The information shown here is for illustrative and academic purposes only. Seek help from a licensed health professional before attempting any techniques and treatment discussed or shown in this story. This publication and its contributors are not responsible for any potential injuries or health problems.

It's been a month after the big one hit. Out of food and water, you figure it's time to hit the road for supplies. Despite the sad state of affairs, you've been feeling good for a long time now. Still, you can't shake the nagging feeling that something is about to go wrong and — bang! — it happens. You hop into your rig and your lower back goes into lock-down. The pain takes your breath away. You're now SOL and basically useless to your family and your community.

You're not alone — about 80 percent of the population will experience a back problem at some point in their lifetimes. If it doesn't happen to you, it may happen to someone you love or a member of your group.

Therefore, we're delving into the topic of back pain. Whether you're an outdoor adventurer who doesn't want to get hobbled mid-hike or you're a prepper looking to prevent a debilitating injury while bugging out, you'll no doubt find some valuable information in these pages.

The bad news? Back pain is the leading cause of disability around the world. Behind only upper-respiratory infections (à la the common cold and the flu), people visit doctors for back pain more than any other reason. The back is a smorgasbord of bones, muscles, tendons, ligaments, discs, blood vessels, lymph, and nerves. You may strain muscles, sprain ligaments, bulge discs, misalign bones, compress nerves, or have a combination of injuries. Did you get all that? Add to this the complexity of “referred pain” (pain coming from a different area) and the back pain plot thickens.

The good news? The cause of most back pain is musculoskeletal in nature (think muscles, bones, tendons, and ligaments) and rarely organic conditions like arthritis, infection, cancers, or fracture. There, go ahead and breathe your sigh of relief because back pain prevention and liberation is within your grasp.


Top Risk Factors

Age: Growing old is not for sissies. As we age, we lose muscle strength, ligament stability, disc height, and experience a loss of bone density — the perfect recipe for back pain. The first back pain episode often starts between 30 and 50 years old, becoming more frequent with aging.

Fitness (or lack thereof): This risk factor is like aging, but on speed. Without a strong and supple body from exercising, we lose strength, flexibility, ligament stability, disc height, and experience a loss of bone density. Poor fitness levels also predisposes people to injuries (traumatic or repetitive) and once injured, it prolongs recovery. [Editor's note: This is why we have a Health column in every issue.]

Weight Gain: Gravity is a downer, and it's even worse when we carry a spare tire. The extra pounds weigh down our spinal joints and discs (the cushions between your vertebrae), which leads to more stress and pain.

Occupational Hazards: Sedentary desk work leads to poor posture, tight muscles, and reduced blood flow. On the other end of the spectrum, heavy work from lifting, bending, twisting, pulling, and pushing can be traumatic. In the middle is repetitive work (performing limited motions over and over for an extended period of time), a major cause of disability. Just can't catch a break, can we?

Bottom line: It hurts, and you need fixing. Let's get to it.

Pre-Apocalyptic Treatments

Does civilization still exist when back pain strikes? Are you close enough to something resembling a city or town? If so, you're in luck. Use the following recommendations.

Leave It to the Pros: Get thee to a licensed healthcare practitioner. There are experts who have spent years learning to take care of back pain. Why try to reinvent the wheel? Get experienced hands on your poor body, and relief will arrive more quickly.

As a chiropractor, my advice is to seek out natural and less invasive therapies first. For over 120 years, chiropractors have made the treatment of low back pain their bread-and-butter practice. Other practitioners to check out include acupuncturists, certified massage therapists, and physical therapists. Look online or get a referral from someone you trust. Finally, use drugs and surgery as a last resort, as they can have lasting side effects.

Ice, Ice Baby: Use the cool tool during the first 24 to 48 hours of a back bombardment. Get an ice pack or a pack of frozen vegetables, wrap it in a thin towel, and place on your back. Apply for 20 minutes, remove for 10 minutes, and reapply for 20 minutes. Do this two to three times a day. What can be easier? Icing will help:

  • Reduce pain: The cold reduces nerve transmission, causes endorphins to be released, and activates the pain gate (cold sensations can block out or override pain sensations).
  • Reduce muscle spasms: Because of the pain, muscles go into spasm to brace the injured area. Ice reduces the pain, which reduces the muscle spasms.
  • Reduce inflammation and swelling: Ice produces the Hunting Response; blood vessels start pumping the bad stuff out and the good stuff in.


Omega-3 Fatty Acids: “Did you say fish oil?” Isn't that for the heart and brain? Omega-3 helps reduce inflammation. Reducing inflammation reduces pain. I was a nonbeliever, but when I injured my knee, I tried it out. Lo and behold, the stuff actually worked.

The Journal of Surgical Neurology reported that omega-3 EFA fish oil supplements are a safe and effective alternative to non-steroidal anti-inflammatory drugs (like ibuprofen, naproxen, and Celebrex). Unlike pharmaceutical drugs, the researchers noted no nasty side effects with omega-3. The participants in this study took 1,200 mg of omega-3 per day. If you're allergic to fish, substitute with flax oil supplements.

Post-Apocalyptic Treatments

What can you do when crap has already hit the fan, and you're without the comforts of civilization? You might not always have access to a medical professional, some fish oil or ice. It's time to turn your attention to more self-reliant care. Naturally, these methods will work in times of normalcy, as well.

Stretch Out: Lower back pain can be so extreme that it may drop you to the floor. Floor-based stretching can help relax muscle spasms. Reducing muscle spasms will take the edge off the pain so you can be more functional. Since you'll already be on the ground from intense agony, might as well start with these stretches and look for loose change or wild edibles while you're at it.


Knee-to-chest stretch: Lie face up. Bend one knee, clasp it with both hands, and pull the knee toward your chest. Take long, deep, slow breaths, and pull a little more with each exhalation. Hold for 10 seconds, switch knees. Do five reps on each leg.


Lumbar rotation: While lying on your back, bend both legs with your feet in the air. With your knees together and shoulders flat to the floor, slowly bring your knees down to one side. Hold for 10 seconds and slowly bring your knees to the other side, keeping both shoulders on the ground. Do five reps on each side, or as many reps as needed to crawl off the floor.

Relief At Your Fingertips: Pressing and rubbing on areas of the body to relieve pain has been around since the beginning of our species. It's instinctive to rub and massage areas of pain. Generation after generation of observance and experimentation culminated into the science of acupressure (the usage of acupuncture theory, without the needles — good news for those who faint at the sight of needles).


Behind the knee: In a sitting position, find the point (called Urinary Bladder 40) behind the knee where the skin folds at the joint. Then simply stick your thumb into the fold and press until there is discomfort. Release and repeat two more times. You can press both sides at the same time.


On the ankle: In a sitting position, find the point (called Urinary Bladder 60) just anterior to the Achilles tendon and behind the lateral malleolus (the bony protuberance at your ankle). Grip this point with your pointer finger and thumb. Squeeze until there is discomfort. Release and repeat two more times. You can squeeze both ankles at the same time.

Science of acupressure? Indeed, my friend. Research on acupressure and acupuncture continue to surface from both the United States and Asia on how it helps everything from headaches to heartburn. For lower back pain, the British Medical Journal discovered that, “acupressure conferred an 89-percent reduction in significant disability compared with physical therapy.” Not bad for natural and free. The only thing it'll cost you is knowledge. Here are two points that can ease lower back pain.

Back Myth Busters

There are a lot of old wives' tales floating out there. Here are the top three:

Myth #1: Surgery is Always Effective


The Truth: Back pain surgery may not always be effective and certainly shouldn't be the first choice for noncomplicated, mechanical back pain. For a few patients, it's a godsend, but for others, a nightmare. According to a 2011 study in the Journal of Spine, back surgery (in this case, fusion) showed an abysmal 74-percent failure rate. (The researchers said if surgery was avoided, there was a 25-percent increase in the patient's chances of returning to work.) Add to this the complications of infection, anesthesia, and post-op drug dependency, and you can see why surgery may be the answer only in the most dire of circumstances.

Myth #2: Get a Hard Mattress


The Truth: Unfortunately, if the mattress is too firm, there will be increased pressure where our bones stick out, mainly shoulders and hips. Too soft, and there's no support. Studies have concluded that a medium-firm mattress is best, providing enough support without the pressure.

Myth #3: Bed Rest is Best


The Truth: Staying in bed for one or two days may be advised in extreme cases, but prolonged rest will only make things worse. Lower back pain leads to a vicious cycle of muscle spasms and joint fixations in the spine and hips. The best thing to do is get up and walk around to your tolerance. Although counterintuitive, gentle movement will reduce muscle spasms, joint fixations, and break the lower back pain cycle.

An Ounce of Prevention …

Preventing back pain is not difficult. A strong, stable, and pain-free back can be had for just a few minutes a day of activity and a dash of awareness. Here are quick and simple steps you can take right now to avoid future spinal beat-downs.

Back Extensions: Working the abs is a common and very important method to strengthening the core. With the goal of the all-elusive six-pack, the back is often neglected. And who can blame you? All the good stuff is found in the front anyway. Unfortunately, this leaves weak back muscles that spasm and give out.


Opposing Arm and Leg Lifts: Lie face down on your stomach with your arms extended overhead like Superman. Lift only your right arm and left leg off the ground simultaneously. Do 10 reps, switch sides, and do 10 more reps.


Sky Divers: Lie face down and extend both arms overhead. Lift both arms and legs off the ground. Do 10 reps and call it a day.

The Three S's: Having the knowledge and being aware goes a long way in preventing back pain. The following is what you need to know to cover your own back.


  • Sit up straight (mom was right all along).
  • Use a back cushion to maintain your lumbar curve.
  • Keep your hip above your knees to maintain good posture and allow blood flow to the feet.



  • Lying on the side is best. Use a pillow between your legs if you need to.
  • Lying on your back is second best. A pillow behind your knees will relieve lower back pressure.
  • Lying on your stomach is the worst. Wear a T-shirt with a front pocket, place a golf ball in the pocket, and safety pin the pocket. The golf ball will cause discomfort every time you try to lie on your stomach, breaking the habit of stomach sleeping.


  • Proper posture will shift weight off your overworked muscles and places the stress on the skeletal structure, where it belongs. From the side view, your head should be over your shoulders, shoulders over hips, and hips over knees.
  • Avoid forward head posture and shoulder hunching. Think Denzel Washington and not Quasimodo.


Proper Lifting: Use the following steps to prevent back sprain and protect your spinal discs.

  1. Get your core as close to the object as possible.
  2. Keep your back straight, bend at the knees into a squat position.
  3. Lift the object and bring it as close to your core as possible. Use your legs to push off the floor and rise to the standing position.
  4. Move your feet and bring the object where you need to. Keep your torso neutral and avoid twisting.


Don't let your back become a pain in the butt. No matter if you're hauling your kids from a burning building or just desk jockeying at work, back pain can strike at any time. But having the knowledge to take care of your spine can save you loads of medical bills … and possibly even help you save your mates.

Red Flags

The following are warning signs of serious conditions that require a trip to a licensed healthcare practitioner or emergency room ASAP:

  • Severe trauma
  • Unrelenting pain for more than four to six weeks
  • No alleviation of pain, even during rest
  • Pain worsens at night and wakes you up
  • Abdominal pain associated with the back pain
  • Numbness or tingling inside the thigh (saddle-like paresthesia)
  • Weakness in the legs and feet. Not able to stand on heels or ball of foot.
  • Loss of bowel and/or bladder control
  • Unexplained weight loss (5 pounds or more a week)
  • Radiating pain past the knee

About the Author

An outdoors enthusiast, Dr. Conrad Bui is a chiropractor with more than 20 years of experience. His offices in Denver have helped thousands of patients recover their health naturally. A former lower-back pain victim since high school, Dr. Bui is proud to say he has conquered this condition. Since graduating from chiropractic school, he has gone on to earn his doctor of naturopathy degree from Trinity College along with certifications in acupuncture and auto-collision injuries. He enjoys the outdoors, teaching martial arts, and practicing chi kung in his spare time.


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