Everyone has either heard or said the phrase, 'My Back Went Out'. What does it actually mean? What goes out? Does anything actually go 'out'?
Let's clear some of these things up, shall we?
Typically, when someone says their back goes out they are referring to a sudden painful episode of back pain. This can be after lifting heavy awkward objects, twisting, or even sneezing.
What typically follows is a severe spasm of the back muscles and the feeling that you can't move and the sense of impending doom.
I have personally had this happen on more than one occasion and I can attest to the fact that it is an awful experience that makes a sore back from raking leaves seem like a walk in the park.
But, what actually happens when your back goes out?
Glad you asked...
First of all, nothing actually goes anywhere. (Except in the event of a disc herniation where the fluid inside the disc is protruded outside of the disc. But, a disc herniation is rarely a sudden event and most times is not what has happened when someone says their back went out.)
It's actually quite the opposite in that things don't go 'out' as much as they lock up.
The feeling of your back going out is actually a protective mechanism by your body to protect your spinal cord. Your body innately knows that your brain and spinal cord are the most essential parts of your lively hood and it goes to great lengths to protect them.
What happens is that during whatever activity sets off your back going out, your body senses that your spinal cord and/or nerves are in a vulnerable position and it sets off a cascade of events to protect itself. This cascade is a combination of incredible muscle spasm and guarding basically to provide a temporary 'cast' around your spine.
In doing so, this guarding and spasm of the muscles in the back and abdomen creates a tremendous amount of pain and the feeling that you are almost paralyzed. Depending on the case, these can be self limiting and get better in a couple days or more severe cases will require professional help.
How can you prevent this from happening?
The real answer is that I don't know. And I'm pretty sure nobody actually knows. Sure, you see the explanation that if your core is strong or if you do these stretches everyday that it will prevent this from happening. I haven't seen any conclusive evidence that there is anything you can do to prevent it from happening. I've seen this happen to overweight couch potatoes and elite athletes and everybody in between.
The real question is what should you do when it does happen so that you can get back to normal life ASAP.
Here are a couple tips for when and if this happens...
1). Try to relax and breathe. Even though it seems like you are going to die, you won't. Controlling your breathing actually helps to reduce muscle spasms. Short shallow panic breathing will make it worse.
2). Get somewhere where you can lay down and put your feet up to help relax the muscle spasm. Ice packs also typically help settle things down.
3). Once the first wave of pain subsides (usually about an hour or so), it’s actually best to try and move around and walk.
Until next time,
Dr. Hanson