Your Back’s “Gone Out” — What’s going on and how to handle it?

If your back has ever “gone out” you know that dreaded feeling.

For me, I first felt that awful “clunk” several years ago when I was sliding an empty dresser just a few inches. (Just a few inches!) All was well until I added a slight twist to the push, then BAM! A sudden **ZING** bolted down the left side of my back and took my breath away. I paused for a minute hoping it would pass. But instead of a rebounding back to normal, my left side slowly began to lock-up, muscle by muscle. And thus began my first experience with a cranky back.  

So what does it mean when a back “goes out”? Why does it hurt so much, and what should you do? I love this explanation from Ian Harvey, LMT:

There are different explanations for why backs “go out,” which mostly depend on the background of the healthcare practitioner you’re talking to. Chiropractors blame shifting vertebrae and ribs, and medical doctors tend to talk about pinched nerves. As a massage therapist, my main concern is soft tissue (muscle and connective tissue), so that’s the first place my mind goes. When a back gets tweaked, I imagine that one of the many tiny muscles crisscrossing your spine and ribs got tweaked, setting off a cascade of painful events.

Muscular guarding

When your back goes out, the muscles are in full-blown guarding mode. It takes a gentle approach to dismantle these widespread protection mechanisms that are on high alert.

Regardless of which explanation is correct, the effect is the same: severe pain and local spasm. The sensation of the surrounding muscles “locking up” is called “guarding” and it’s something that your body does on purpose. All of the muscles in the region contract, forcing you to move stiffly until you finally give in and lay down. Your nervous system has used your muscles to form a cast, which is kind of clever when you think about it.

A tweaked back also tends to be very painful, making it difficult to stand, bend, or even breathe. This is another tool that your body uses to protect the presumed area of injury. By forcing you to spend a day or two on your back, you’re unable to further injure the area. This makes sense, but it’s also really unpleasant.

So the body’s in full-blown protection mode. Now how do you regain mobility? When you’re in the acute stage, the best thing to do is to rest so you can avoid any additional injuries. Applying a heat can help soften the muscle tissues that are working overtime to protect the injured area. Alternating twenty minutes of heat with twenty minutes of covered ice or cold packs may help promote circulation and soothe the frazzled central nervous system. The stiffness will likely continue for a few days. Avoid intense stretching and try to resist the urge to dig into your muscles to get them to release. It’s easy for these activities to further aggravate the region and keep those guarded muscles on high alert.  

So should you immediately call your favorite massage therapist? Possibly. This is not the time to see someone who tends to be heavy handed with a deep tissue “no pain, no gain attitude.” However, if you’ve got a massage therapist that focuses on slow and steady release methods, then a massage could be very beneficial to the healing process. The type of fascial release that I practice relies on more of a “melting” process that can help guarded backs release more easily.

So will a slow, steady and gentle massage make the pain go away and flexibility return? Probably not immediately. You will probably continue to experience stiffness for several days. When my clients come in with this type of guarding, I usually recommend they try to come back 3-5 days after our first session. Depending on the severity of the situation and activities of daily living, it may take 2-3 sessions (or more) before you feel like yourself again.  

Massage therapy is not a magic bullet when your back goes out, but it can certainly help you on the road to recovery by leaps and bounds.

If you’ve experienced an episode like this and would like recommendations on how to better address it, please contact me. I’d love to help you find answers and help get you back to your normal life.

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