What to Do When Your Back "Goes Out."

Many patients become understandably concerned when their back suddenly “goes out.” Back pain can be intense, limiting, and sometimes frightening. In most cases, however, it is not dangerous and is highly treatable with the right approach.

The purpose of this guide is to help you understand what is happening when a back sprain or strain occurs and what steps you can take to recover safely and effectively.

Why Back Pain Happens

More often than not, back pain begins with simple everyday movements... picking up a child, twisting to grab something, doing laundry, or even standing up awkwardly. The exact moment of injury often feels insignificant.

One widely accepted explanation is that during certain movements, muscles may not activate at the right time or with enough coordination. This is usually a subconscious issue rather than something you can consciously prevent.

When this happens, the load that is normally absorbed by muscles can shift to passive structures like ligaments, facet joints, or spinal discs. These tissues are not designed to handle that stress, and a strain or sprain can occur. The result may include sharp pain, muscle guarding, inflammation, and sometimes significant difficulty moving.

While symptoms can feel severe, serious causes are rare. The vast majority of acute back pain cases are not due to dangerous pathology.

The Three Phases of Healing: Relieve, Repair, Rehabilitate

Back sprains and strains recover best when treated in stages. Each phase has a different goal and requires a different focus.

Phase 1: Relieve (Acute Phase)

Timeframe: First 2–7 days.

Goal: Reduce pain and inflammation

In the acute phase, tissues are irritated and inflamed. Pain may be sharp, movement is limited, and muscle spasms are common. The goal here is not to “push through it,” but to calm the system and protect healing tissue.

Helpful strategies include:

• Ice therapy: Apply for 15–20 minutes at a time, several times per day, to reduce inflammation and numb pain.

• TENS therapy: May help reduce pain signals and relax muscle spasm.

• Topical analgesics: Products like menthol-based creams can provide temporary relief.

• Bracing or support (short-term use): May offer stability during severe pain episodes.

• Gentle manual therapy or chiropractic care: Can help reduce muscle guarding and restore early mobility when applied appropriately.

• Activity modification: Staying gently active is generally preferred over prolonged bed rest.

• Anti-inflammatory medications: May be helpful when used as directed by a healthcare provider.

• Supplements: Some individuals use curcumin, fish oil, devil’s claw, or magnesium for adjunct support, though these should be discussed with a provider due to potential interactions.

The goal is decreasing pain, decreasing inflammation, protection, and preventing stiffness from setting in, not forcing movement.

Phase 2: Repair (Sub-Acute Phase)

Timeframe: ~2 days to 6 weeks.

Goal: Support tissue healing and prevent re-injury

As inflammation decreases, the body begins laying down new repair tissue. This tissue is initially weaker and less organized than normal muscle or ligament fibers. Without proper movement, it can stiffen and contribute to future dysfunction.

During this phase, controlled movement becomes important:

• Manual therapy or chiropractic adjustments: Help restore joint motion and reduce residual tension.

• Gentle mobility exercises: Maintain flexibility and guide proper tissue alignment.

• Light strengthening: Reactivates core and spinal stabilizers without overloading healing structures.

• Continued use of ice or pain-relieving modalities (as needed). 

• TENS or topical treatments: For ongoing symptom relief.

Prolonged inactivity is usually counterproductive. Instead, light movement, such as walking or changing positions regularly, supports recovery. At this stage, most people notice gradual improvement in pain and function, though full recovery is still in progress.

Phase 3: Rehabilitate (Remodeling Phase)

Timeframe: 3 weeks to 12 months (varies by severity of injury)

Goal: Restore strength, stability, and full function

Even after pain resolves, the body continues remodeling tissue and re-establishing normal movement patterns. Without rehabilitation, the risk of recurrence remains high.

This phase focuses on long-term resilience:

• Progressive exercise therapy: Strengthening the core, hips, and spinal stabilizers.

• Mobility and flexibility work: Restores a full, balanced range of motion.

• Postural and ergonomic training: Improves movement habits during daily activities.

• Activity-specific conditioning: Tailored to work, sport, or lifestyle demands.

• Continued manual therapy or adjustments (if appropriate): To support optimal joint mechanics during strengthening.

This is the phase where recovery becomes durability—transforming short-term healing into long-term spinal health.

When to Seek Medical Evaluation

While most back pain improves with conservative care, it is important to be evaluated by a healthcare professional for proper diagnosis and treatment planning. Less than a small percentage of cases are associated with serious underlying conditions, but a proper assessment helps rule these out.

Seek evaluation if pain is severe, persistent, worsening, or associated with neurological symptoms such as weakness, numbness, or changes in bladder/bowel control.

Final Thoughts

Back sprains and strains are common, but they follow a predictable recovery pattern when managed correctly. The key is understanding that healing happens in phases:

Relieve the pain. Repair the tissue. Rehabilitate the system.

Rushing recovery or stopping too early often leads to recurrence. With the right balance of rest, movement, and rehabilitation, most people recover fully and can return to normal activity with a stronger, more resilient spine.

If you would like more information, feel free to call (304-840-2820) or stop by the office. No appointments are necessary, and consultations are free. You can also email me at DocLeviChiropractic@yahoo.com.

Yours in Health,

Dr. Levi G. Merritt, D.C., CPT, CHC