Self-Assessment: what hurts and what feels better?
This course is meant for people with straightforward recurring back pain or discomfort. Nearly everyone can proceed with the following self-assessment and self-treatment, provided you pay attention to the way you are feeling.
Once you have started the exercises, pay attention to your pain. If it is getting worse, either immediately or the next day, or they are slowly increasing in severity, seek advice from a physical healthcare provider.
In these situations, you should NOT proceed with the exercises without first consulting with a physical healthcare provider:
- If you have pain near or at the ankle or foot and experience sensations of pins and needles or numbness in the toes.
- If you have developed back problems following a recent, severe accident.
This guide is not meant to diagnose or treat any conditions. Please pay attention to your symptoms and consult with a qualified physical healthcare provider if you have any concerns. The authors will not be held liable for any issues that result from inappropriate use of this guide.
When we want to see if something works in the clinic, we assess it first, try something, and then assess it again. If there is a positive change in any of the things we are testing (frequently pain and range of motion), we consider that technique as effective.
In that way, we want to test our back range of motion before we try this technique. The video above is the assessment. Bend and touch your toes. For a self-test, take note of how close your fingers get to your feet, and take note of how it feels in that position and getting to that position. If it hurts, take note of that.
- Bend and touch your toes, keeping your knees straight.
- Perform 10 prone press-ups (pictured below).
- Repeat the above range of motion and compare the way you felt, the level of pain, and the range of motion.
Perform your range of motion self test
Lie face down on the floor, mat, etc. Make sure you can be comfortable in this position before starting, and take note of a few things, including how far away your hands are from your shoulders, and if there is any pain, numbness, or tingling, in either leg. Keeping your lower body completely relaxed, straighten your arms to press your upper body up, like a push-up without the lower half working at all. Don't push through the pain if there is any. Instead stop, lower yourself down, and repeat. Many times the first few are alarming and painful, but then it all mellows out.
The purpose is to attempt to determine the directional preference of your low back. When you perform the press-ups, pay attention to your pain level, pay attention to the range of motion. Is it getting easier to press yourself up further?
Following our 10 press-ups, repeat the range of motion assessment again. Does it feel easier? Does it feel less painful? Do you bend lower?
Perform your prone press-ups
Next we recheck your range of motion to see if there is any change. If there isn't, but your pain doesn't increase, try 10-20 more press-ups.
A note about radiating pain
Sometimes back pain is accompanied by radiating leg or foot pain. Part of the potential benefit of this self-treatment is the reduction of these symptoms.
If you have any of these symptoms, pay attention to how they present after the self assessment. Ideally, they begin to move up the leg, toward the hip or lower back (see diagram at right).
We are looking for the symptoms to centralize, which means to end up in the spine. in the area of complaint, no longer radiating out to the leg or foot.
It is possible for these symptoms to come back again after they are gone, but if these exercises got rid of them once, they are likely to do so again.