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Acute Care Tips

Updated: Dec 11, 2018




Acute lower back pain:


1. If you are experiencing moderate or severe lower back pain with sitting, then sit for only brief periods (meals) and get up before the pain forces you out of the chair.  Lie down multiple times through the day but no longer than 45 minutes each time before getting up and walking i.e. ‘keep it moving’ when not lying down. If lying down increases your pain then do not lie down.


2. When standing, if your pain causes you to bend forward or sideways do not try to straighten up.  


3. Ice or use non-electric heat repeatedly for 20 minute applications as long as you stop for a minimum of 20 minutes between applications.  Non-electric heat sources include a: magic  bag, gel pack or hot water bottle.  Do not apply an electric heating pad.


4. If you’re waking up at night in pain despite not having moved i.e. trying to turn over, then consider starting an oral over-the-counter anti-inflammatory drug as directed on the label for 2-3 days or until you have seen the doctor.   Depending on the drug, this will be either every 4 to 6 hours (Ibuprofen-based) or every 12 hours (Naproxen-based).


5. If you cannot ‘hold’  either your bowels or bladder, or cannot void your bladder then attend your nearest hospital emergency department.  If you cannot void your bowels after several days and, if you haven’t been taking codeine products which can cause constipation, then attend you nearest hospital emergency department.




Acute neck pain:


1. If you are experiencing severe neck pain or your head feels too heavy for your neck, lie down on your back for 30-40 minutes several times per day using only a thin or moderate pillow, no thick pillows.  If lying down increases your pain then do not lie down.


2. If it hurts when you turn your neck a specific direction, then avoid looking that direction.


3. Ice or use non-electric heat repeatedly for 20 minute applications as long as you stop for a minimum of 20 minutes between applications.  Non-electric heat sources include a: magic bag, gel pack or hot water bottle.  Do not apply an electric heating pad.


4. If you’re waking up at night in pain despite not having moved, then consider starting an oral over-the-counter anti-inflammatory drug as directed on the label for 2-3 days or until you have seen the doctor.   Depending on the drug, this will be either every 4 to 6 hours (Ibuprofen-based) or every 12 hours (Naproxen-based).


5. If you are experiencing severe neck or headache like you have never felt before, or if you have difficulty talking, go to your nearest hospital emergency department.




Peripheral joint pain (foot, ankle knee, wrist, elbow, shoulder): R-I-C-E


1. Rest: avoid aggravating activities and use splint or sling if necessary.


2. Ice: repeated 20 minute applications as long as you stop for a minimum of 20 minutes between applications.


3. Compression bandage: Wrap the joint as soon as you arise in the morning to not allow gravity to accumulate swelling in the joint during the day.  Use 2 or 3 inch width tensor bandages for ankles, wrists or elbows and 4 inch for knees.  Start wrapping below/distal to the injury then upwards.  Re-wrap when necessary (feels to loose) during the day.


4. Elevation: when possible at rest/sleep elevate the injured joint to drain swelling, or least, not allow more inflammation to accumulate at the joint.  



About the Author:


In 2015, Dr. Arthur received the "Award of Excellence" from the British Columbia Chiropractic Association. For more about Dr. Arthur view his cv.

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