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Last few years I’ve struggled with lower back problems, at first thought it was bike related but had a bike fit, changed to a plus bike and new full sus and during the summer no problems.
Today bent down to untie shoe laces and a back spasm so painful I nearly passed out!! Being the only key holder at work I couldn’t leave so tried to walk it off. When the next key holder came in I went to the doctors been told it’s a back spasm and recovery time 4-8 weeks so self cert a week then pop back for a fit note.
Obviously I’ve got lower back problems, so during my time off what should or shouldn’t I be doing? Doctor said rest but that makes it worse as I’m in agony when I do move, once recovered what can I do to strengthen the back to prevent this happening again? What do you guys do to keep the back healthy and strong?
I'm finding pilates pretty good at slowly improving the strength of my core, although no doubt it would help if I did more than one hour a week... It's incredibly relaxing too, which so a nice post-work break.
Very gentle riding was great once I was past the point where I couldn't even get on a bike, something about the lack of impacts but constant gentle movement was good at working out stiffness.
I slipped 2 discs last week. Had them pushed back and I’ve been on rest for 7 days no more than 30min sitting then a short walk around. Rest and keeping it moving without stretching or putting load on it is working so far.
Stay active, don't sit still for too long, go for regular short walks.
When you're not so tender, start doing core exercises like the plank, the bridge etc.
Similar problems here over the years, i share your pain!
Once you can, get yourself moving. My problems are exacerbated by sitting about and getting tight, so rest is the worst for me. So easy walking is good, gentle activity, keeping warm etc. Pilates and Yoga good and helps with a bit of a lifestyle change. I find specific stretching to loosen the glutes, quads and ITB are sorting me out.
I have used an osteopath on occasions where i have been really uncomfortable and he has generally helped a lot to get me back to where I can function normally. It also helped me understand where the problems where and how to self help. A good physio would also help if you don't fancy the osteopath route. My experience of GP's and back pain is generally poor, so no longer bother. Far better results via physio, osteo and self help
Vader +1 pretty much to the letter. Osteo helps straighten me out which is gradually correcting itself, core exercises help build the supporting strength and glute / cat stretches help with daily relief.
Tbh when I first did it this morning I was in agony, after 20 mins I tried to walk it off and was mobile, sat down for breakfast 30 min break and couldn’t get back up, took me 10 mins to get out of the chair tried again to walk it off but it got too much, luckily a colleague drove me to the doctors as I cycled to work. After doctors took the tablets which knocked me out tbh for at least 5 hrs and have been sitting 15-20 mins then up just to move, I’m dreading trying to get up tomorrow morning.
I don’t know if my experience is relevant but I’ve had lower back pain before and I am much better now. For me, stretching was key. Daily (almost!) I stretch my quads, hamstrings, glutes and hip flexors along with some shoulder bridges. I read up on some yoga recently - tight psoar muscles can be almost debilitating, maybe some lunges can help you? I drive a lot however and sit at a desk when I’m not driving - the lack of movement it very unhealthy! All the best with your recovery.
Stretch first thing in morning before leaving the house. 10 minutes or so of yoga when get home. Core strengthening classes at gym once a week. Had lower back issues for a lot of last year and this on a regular basis has helped. Also make sure you’re car/van seat is good if you drive a lot. Changed this as well and stretch when get out my van after driving. All long term solutions.
new mattress has worked wonders for my lower back.
Not had back pain to anything like that extent (its mostly just niggly stuff now with the odd flare up if I lift awkwardly from cold), but it's stretching, stretching, stretching for me - especially hamstrings, plus as others have said - core stuff. (I do an S&C class once a week - squats, deadlifts etc)
Sitting for long periods is horrible for it.
Feldenkrais lessons or classes. When back gets a bit better do the Feldenkrais clock. Also Sarah Key back block excercises before bed. A few good short videos by her on youtube.
Use Suspension seatpost.
Where is the back pain, I get it in my very lower back, just above hips and it is related to tight it band. Physio identified it and stretches and rollering helps massively.
if you get knee pain below the knee as well it is likely due to it band
core strength all the way, very simple to sort.
ive suffered lower back all my life, ive had lock ups that have literally seen me crawl out the surf.
when i started running 5 or 6 years ago i started doing a weekly circuits session with my club and since then i've had no problems.
but to prove the point, the last 9 or 10 months ive really slacked off and my back has gradually started playing up more and more until before christmas it was really bad again. so all i did was make sure i did a bit of stretching, salutation to the sun, and daily before bed grab my iphone, hit the stopwatch, and do a 1m now up to 1m.30 plank, 15sec rest, 30 sec strong push ups. it sorted itself out very fast.
for immediate relief google it, there are some good stretch sequences for lower back pain that really do help. and also keep your back warm, use ralgex and the boots ibuprofen gel with menthol.
I can highly recommend this book (Treat Your Own Back - Robin McKenzie. Link below) which sorted my lower back issues. His techniques are now recognised as physio standards.
As with all rehab, it takes time and you need to be patient and disciplined.
Thisnis the reading I referred to in my earlier post. I hope it helps you.
https://yogainternational.com/article/view/how-to-stretch-and-strengthen-the-psoas
Did my back in badly a few years ago to the point where once when i fell down I couldn't get back up again. Had to wait for family to come back home and get me upright. Went to physio who game me a bunch of exercises to do that got me back into shape reasonable quickly
Took a look at yoga a couple of years ago and was amused to see that the physio's exercises were all yoga moves of some sort and not even particularly complex ones. Doing a bit of simple yoga seems to be keeping it at bay for the moment
I'm not going to add any new info but I'd also recommend pilates. At various points when I've been to a physio for injuries they recommend it. Many of the excercises are similar. By keeping your core muscles strong you reduce the chances of issues. I think of it as preventitive physio. Did more for my comfort/power in an aero position than any bike fit did.
Thanks all, I will admit it’s worse today, struggled to get out of bed, I have a new mattress and one of those toppers that forms to you body shape to help support.
The doctor prescribed some diazepam but that’s not touching it tbh, tried some stretches from the above google searches and it’s just immensely painful, but will keep at it. I need to get through this as it’s impacting on everything I do, been advised it could take weeks until I’m fit to return to work and not to even consider going back until I’m pain free.
Heat patches for the immediate problem, get you moving again.
Pilates for longer term fixing the problem.
Reading your OP rang many bells!
Pilates? Home dvd style or join a club? I prefer the idea of home as shift work so can fit it in easy enough.
I swam through my bad last summer. Helped keep it all moving
To be honest the couple of times when it was that bad that I couldn't lie down/sit up I just went straight to the osteopath - instant relief. That was a few years ago now and since then i have generally self managed as per most of the previous posts. Pain killers never touched it, at least nothing I could buy over the counter ( I have never tried prescription)
It is misery but you can be fixed, don't despair.
Firstly ICE it, secondly ICE it and later ICE it again.
Keep moving with just long walks and dont stiffen up with long sessions sat at a pc.
Later once the spasms are under control get onto youtube and look up deadlifts and overhead squats. Deadlifts are great if you have gym membership but if not overheads with nothing more than a broom handle will (if done correctly) strengthen and improve your posture and overall condition.
You could also just use a kettlebell or small weight because the technique is much more important than heavy weight.
I go to classes as I have no idea what I'm doing. Also stops me cheating with the exercises.
The heat patches are great for the immediate problem as they block the pain signals apparently.
• Buy a back brace and a party pack of ibuprofen, take regularly.
• Stop driving a car if you haven't already.
• As and when you're able (up to 3 months for swelling to settle), start doing pilates.
If you're trying to stretch before the inflammation has gone down, you're just going to be making it worse. Rest and ibuprofen and gentle movement (as you're able to) only.
Obvs I don't actually know what's causing your pain, but the above is a summary of what worked for me when I had a large disk bulge last May. I got an MRI for accurate diagnosis, which helped. Pilates was an eye-opener, and is what eventually helped me get back on the bike.
Good luck! 🙂
agreed. don't try all those stretches while it's inflamed! there's not way you muscles will comply because they are in protection mode.
go see an osteopath. there is some variety, but good ones have as good an understanding of the anatomy as doctors, and have ways of treating it that doctors don't. if you're not into the wafty non-scientific part of it then just say so (tho annoyingly i have found that par tof it to work too). you'll get a diagnosis too of what's going on.
all those recommendations for yoga, pilates and building strenght are right of course, but that's in answer to you maintainance question, not what to do now.
and hot water bottle on the spot can help, but depends how bad. helps keep plenty of blood-flow
Get to a decent physio and have an MOT of all your connected tissues, my initial diagnosis was a back spasm from the GP, but after all the rest and meds, something didn't feel right, so i paid to see a private physio, diagnosed tight hip flexors, overloading lumbar vertebrae combined with week thoracic muscles, a good few months of structured rehabilitation consisting of yoga, lots of stretches and targeted strengthening (quite a few sports massages and a couple of chiro visits) and I'm pain free and enjoying riding more than I ever have.
TL:DR, your back is complex and can be affected by things you may not even think of. Go get it looked at by someone who specialises and work from there. Good luck.
Today it’s much worse the diazepam isn’t touching it tbh just makes me sleep, I’ve contacted an oestopath and have an appointment next week, told them what the issue is and they say they can help relieve the pain but might be painful to start with, £50 a session seems the going rate locally. Once on the mend I’ve got an exercise mat and a dvd yesterday for Pilates thanks to amazon just need to recover first!
Been using deep heat but today’s the first day of those heat pads you wrap round, a short walk and that’s about all I can manage.
I think I know what triggered it, I went for a cycle down the canals on nyd normally I get off at the bridges with the stepped bricks but this time i shot over then with speed I’m guessing the juddering has upset my back, can’t think of much else or it could just be innocently changing my shoes at work when it happened. Ether way I’m definitely taking better care of my back in the future.
Osteopath might work but def try and see a good physio if you get a chance they can normally figure out if it is muscular or connective tissue rather than being skeletal like osteopaths.
I am lucky as have a really good physio who can normally see where issues are when I turn up (yes I do it as a test frequently), to give you an idea about the affect of it band I couldn't actually walk properly 3 days ago, so used a massage ball on my it band and now am pain free. Just have to keep doing it.
seems a good thread to ask...has anyone had back/hip pain persist and after a couple of years feel like it is impacting the diaphran / breathing deeply? I'm 3 months / £500 into physio and whilst pain is much more manageable and breathing better it's not gone away.
Doesn't impact riding much and often feels better when riding at pace which suggests to me it's a postural / muscular issue.
no scans as of yet (prob the next thing I ask for) but physios assessment is spine is ok. had ecg at gp heart is ok...had bloods they are ok. GP has said stress but there is no correlation between events and pain / breathing.
Osteopathy is bones and muscles, chiropractor is bones only.
But whatever path you follow it's usually the practitioner that is important.
I had bad hip pain with my back pain, some days it was hard to walk more than a few yards. All went after the first Pilates session. Sounds unlikely but what have you got to lose (apart from the pain)?
Quite a few on here said osteopath and I asked a friend who is a nurse who said the same even if it’s just the one appointment to rule things out, my only loss is £50 which if there’s any improvement or even a better understanding I’m happy enough.
Many thanks for all the replies, today I’ve used a heat pad that wraps round still found it difficult to walk sit etc but not as bad getting up and initially moving but it’s painful enough. The toughest part for me is time off work, I hate my job but I hate letting people down, I know while there’s pain I can’t risk rushing back so I’m looking at a few weeks off that hurts more tbh. I don’t want to rush back and end up making it worse or being vunerable, when I did the initial injury I was solo at work for 5 hours that’s not a risk I can take again.
From 2008 until around early 2017, I was completely dependent upon a Homedics shiatsu massager with heat outside work, that was permanently on my PC chair, typically used for 5-10 sessions per day. The second one got damaged and I replaced it with a more portable version in late 2016, but I've barely needed to use it over the last two years, maybe ten times in total.
I have this due to injury - I am starting Yoga on Monday to try and help after seeing a physio! I made the same connection as above that most of the exercises she was suggesting looked like yoga, she said they basically were so I asked if a class would help. She said it would be perfect, so here we go 🙂
how do people not fart when doing yoga? no way I could do a class. it seems to push it out! I use YouTube...
I echo the physio thing, though if you’re not convinced you’re making the correct progress then don’t be worried about seeing another. I’ve had sciatica/bad backs for about 5 years and have seen 3 different physios, 3 doctors and a chiro. It was only the last physio who arranged an MRI, identified a bulging disc which is squeezing my spinal cord, arthrosis in 2 of the vertebrae and a massive strength imbalance between left of right sides. Finally, focussed treatment and Pilates twice a week is making a difference.
I had back issues for a while. Worst in the morning that seemed to ease as i moved about. Bought new mattress, did physio etc. Then by chance (eye issue, found the hla b27 in my blood) i was diagnosed with ankylosing spondylitis . Basically my spine is slowly fusing, with other issues (hip joints etc). Can struggle to get socks on these days but exercise, keeping the weight off all help. I really should do pilates but struggle to get the time. Backs pain is a 'pain'. Apparently ankylosing spondalitis can often be missed when people complain of back issues. I went years before diagnosis....not that there is a cure.
Many thanks for those who recommended an osteopath, cost was £45 for an hour session, yes I feel no better but he explained everything was friendly helpful and a nice guy to talk to. He said I’ve damaged my level 3 disc the fluid has moved to the left hence muscle pain in my upper legs and the other issues I’m having. I have a trapped nerve where the fluid has moved, looking at 3-4 week recovery more tablets as my back muscles are inflammed. Feel happier knowing what I’ve done, next step doctors for meds and a fit note.
Thanks again!
Quite a few on here said osteopath and I asked a friend who is a nurse who said the same even if it’s just the one appointment to rule things out, my only loss is £50 which if there’s any improvement or even a better understanding I’m happy enough.
find an osteopath that does massage as well - generally those from the British School of Osteopathy don't unless they have learnt it after but those from the British College of Osteopathic Medicine learn massage in their course.
Having a deep tissue massage first before any 'adjustment' means that those stiff muscles are much less likely to pull you back into that bad position, and so you are less likely to have to go back for another dose of adjustment. And it is those stiff mucles that are causing you the pain.
When seeing well regarded osteos that didn't manipulate I might have to go see them twice or maybe even 3 times, but when seeing Xerxes at www.cityclinic.co.uk I rarely go back unless he is treating muscle issues, so sometimes a year or more between visits.
I have one of these rests that might not actually be the best idea as at full adjustment it probably tries to bend you more than is healthy, but I find it good for lower back pain as you are forced to learn to relax those muscles to avoid the intense pain lying on it causes !
https://www.amazon.co.uk/gp/product/B00BOL941A/ref=oh_aui_search_detailpage?ie=UTF8&psc=1
get a TENS machine fro your local pharmacy. They work really well for back pain and sometimes the only thing that keeps me moving. Best £20 I've spent.
The key thing is that the induced fast muscle spasms stop the major spasming that stops you moving, getting moving gets you better.
you won't look back
you won’t look back
is that because your back will still be too stiff and painful to look around ?
LOL
I was a cynic, then the back was in a really bad place, thought it's £20 of risk, works brilliantly
Getting back on the bike? Any advice? Hints tips? Been off work 10 days and missing not being on the bike, was thinking my plus bike or full bouncer round something tame like the dog at Cannock.
Been lucky as in the pain is now manageable, and I know I should return to work before thinking of biking but would rather see if I can bike before getting back to work. So any pointers??
Osteopathy is pure bunkum. Dangerous charlatans with precisely zero evidence of any good and plenty of doing harm.
The relief you got is from the soft tissue work they do prior to manipulation. Stopped the muscles spasming. spinal manipulation does no good and is dangerous.
Evidence based practice. There's no evidence that osteopathy does any good
What do you call alternative medicine that works? Medicine!
Osteopathy is pure bunkum
tjagains opinions are mostly bunkum as well but that doesn't stop you making them...
There’s no evidence that osteopathy does any good
It's recommended as a form of treatment by NICE...
The two sessions I have had helped massively I can get up in the morning with no pain, yes the pain starts as the day goes on but it’s a start.
My aim is to get back on the bike, I’ve got a couple of weeks off work so that’s my time to get fully fit and able to work and bike again, if I can get through the day with no pain then it’s all good!
Turner
It's a fact that there is zero evidence of osteopathy doing any good and plenty of doing harm
Nice recommended? Link please
Osteopathy is pure bunkum.
Google bmj osteopathy for debunking of this dangerous pseudo medicine
Also on Google you can find the people paralysed by stroke or spinal injury following spinal manipulation
Medical concensus states one thing. It does no good and sometimes harm.
This is not simply my opinion. This is the medical consensus and what the evidence proves beyond any doubt
Chiropractic and osteopathy both have relatively shonky histories, and depending on the practitioner may or may not follow best advice (but then Physio's can be just as off target too). Chiro and Osteo are probably a bit more manipulation happy then Physio, and are happier to use cervical manipulations (which have been associated with stroke, and vertebral artery dissection). Depending on the practitioner though i think the end product may not vary, but the clinical reasoning process they followed to get to that outcome might be pretty different...
My personal opinion is no two backs are the same, and different people respond to different things and different approaches. In weighing up the evidence pretty much all types of modern intervention bring about similar responses at the population level... whether that be core strengthening / pilates, education, manipulation.
At the moment, we still don't really know why back pain persists, and why some people get better when others don't. We are pretty sure in most cases it isn't down to any mechanical deformation (as there are many, many people with awful looking back scans / x-rays who have no pain and have never had pain), so the mechanical argument has been debunked, and also it seems as though people who have scans and x-rays tend to have a worse prognosis than those that don't have them. This is why the guidance has changed to only scan when absolutely necessary (potential for serious problems such as spinal cord compression, tumours etc) as the risk outweighs any potential benefit in most cases.
The best current advice is to try not to stress about your back too much. Your backs are very strong and designed to last you more than a lifetime. Things don't slip out of place very easily (there is a lot of muscle, connective issue and ligaments around the back). In most instances it will get back to normal in 6-12 weeks, and in that recovery period try to work out what works best for you to control your pain levels. For some that may be swimming or yoga, for others it might be a gentle walk or a slow bike ride. Try to keep as active as you can, take painkillers if you need them (but avoid the opiates) or try TENS, try not to sit still for too long, try not to avoid doing simple things for fear of making your back injury worse (obviously within limits, i probably would advice against starting lots of heavy lifting if you weren't conditioned for it in the first place).
Nice recommended? Link please
from the main NHS page on it (who'd have thought...)
https://www.nhs.uk/conditions/osteopathy/
"The National Institute for Health and Care Excellence (NICE) recommends manual therapy alongside exercise as a treatment option for lower back pain, with or without sciatica.
There's limited evidence to suggest that osteopathy may be effective for some types of neck, shoulder or lower-limb pain, and recovery after hip or knee operations. "
note the word 'little', that implies they acknowledge that there is some, at the least.
take painkillers if you need them
also somewhat dodgy, my mate had real problems after taking a lot of ibuprofen for a problem (advised by a doctor).
Something to do with his Scottish genes, but he now can't take any more.
TurnerGuy...
Yeah, long term use of NSAIDs isn't advocated. But in the short term, acute window (2-4 weeks) if they provide symptomatic relief they are worth considering. Then again, the evidence of their impact on reducing pain compared to placebo is marginal.
Then again, the evidence of their impact on reducing pain compared to placebo is marginal.
and what was the argument against osteopathy again - I know my osteopath has been very effective at reducing pain when I've needed him...
Exactly. That's why i said
'pretty much all types of modern intervention bring about similar responses at the population level'
and
'in that recovery period try to work out what works best for you to control your pain levels'
When looking into the evidence there is no magic bullet that cures / heals LBP. Its finding what works for you, what provides best value for money (for individuals and healthcare providers / insurers) and what has the least likelihood of causing harm. As long as your osteo / chiro isn't old school and doing risky manouvres (such as cervical manips) then in all honesty there probably isn't a huge difference between approaches. The more important thing is that if you think it will help you, then in all likelihood it will have a better chance of helping than if you don't think it will help.
Turnrguy anecdotes are not evidence.
That is not a recommendation for spinal manipulation.
The actual evidence is very clear. Zero evidence of any benefits plenty of evidence of harm. Read the research. I have
Sorry TJ, you're a little off the mark.
Cochrane reviews state SMT is no better than other recommended therapies for acute or chronic LBP. More recent systematic reviews (not cochrane) indicate it may produce modest improvements in pain and function, and that SMT is better than simple mobilisations.
Sorry TJ, you’re a little off the mark.
he's always a bit off the mark, especially when it comes to Jeremy Corbyn 🙂
How can a scan or X-ray cause damage or give a worse prognosis?
Sorry I don’t understand that.
I would have said that a Chiro is more likely to cause damage because they try to trap you into an endless course of (possibly needless) treatment whereas I have never experienced or heard of an osteo trying to do that.
Highpeak,
The current thinking is that by having an x-ray or CT unnecessarily (i.e. you have no focal pathology that makes it an emergency), and you are shown to have degenerated discs, OA of the spine, degenerative disc disease, reduced joint space etc all of which are actually totally normal and associated with being age over 25 (ish).
These 'degenerative changes' are not thought to be associated with pain (see Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015; 36(4):811-6), and it is a current failing in how many people (including clinicians) approach pain that we still use a very old, biomedical model of pain in that we think pain = tissue damage.
This is not the case, and there have been lots of studies to show this. In fact the international association for the study of pain (IASP) definition of pain is 'An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.' So it is an experience, i.e. it is produced by the CNS, not simply an output of sensory information, and it is related to actual or potential tissue damage. So pain can be generated without a noxious stimulus (e.g. in CRPS people can have inflammatory responses by thinking about moving their affected hand, not even moving it).
And here is the rub....
If you have a scan following a back injury when you didn't need it (i.e. you had no serious focal pathology - here we mean things like signs of cancer or cauda equina syndrome). Then your central nervous system has been given information that your back pain is very serious (you were sent for a costly scan) and therefore should be protected. On top of this, you will be reported to about the condition of your back where you will be told a list of things that appear to be wrong with it (disc protrusions, degenerative disc disease, OA etc).This information is likely taken on board by the CNS and makes it more hyper aware of how fragile it appears to be and that it should be protected further. This, in conjunction with what is going on in your life at the time, how you cope with pain, your health beliefs, what your treating clinicians have said to you, your previous experience of pain etc, all come together (we still aren't 100% sure how), to produce this experience we call pain.
If you didn't have the scans, you would have had 2 less threatening inputs into the mixing pot, and would have received less 'diagnostic' detail (which is likely irrelevant). In our current understanding of pain, that in all probability will reduce your likelihood of experiencing pain that persists beyond its expected course.
phew that was long.....
Hope that makes sense, but that is a basic run down of about 25 years of quite complicated research. If you want to learn more there are TED talks by a bloke called Prof. Lorimer Mosely, (we have done some work with him), he is a great bloke and a very good scientist/ clinician. He can explain it way better than I...
I cannot heap enough praise on Foundation Training for both recovery and strengthening.
I’ve had back issues for the last 20 years leading to two caudal epidurals around 3 years ago.
I’ve spent a fortune on osteopaths, chiropractors, yoga but this has been life changing.
https://www.foundationtraining.com/
A lot of free content on YouTube as well
Yoga has helped me after a particularly bad do a couple of years ago. Once you are back up and running, so to speak, you need to investigate what is causing it.
So my partner is currently dealing an immense amount of back pain. This has been going on since before Christmas - she went to see a doctor who advised rest, after explaining to them that she had tried that & already been in pain for a few weeks he referred her to an osteopath. Her last appointment was last Thursday & still she's in a huge amount of pain.
She's following the advice of keeping it moving, & doing lots of walking, however now with walking she is complaining of knee pain.
The osteopath has said she needs a scan so she's been trying to get an appointment with the doctor. She had a phone call appointment yesterday & was told she would get a letter in 2-3 weeks advising her of when they can get her in for a scan. The best they can do in the mean time is an appointment on Friday to discuss pain management.
She has now had a phone call today saying there are no appointments & to get in touch with a different surgery, she has phoned them & the waiting list is 12 weeks for a scan... So it looks like she might not know what is causing this until May...
Literally at our wit's end & don't know what to do about this. Can anyone offer any advice?!
I can only say what the docs have done for me I’m on naproxen and co-codamol, doing lots of short walks, I don’t sit fit more than 30mins which is annoying my other half a fair bit, I got an exercise mat and have done some exercises advised by the osteopath, I’ve had 3 visits to as well and while still in pain it’s getting better day by day.
Andy, the problem is you can't easily find out what is causing it.... especially if it is persisting (scans are not really the way forward here). There are a number of different theories / popular ideas that change over time (e.g. muscle imbalance, core strength, tightness in any number of muscles, posture), but i don't think any of them are predictive for causing pain. I think finding a way to manage it that works for you is the best approach, and whether that is addressing tightness, strength, activation etc will work out as you progress treatment.
PrinceJohn - Sorry to hear about your partner. Advising some increase in rest is a good place to start, this should be interspersed frequent movement (as able), so no bed rest. It would also be worth investigating whether there are any things that help ease her pain (any specific body positions, swimming / floating in the water or being in the bath, TENS etc). A visit to a recommended health care professional (e.g. physio) with a lot of MSK experience is worth it, they will provide advice and tips for management and will likely be able to do soft tissue work / mobs / manips to free things up a bit in the short term.
The thing for your partner to keep in mind, is that her back is, in all likelihood, structurally fine (if the GP was worried then your partner would likely have been referred on for scanning very quickly). Your partners central nervous system has gone into a protective mode in response to the initial injury (this is what produces the intense pain she is experiencing). What she needs to do is start to provide herself and her CNS that the injury is healing (it has bee about 6 weeks, so under normal tissue healing timelines some healing would have occurred depending on the type of injury). A way to do this is by slowly increasing movement and being more active (this would be advised and under the supervision of a healthcare professional), thinking more positively about her back and trying not to worry that it will fall apart (it won't). Over time, the central nervous system will realise that everything is ok that there is little threat of re-injury, and will switch off the alarms! This typically takes up to 3 months so it is in part about being patient, and not trying to worry when it is taking a long time to heal.
A hot water bottle is good for deflecting pain, or even better is one of these :
https://www.amazon.co.uk/gp/product/B014I7V7CK/ref=ppx_yo_dt_b_asin_title_o06__o00_s00?ie=UTF8&psc=1
and make sure your osteopath is one that does lots of massage, plain 'clickers' aren't much cop imo.
Lots of advice, but the real issue is to find out what is causing your symptoms and pain. I suffer from issues L4, L5 and S1, mainly Herniated disc problems. I’ve had the meds, the x-rays and the scans but little practical advice has ever been forthcoming. The Robin McKenzie book is good for a basic understanding and a recovery system, however I have found a Canadian guy Stuart McGill PhD who has spent most of his career studying Spinal issues has written a book called “Back Mechanic” where he explains how to diagnose the causes of your symptoms and pain. He then goes on to explain the steps you can take to help yourself, the areas to avoid and movements not to make. Having studied the book I had a clearer understanding of my issues and what to do to help the situation. I learnt that some of my Pilates/Yoga exercises are counterproductive. The book is expensive £29, but less than a visit to a Chiro or Osteo practitioner. Here is a link to the cheapest supplier I have found.
https://www.amazon.co.uk/Back-Mechanic-Stuart-McGill-2015-09-30/dp/B01FKSGJYC
plain ‘clickers’ aren’t much cop imo.
I take that back somewhat - in an earlier job my colleague insisted on wearing cheap suits and they looked cheap.
He had some back issues and I recommended a local osteo, and when he came back his suits looked much better as he was now standing stright whereas before he had been locked into a position where his hips weren't level.
At another job a colleague's bother was an osteopath with a client who did dressage, but never was in the medals. After he had straightened her up she won silver, because the horse now didn't think that she constantly wanted to turn to the left...
The cold yesterday and today hasn’t helped, I thought I was on the road to recovery but familiar aches and pains cane flooding back....