Back attack! Where to start with acute onset low back pain

By Erik Zamboni, doctor of Physical Therapy and clinic director at Living Well  Therapy LLC

Erik Zamboni earned his clinical Doctor of Physical Therapy degree from the University of Southern California in 1999. He has been the clinical director of Living Well Therapy in Bend since 2004 and has over 14 years of experience in private practice physical therapy. Living Well Therapy enjoys providing cutting-edge care starting with an individualized treatment plan that often includes a sports medicine approach with tools such as low-level laser to expedite patient recovery.

“Ugh!” groaned Nate as his aching back throbbed with pain so severe he couldn’t concentrate, despite having taken three ibuprofens.

Nate hadn’t  always suffered from lower back pain. He had felt fine just three weeks earlier.  However, with the sudden bouts of pain, he pondered, how did he injure himself and what was causing his persistent pain? There was no auto accident, big slip and fall or athletic injury. His mind wandered into multiple scenarios. Was it the five minutes of shoveling snow in the driveway? Was it lifting a few bags of ice melt at work without bending the knees? Nate even pondered if he was simply just getting old.

While Nate is a fictitious character, his symptoms are not and they are all the more prevalent in patients we see at Living Well Physical Therapy.  Low back pain will affect 80 percent of people at some time in their life. Millions of dollars are spent each year on treatment, contributing to millions more spent on lost work time.

Low back pain can be difficult to diagnose with an Xray, and while MRIs assist in proper diagnosing, they typically cost upwards of $1,200.  Medical insurance deductibles typically renew in January, and with the high cost of healthcare, many choose to increase their health insurance deductible. Either way, this means more cash out of pocket to treat such health issues.

So, what can one do to mitigate the pain and recover from the injury?

Nate took three ibuprofens to assuage the pain.  Treating his back with a cold ice pack off and on for the first 24-48 hours immediately after he first noticed the pain would also help. Additionally, a few gentle stretches and exercises could reduce the severity, duration and speed the recovery of his back pain:

Lower Trunk Rotation: Start on you back with your knees bent and feet flat on the floor. With your knees together, bring them to one side keeping your feet on the floor. Hold 3-5 seconds. Contract your abdominal muscles while moving your legs to the opposite side, again holding 3-5 seconds.

Lower trunk rotation




Posterior Pelvic Tilt: Lie on your back with your knees bend and feet flat on the floor. Exhale. Using your abdominal muscles, press your low back into the floor. Do not lift your hips or let your tailbone roll off the floor. Hold this position 3-5 seconds.

Pelvic tilt




Single Knee to chest: Start with both legs and heals together flat on the ground. Raise your right knee upward and pull it toward your chest with your hands. Hold for 30 seconds, then return to starting position. Repeat with other leg.

Knee to chest




Perform exercises up to 10 repetitions two to three times per day.  If the pain increases, discontinue the exercise. If severe back pain, numbness, tingling, weakness, or worsening pain occurs, seek medical attention from a doctor or physical therapist. While these recommendations may be generally appropriate, they should not be misconstrued as medical advice.

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