Flare Up Control - Don't panic, we have a strategy for you!

There are two main objectives when treating a back or neck pain flare-up:

• Control Inflammation
• Maintain ROM ( range of motion)

Inflammation comes out of the bloodstream. It is the body’s universal response to injury. If you cut, bruise, burn, sprain or strain yourself the blood vessel pores will dilate and allow fluid to spill out around the injured area. Inflammation has the ability to attack disease, clean up damaged tissue and create scar tissue. The inflammatory response must be controlled after a back or neck strain. There is no disease to attack, no tissue to be cleaned up and no need for scar tissue formation. Ice packs control inflammation by constricting blood vessel pores. Heat increases inflammation by dilating blood vessel pores. DO NOT apply hot packs to a flared up area. Ice packs should be applied to the injured area for 15 – 20 minutes 4-5 times per day. Be sure that two of those times are morning and evening ( before bedtime). Leave at least 40 minutes between ice pack treatments. Do not stay in bed if you can tolerate the upright position. Anti-inflammatory medicine can be helpful if allowed by your MD.

During your recovery period it is important to maintain your ROM. Do your stretching exercises 2-3 times per day. You might not be able to stretch as far as you could prior to your flare-up. Modify your stretches so that you do not increase your pain level. Include any special instructions that your therapist might have given you. If you are unable to stretch without increasing pain do the following each time you apply an ice pack:

• For LOW BACK PAIN - do 5 repetitions of the pelvic tilt. Hold for 1-2 seconds. Make the tilt small enough that it does not increase pain.

• For NECK PAIN – do 5 slow repetitions of cervical rotation while lying down. Avoid pain at end range.

Add in your stretch routine and cardio exercise as tolerated. Postpone your strengthening until the flare-up is resolved. You might have to decrease repetitions and/or weight when strengthening is resumed. A flare-up should be under control within three days. You might not feel 100% but you should feel that you are on the mend. If this is not the case you should consult your rehab therapist or your MD.

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