Nearly 7 out of 10 French people say they often have back pain, including a large majority of women, while only 22% are satisfied with their treatment*. If the management of chronic back and lower back pain seems difficult, we should act as soon as possible when we have hurt ourselves after a false movement, excessive effort, or that we suddenly pay a bad position. Explanation by Dr. Marc Pérez, general practitioner, osteopath and phytotherapist**.
A muscle contracture to relax
By sitting on a buttock, jamming the phone in his neck to do something else at the same time, or repeating a gesture with the bust in tension, the muscles eventually contract and form a knot. A very localized pain is then similar to a stab. It can be located between or under the shoulder blades, behind the shoulder or in the axillary hollow (armpit) depending on the muscle affected.
Be careful, it should not be confused with a cardiac symptom and, in case of fatigue and associated stress, it is necessary to consult the doctor without delay. If you also feel fit and the sensation is essentially related to a specific movement, it remains reassuring.
Solutions
• Paracetamol can relieve temporarily, the time to act on the contracture.
• We also apply heat using a hot water bottle, by taking a good bath, or by orienting the hairdryer on the sensitive area.
• The most effective gesture is then to spot the sore spot and compress it by pressing it firmly for a minute, exerting small circular pressures. This forces the muscle to let go. The ideal is to solicit the osteopath.
A joint to be released
We turned around or got up too quickly, and we find ourselves stuck, unable to bend or turn to one side, to the other… What happened? In one of the vertebrae, a small capsule containing synovial fluid and cartilage may have cracked under pressure. Damaged tissues (scratched or torn) can hinder the return movement of the joint in its usual axis of mobilization… and it’s very painful.
When the pain occurs after a fall forcing the twisting of the lower back or after a violent effort to lift a load too heavy by taking a bad position, we speak of the famous lumbago which is manifested by a spectacular analgesic position (position leaning forward forward or to the side), due to a contracture and a disc sprain at the same time.
Solutions
• Still no anti-inflammatories, paracetamol is enough for a while to relieve.
• Heat is then applied before massaging with essential oils of wintergreen and helichrysum (3 drops of each mixed with a dose of sweet almond oil). Enough to prepare the joint to be remobilized gently.
• It is therefore necessary to move, but it is not a question of forcing, only of performing the opposite movement to that which triggers the pain. Do you have pain while twisting the bust to the right? Then go to the left, before gradually returning in the other direction. To be done possibly in a supine position, knees bent towards the chest to swing to one side or the other. This effectively stretches the muscle and tendons near the blocked joint and releases it little by little. Here too, the osteopath knows how to perform the right gestures for an accelerated recovery.
• Finally, we avoid total rest: we must move smoothly, by performing the usual gestures and movements in slow motion.
A nerve to protect
A violent pain suddenly wakes up in the back, radiates, possibly tingles and is reminiscent of neuralgia: it is then important to look in the mirror to detect a possible associated rash, localized on the path of a nerve. The table evokes in this case a shingles and it is necessary to consult the doctor without delay to benefit from a treatment that will preserve the nerve.
If it pinches and throws from the top of the buttock and into the leg, it is more likely a herniated disc that compresses a nerve root in the spine, when the intervertebral disc no longer plays its role as a shock absorber over time. The pain then spreads in the pelvis and on only one side, along the lower limb: either to the back of the thigh and to the outer side when the sciatic nerve is affected, or to the front and on the inner side when the cruralgic nerve is affected. This can happen without warning, or after a violent effort.
Solutions
• Shingles is treated with antiviral drugs, such as aciclovir or valaciclovir. And for pain, paracetamol or an opiate derivative is taken on prescription in case of resistance and for a very limited time. An anesthetic plaster, to be applied to the painful area may also be proposed.
• Sciatica and cruralgia are relieved by painkillers such as paracetamol, anti-inflammatories and an opiate derivative possibly (always in small doses). Well too: the belt of the maintenance bought in pharmacy on prescription. It is only to be worn in a standing or sitting position and punctually, but relieves well.
• Are we moving? After a period of relative rest and without keeping the bed, it is essential to resume physical activity to maintain a protective musculature and limit recurrence, once the painful crisis has passed.