What to Do With A Back or Neck Injury?
What is the correct thing to do when I hurt my back or neck? Or, expressed another way, what is the protocol I should follow? Questions that have been asked countless times over the years, and when the correct protocol is followed, the benefits to the sufferer are major. The reverse is also true, in that an incalculable number of people have suffered so unnecessarily simple because they have been unaware of the correct way to proceed, or they have been given very poor advice. As a consequence of any sudden trauma, whether it is an episode such as a fall, an impact injury, a spinal compression incident, or any other episode that might lead a person to suspect trauma has occurred, there are two matters that should be considered urgently.
The first of these matters is the high likelihood the spine has been compressed as a consequence of the episode, due either to the weight-bearing effect of the episode causing a vertical compression of the spinal column, or the muscles have contracted into a protective spasm shortening their fibres across segments of the spine. This is commonplace and often results in prolonged spinal compression if not addressed within a short-to-medium timeframe directly after the episode. It is worthy of note though that with appropriate action this is generally reversible, however failure to do so can, and usually does, result in degenerative and painful consequences. Both of these factors can and generally do occur simultaneously.
The second matter is associated with the distinct possibility that the trauma may have produced a response causing the soft tissue and/or the vertebral column to become inflamed. Commonly, the body may also dump fluid into the affected region. Urgency in dealing with inflammation, and fluid, must be a priority. Any delay in controlling these factors will also delay the process of rehabilitation. It is universally agreed by those who have had success in these matters that the presence of inflammation and/or fluid must be addressed as the highest priority before any other steps are taken to rehabilitate, and will probably prolong the suffering significantly.
By looking more closely at the first matter [that of probable spinal compression], we conclude that, if handled correctly, the inflammatory phase can be avoided completely, or in the very least, can be shortened significantly by de-compressing the spine as soon after the trauma as possible. Generally speaking, the sooner this is done, the better. The manner in which this is carried out is crucial to the chances of a quick recovery, and must be performed before the spinal compression has time to degenerate the spine. As previously stated, the removal of excessive spinal compression soon after the trauma can avoid inflammation, and in the majority of cases de-compression can be achieved without the need for medical intervention or specialised equipment. This is the case provided the spinal column with its component structures has retained its integrity. Sadly though, failure to reverse the effects of prolonged compression has been the major contributing cause of spinal degeneration, rather than the initial traumatic episode.
The method of spinal de-compression is a crucial one, and should be done utilising the person’s own body weight in accordance with a proven de-compression strategy. This strategy must encompass the three essential elements of rehabilitation; 1) restoration of body symmetry, 2) restoration of the 3 spinal movement functions, and 3) restoration of specific spinal support strength, which is an issue that is lost with muscles beginning to atrophy within days of the episode. The method should be done in a non-weight bearing environment with the spine in a horizontal aspect, or with the spine vertical but in a buoyant medium such as water below body temperature.
The second matter that has been stated above revolves around the likelihood of inflammation being present. This reaction often occurs after the sorts of traumas detailed above and when spinal de-compression has not been effectively performed soon enough after the trauma. This is a matter that can never be overstated, and should almost always be seen as a matter of absolute urgency. Also it is prudent to implement a protocol that suspects the presence of inflammation as a precautionary measure if it is considered that sufficient trauma has occurred.
Immediately after the essential de-compression of the spine, and ideally prior to the body cooling down after the trauma has occurred, it is wise to follow the I.C.E. protocol. The I.C.E. acronym affords a prudent and effective way to combat the effects of inflammation and fluid. ‘I’ standing for ice, which is a naturally occurring analgesic and a safe way to reduce and minimise inflammation. The ‘C’ stands for compression and is an efficient means of reducing fluid, and the ‘E’ stands for elevation, a useful method to assist in draining fluid to be eliminated from the body
Soon after the evidence of inflammation and fluid has been eliminated an efficient method of achieving spinal de-compression and the restoration of the spine’s three movement functions should be initiated. The out-dated mind-set of ‘get plenty of bed rest and the problem will heal itself’ is a dangerous strategy to follow in most instances, and more people have prolonged their suffering by adopting this policy than those who have benefited. Bed rest, particularly bed rest with a de-compressed spine and atrophying muscle fibres is tantamount to a painful failure, and the quicker a person in this predicament is able to address these issues within a respectful consideration of possible inflammation and the presence of fluid, the better placed the person is to enjoy complete and rapid rehabilitate from the perils of back and neck pain.
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