What Actually Happens When You ‘Tweak’ Your Back & What to Do About It

by Natalie Kiser

You know the drill: One minute you’re bending down to pick up a box off the floor or to scratch your cat’s belly and somehow, some way, “Ouch!” You’ve tweaked your back, and now you’re doubling over in pain. Then before you know it you’re on the couch for days completely incapacitated and feeling bad about yourself. What the heck happened?

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Don’t worry. According to Eni Kadar, PT, DPT, Cert. DN, CHN, tweaking your back over the simple stuff is quite common.

“There are two common scenarios that I’ve seen in practice: one, someone is just bending over to tie their shoe or something benign and their back ‘goes out’ or two, they twist or make an odd movement and their back ‘goes out’.”

Sound familiar? So why does this happen and how can we make the pain go away faster to ensure a swift recovery?

What causes us to tweak our backs

When you tweak your back, it’s generally because something happened in your spine. While you might experience muscle spasms, the cause isn’t typically muscular and could be related to a pinched nerve or something else entirely.

“It’s important to note that nothing actually comes out of place like most of us think,” says Kadar. “The term ‘slipped disc’ is a misnomer as your vertebral discs are actually quite firmly rooted in place, unless you were in a high impact collision.”

When you picture a vertebral disc, Kadar suggests it might be easier to picture it as a jelly donut (which is the nucleus pulposus) with a fibrous exterior (annulus fibrosis). When you bend forward (like pushing the front of a jelly donut), the jelly moves more toward the back. When you bend backward (like pushing the back of a jelly donut) the jelly moves toward the front. When you bend sideways to the right, the jelly moves to the left.

“This disc material is meant to move this way in a normal, healthy spine as it allows freedom of movement and cushioning for the spine,” she says. “Sometimes, though, based on positions we stay in for long periods of time (i.e.. sitting) or due to weakness somewhere in the chain, the load on the fibrous exterior can become too much, making it weak and the ‘jelly’ can start to push farther than it’s supposed to.”

Because there are a tonne of nerves running down your spine, we will perceive pain, numbness, tingling, or a burning feeling when that disc material presses on it, explains Kadar. “If there was an acute injury to the area, there are also inflammatory chemicals released by the body to help heal the tissue but these will also cause pain. In response, muscles will spasm in the area because that’s the body’s way of protecting itself.”

What can you do to make it feel less awful

In order to heal the inflammation and find relief, Kris Ceniza, a physical therapist, recommends the following exercises.

  1. McKenzie exercises. “These are exercises that are generally part of low back pain protocol in physical therapy and it comes in stages. First, simply lie face down. If you can hold this position for two minutes without intense pain, you can then prop yourself up on your elbows to extend your spine. If you can hold that for two minutes, gradually prop yourself up with your hands to create even more extension.”
  2. Cat and camel. “Again, this is protocol in physical therapy. Simply get down on all fours and slowly round then extend your back. This mobilizes your spine. Repeat ten times for three sets everyday until your pain levels go down.”
  3. Controlled kickbacks. “This mobilizes your hips and gets you better control of your core. On all fours, slowly raise your right leg as high as you can without changing the angle of your hip and spine. If your hips tilt/rotate or your low back extends, this suggests tightness in your hips and poor control of your core. Do the same for the left leg and repeat ten times for three sets everyday until your pain levels go down.”

In addition, Kadar recommends using ice for ten minutes at a time. “Once that pain subsides and it just feels tight and stiff, I’d switch to heat.” And contrary to popular belief, Kadar says it’s best if you can keep moving within your tolerance because “using bed rest or inactivity for extended periods of time can actually make your body weaker over time and make the healing process longer.”

She also suggests being evaluated by a movement professional such as a physical therapist to determine the most efficient and effective plan of care for you since everyone’s body is different and have different areas of weakness or immobility.

Kadar warns if symptoms worsen or travel down your leg farther, to not push through the pain and to seek evaluation immediately.

Additionally, if you experience paresthesia in the ‘saddle area’, or any changes in bowel and bladder function concurrently with your symptoms, Kadar urges you to seek emergency medical treatment immediately as this can be a sign of a serious spine injury.

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