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This article is a transcribed edited summary of a video Bob and Brad recorded in November of 2022. For the original video go to https://youtu.be/Q_nXIvpiUfg
Bob: All right, the question we have is if you have back pain, do you have inflammation in the back?
-Brad: All I'm saying, is if it hurts and it's painful when you move, you probably have inflammation.
-Bob: Right? Let's talk about it. If you have constant, severe pain, that's a good chance there is some inflammation in it. So, a flare-up of pain, you know, if you went out and did something stupid.
Brad: Like if you went out and cut a tree down in the backyard and moved all the wood by yourself with poor body mechanics and then it hurts for the whole night and the next day
Bob: Yeah, it's just like spraining your ankle. You're going to get swelling in there.
Bad: Yeah.
-Bob: If you have trouble sleeping at night, you know you're lying down, you would think it should not hurt, right? But if there is actually swelling in your back, it may hurt. Finally, if it hurts all the time when you're standing or walking.
Brad: That chronic pain situation.
Bob: Yeah. It doesn't matter what your diagnosis is. If it’s sciatica, spinal stenosis, or Spondylolisthesis. Whatever it is, inflammation is going to make it worse. So your first step should be to try to reduce inflammation. For at least a five-day plan.
Brad: Yeah. That sounds like an exceptional plan.
Bob: So, one of the things you want to do is walk. Walking helps get things moving and it actually helps the swelling go down.
Brad: Right. If it's so flared up, that walking makes it worse. Which I've experienced as well as some patients, then we're going to show you how to settle it down and then get to walking when you can.
Bob: Right. You could try a back brace. It might feel better when you walk. We have a couple here. Brad, do you want to show yours?
Brad: Yeah. You know, if you don't have one, I don't know if you really want to go out and buy one. I would try some of these other tools.
Bob: Right. They are less expensive.
Brad: So, these aren't that expensive actually, you know this one has the elastic. We like the kind that you can keep reasonably loose and then adjust. When you're walking, you may want to tighten it up and feel that support. It should feel like good support as soon as you tighten it up.
Bob: Right. This one works the same way. This one has a Velcro closure here and then I can tighten it and really cinches up.
Brad: The one Bob has on is actually more supportive than the style I have on, which I like that one.
Bob: If this allows you to walk and you can't walk without it. It's a great thing to do.
Brad: Yeah. Stabilize that pelvis and eventually, you take it off when you can, you don't continue to wear it forever.
Bob: A little less active thing is getting into the right position and using the ice pack.
Brad: So, this has been my go-to personally as well with patients that come in with severe back pain. I'll have them lie down. You can use pillows. This wedge works better for at least 90% of the people I've worked with. And you could do this on your bed or on the floor.
Brad: A cold pack when it's really flared up for most people is what my go-to advice is. Get that underneath your back. And I've done this literally after I’ve been out doing yard work because I'm guilty of that. I like doing yard work and I break the rules sometimes. Literally in the middle of the day, I'll go in, lay down like this with a cold pack for 20 minutes, get up, relax, and go back out. And then I behave myself though. I won’t do things I shouldn't be doing.
Bob: And you could do this throughout the day for 10 minutes. I mean, if you want you could go longer but I like to see if your pain is really flared up, do at least twice, maybe four times where you get on the ice pack and get the legs up.
Brad: It really feels good, and I don't even have a flare-up right now.
Bob: All right. If you're having trouble at night sleeping because of the flare-up or the pain, you might want to wear the back support or back brace at night. Because whenever you roll over it's going to hurt and that’ll help stop that.
Brad: It will stabilize it. Yeah.
Bob: Give it a try. We’re not worried about your back getting weak during sleep because you're not working out too much. The last thing is to avoid pain makers for now.
Brad: Where do you get a pain-maker?
Bob: There could be a whole list of them, Brad.
Brad: Actually, I guess we've gone over that in a previous video in this series.
Bob: You don't want to be riding that snowmobile when your back is flared up. You don't want to be shoveling snow. You might not want to be cutting the lawn.
Brad: Yeah, on a riding lawn mower, boy, that can really tear it apart.
Bob: So, until your pain calms down, then you can reintroduce the pain makers. And then at that point, use good judgment.
Brad: Right.
Bob: All right. Remember, get that back calmed down.
Brad: That's right. Feel calm and relaxed.
Bob: All right. Take care.
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