Acute Locked Back
Acute locked back (ALB)
Acute locked back pain is a common medical problem. Acute pain is pain that has been present in your back for less than 4-6 weeks. Locked means that the source of the pain may be in your spinal joints, discs, vertebrae, or soft tissues.
ALB Happens when an unguarded movement causes a sudden jolt of pain to shoot through the back in movements such as:
Turning over in bed, getting out of a car, or even bending down to pick up an object. The absence of effort and preparedness for what you were about to do seem to play a key part
Causes of ALB:
Segmental stiffness
Tightness in the back muscles that have been there for a while
Due to previous disc herniation
Means that the source of pain is in the spine and/or its supporting structure. The surrounding muscles and ligaments may develop a reactive spasm and pain
Muscle weakness
Weakness of the small muscles around the stiff segment of the back lead to failure to prevent the sideways twist for the lumbar spine
Weakness in core stability due to the reliance on superficial back muscles
The timing and the co-contraction of segmental muscles being out of synchronization
Symptoms:
Acute phase - back muscles lock up to protect the individual spinal joint
Sudden sharp pain during the beginning phase of a movement
The pain at this stage can alternate between a cramp hovering in the background and an excruciating jolt whenever you move
Back feels “rock hard”, secondary to constant pain and muscle spasm
Sub-acute phase: within a few days the intensity of the acute condition should start to settle
As the muscles relax, it becomes easier to move. Although it is still painful with simple movements such as turning over in bed and switching positions
The broad surface area of pain becomes reduced to localized area of soreness
Your back feels bruised and fragile and the pain is no longer constant
The chronic phase - the protective muscle spasm is greatly reduced, the joint underneath often emerges as dysfunctional region
Low grade tenderness and chronically stiffened muscle in you back
Pain the in buttock and thigh increases and decreases in accordance with activities which create the pressure on the facets (eg. sitting in a slumped position, such as computing and commuting or prolonged bending activities like gardening)
Management and treatment:
Rest: if experiencing severe pain, short term bed rest may be recommended. However, it is rarely recommended for more than 48 hours of bed rest
Physical activity: physical activity may allow for rapid recovery from back pain
Ice and heat: alternating between heat and ice to the lower back would promote relaxation and decrease inflammation. For ta general rule of thumb, apply 20 minutes of heat, followed by 20 minutes of ice. You may choose one over the other if you find it to be more helpful, totally up to you. Generally, heat +/- ice should be applied 2/3 times a day
Medication: NSAIDs such as ibuprofen or naproxen are helpful for decreasing muscle spasms.
Physiotherapy: Physiotherapists can use techniques such as soft tissue release, modalities such as dry needling and also designing a home exercise program that will help promote rapid healing. Active rehabilitation can shorten recovery time and return you to work/leisure activities as quickly as possible
Resources:
The clinical aspects of the acute facet syndrome: results from a structured discussion among European chiropractors https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642848/
Acute Mechanical Back Pain https://my.clevelandclinic.org/health/diseases/4879-acute-mechanical-back-pain
3 Simple Stretches for the lower back. Click on the Image to watch the video!
