovery process can be. Since most chronic conditions tend to accumulate over the years, age becomes an important player in the recovery process. For the most part, healing is much faster in younger and healthier individuals. That is not to say, however, that growing old is always plagued with long term recovery process. A healthy and active 60-year-old individual with back strain may recover much faster than a 30-year-old sedentary obese office worker.

Prior injuriesHistory of prior back pain or the presence of other chronic musculoskeletal injuries plays a significant role in the recovery process. Individuals who suffer from chronic pain which is not well controlled, have gone through a process of so-called sensitization. In other words, their nervous system has become more sensitive to any pain stimulus. Any new injury will, therefore, cause a lot more intense pain and take much longer to subside, despite the fact that the area of injury may be already healed. Importance of early mobilizationWhen significant acute injury develops, bed rest may be necessary. It should be, however, limited to no more than 24 - 48 hours. Numerous studies have demonstrated the detrimental effect of prolonged bed rest on the recovery process. Motion is the lotion and muscles need to move to heal. While you should not push through the pain to further aggravate your condition, gentle exercises focused on a pain-free range of motion and stretching will allow the muscles to become less stiff and maintain their flexibility. Muscles that are not used, start to deteriorate very rapidly. They lose flexibility, mass, strength and become stiff. Intense pain with even small movements may then result from any attempt to use the stiff muscle since it will be pulling on the injured area. Movement also creates important muscle pump which helps to increase local blood circulation. Increased blood circulation helps to flush out the inflammatory chemicals present at the site of the injury. The accumulated inflammatory chemicals irritate the nerve endings at the site of the injured area. These chemicals are the primary reason for sensation of pain. Increased blood circulation also helps to supply the injured area with nutrients, oxygen and white blood cells that help to heal the injured tissue. Getting an early referral to a physical therapist to start the rehabilitation from acute injury is important for fast recovery and preventing the development of chronic conditions. Application of heat versus coldUsing cold compresses for the injured muscles may be soothing in the first 24 – 48 hrs. This should be, however, followed by the application of heat to promote local blood circulation and to relax the muscle spasm. Moist heat is preferred over dry heat, and moist heating pads, hot showers or baths work great. Heating pads can be applied to the injured area several times a day, but no longer than 20 minutes at a time. You should never sleep on the heating pad. Exposing the injured area to the heat longer than 20 minutes at the time leads to overheating. This will trigger a protective mechanism, which may cause changes in the local vasculature and eventually decrease blood circulation in the injured area. If pain prevents you from getting good night restful sleep, talk to your provider about prescribing short course of pain medication that can decrease the intensity of pain at night, while at the same time help you get better sleep. Taking a muscle relaxant 30 minutes to one hour before sleep is generally a good option. However, your medical provider will be able to make more specific recommendations based on your particular condition.

Sleep and DepressionGetting a sufficient amount of sleep is important for everybody, but it is critical when recovering from an acute injury. The body heals and tissue regenerates when we sleep. Insufficient sleep promotes systemic inflammation within our body, which slows down the healing and contributes to more pain perception. A minimum of seven, but preferably eight hours of sleep is recommended for optimal functioning and recovery. Additionally, an insufficient amount of sleep combined with new intense pain has a strong effect on mood and may lead to depression. Whether depression results from sleep deprivation and pain or the depression has been present prior to the injury, it’s presence further intensifies pain and interferes with sleep, thus creating downward spiral leading to worse outcomes.

Complementary medicine, pain medication, and acute painAn increasing number of patients do not wish to take any pain medication when they develop acute pain from fear of their side effects. There is an ongoing battle and numerous initiatives to fight the opioid crisis around the world. Additionally, it is also true that every medication carries a risk of side effects. This, however, doesn’t mean that taking pain medication is bad and should be avoided by all means. It is important to understand that there is a role for pain medication in particular when it comes to severe pain. Getting pain under control as soon as possible will prevent altering the way in which our brain deals with pain. Any uncontrolled pain lasting longer than several days can sensitize the brain to pain and lower the pain threshold. This ultimately translates to experiencing painful sensation at much higher intensity with much lover stimulus. A simple gentle touch over the painful area could, therefore, lead to severe pain. Complementary and alternative medicine modalities have been used successfully for the management of pain and injuries for hundreds of years. Many of them have been extensively studied and their effectiveness proven in rigorous trials. Despite their popularity, however, their role is primarily in the management of chronic pain and injuries. This is largely because their main mechanism of action, by which they help to control pain and promote recovery, is through stimulating body own healing processes and pain control. In other words, their primary role is to restore the body homeostasis. The subtle changes they produce over time are sufficient to create a noticeable difference when treating chronic pain or injuries. It is, however, usually not enough to promote lasting pain relief in severe acute pain Click here to read more about the complementary medicine, pain medication and acute pain.

The role of NutritionThe importance of nutrition cannot be emphasized enough when it comes to recovery from an acute injury. Providing our body with a sufficient amount of lean protein which is important for building tissue, as well as getting enough vitamin C to promote formation of collagen, is the very minimum. Minimizing the intake of vegetable oils by decreasing consumption of fried foods and pastries and replacing them with monounsaturated fats from olive oil, canola oil, and avocados helps to decrease inflammatory process in the body. Eating a wild salmon or other fish high in omega 3 fatty acids at least 2-3 times a week, or taking 1000- 2000 mg of mercury-free omega 3 fatty acids daily in the form of a supplement, has been also shown to decrease systemic inflammation. Having fresh vegetables at least two times a day and eating 2-3 pieces of seasonal fruits will add much-needed vitamins and phytochemicals to act as powerful antioxidants.

Topical analgesic creamsTopical analgesic creams, ointments, and plasters have been used in many traditions to treat injured muscles and bones for millenniums. They have been made from a variety of herbs and other natural substances. Their use not only soothes the pain but also promotes healing. A number of topical analgesic creams have been developed by the pharmaceutical industry based on these old folk remedies. Most of these products contain some combination of menthol, capsaicin and salicylic acid. While these products have been marketed primarily to help to soothe the pain and aches, they also promote local blood circulation by stimulating special receptors on the skin. As mentioned throughout this article, increased blood circulation in the area of pain promotes healing. The use of these products should be therefore encouraged for any musculoskeletal injury where application of topical creams is not contraindicated. Before rubbing any of these products to the skin, try to apply only a small amount to observe for any skin reaction. You should also never apply these creams right before or after hot shower to avoid intense burning sensation. In summaryRecovering from an acute musculoskeletal injury is a complex process. There is no one single recipe since everybody has a unique combination of factors that may either promote or hinder the recovery process. In this article, we have covered only few of the most important aspects that exert a major influence on the recovery process. Optimizing sleep, physical activity, nutrition, and appropriate use of heat/cold and topical creams, can have significant effect on the speed of your recovery. To learn more about complementary therapies that can be used for recovery from acute back pain, visit National Center for Complementary and Integrative Health