“Doc, I was just bending over to pick up an envelope and when I stood up, Oh Boy!”

A back attack can occur without warning and you don’t need to be a piano mover or a weight lifter to have an acute episode. You can fight back however. Here’s how.

Get 90 - 90

Lie on the floor with your legs bent at a 90 degree angle on a couch, chair or pillows. This takes much of the pressure off the spine and will give you surprising relief. Maintain this position for up to 30 minutes. If necessary you can even sleep in this position by stacking pillows underneath your knees. Do not stay in bed too long however, usually 1-2 days at most. As you begin to recover you can use this position to continue to give you relief by using it for 30 minutes three-five times daily. We have even seen people in airports using the 90 – 90 approach and while they make look a little odd we know they’re fighting back.

Put Out the Fire

Assuming that you have no allergies to anti-inflammatory medications you should immediately begin taking an over-the-counter variety such as Motrin, Nuprin, Alleve, or Advil, but any generic brand of ibuprofen will do fine. Always follow the instructions on the label regarding dosage, frequency and contra-indications. Keep taking the medication even if you begin to feel better as anti-inflammatories tend to work best after they have been in the blood system for 1-2 weeks.

Apply Ice and Heat

Apply ice during the first 24 hours of the attack and then switch to heat for the next 24 hours. A zip lock plastic bag with ice cubes wrapped in a thin towel works great. Use the ice for 20 minutes 3-5 times during the first 24 hours. Any variety heating pad will do for the next 24 hour period, again 20 minutes 3-5 times. After the first 48 hours alternate heat and ice. Use ice for 20 minutes, wait an hour or so and apply heat for 20 minutes. Alternate for 3-5 times daily.

Try Exercises

Try to perform these exercises as soon as possible after your back attack 3-10 times per day even though it hurts a little. However, please note that if performing these exercises causes severe or intolerable pain consult your doctor.


Light Rotation:
While on all fours gently sway side to side, increasing range as you feel comfortable doing so. Do 30 repetitions.


Cat Stretch:
Perform this exercise very slowly, inhale as you curve your spine upwards and exhale as you slowly rest your spine towards the floor. Do 10 repetitions.


Get back:
Gradually increase your activities. Taking a short (5-10 minute) walk on level ground while swinging your arms is a good way to get started.


Do the lumbar roll:
Take an ordinary bath towel, fold it in half lengthwise and roll it up. When sitting or driving place this “lumbar roll” in the small of your back between you and your seat. This helps to keep the spine aligned.