The acute injury acronym is R.I.C.E.

Rest Ice Compression Elevation.

I generally reserve this for limb injuries.

Rest is pretty obvious. Take it easy for a few hours or days after a trauma. Give that part of your body a chance to deal with damage or strain.

Keep moving

If you have bad or severe back pain it’s good to lie down frequently to rest but you must be sure to keep moving, even if it’s slow and steady, in between rests. If the pain is so bad that moving around is difficult or worse go and get assessed by a health professional.

Ice, or a packet of frozen peas is something you use straight away, particularly on feet ankles knees hands wrists and elbows. Do not put ice directly on the effected area, cover it with a cloth.


10 mins on then 10 mins off then on again. If you just leave it on you can actually cut the blood supply off and cause damage to the local tissues.

Extreme cold numbs the pain and reduces swelling. Swelling is your body’s way of splinting and reducing movement of the injured area, so it’s a good thing but too much of it can increase your pain and impede recovery.

This works really well with limb joints but often not so well with the spine because of the amount of muscle surrounding it. If you ice muscle it tends to contract and that is something we want to avoid around the spine.


Strapping with a bandage, especially an elastic bandage does two things. It reduces the amount of swelling that occurs and it supports the area and moderately restricts movement.


This is for distal limb (elbows and below, knees and below) injuries.

This helps with circulation and reduces swelling by helping blood and lymph drain away from the area. It’s easier for fluid to drain downhill!

Acute spinal injuries require a somewhat different approach.

Rest. Take it easy for a few hours, days or even weeks if it’s really bad. Don’t just ‘push through the pain’, you may extend your injury.

An acute spinal strain can cause pain that ranges from a bit sore to agonising and debilitating.

You can’t tell if it’s damaged

If you hurt your back or your neck, and you have significant or worse pain, there is no reliable way you can be sure that you haven’t damaged yourself. Especially your neck.


If you have a significant fall or an impact that involves your neck or spine get it checked out as soon as possible.

That means seeing your osteopath or doctor or getting to a hospital and having an X ray or CAT scan.

Do not muck around with this one. The ability to move your limbs and control your bladder and bowel – for the rest of your life – may be at stake here.

Old Injuries

Old injuries can be stirred up with surprising ease. Coughing, leaning, twisting or lifting can all spark off old problems. I see this often.


Remember that once you have had a significant strain or injury, it is easier for that to be triggered off again than if you have never hurt that area before. Think of it as being easier to get somewhere that you’ve been to before than to get somewhere that you haven’t been to, because you already know the way. Our bodies are the same.

You can minimize the chances of this happening by keeping your joints flexible, your bones aligned and your muscles supple and strong. And not doing what you did the 1st time to injure it.

What to do

If you do trigger off an old injury, rest enough to let it settle.

Lying down often helps. The astronaut position may be useful. That is lying down with your hips and knees bent at 90° with your calves resting on a lounge or a chair. (The position astronauts take off in).

Heat  Cold

Using heat helps the muscles relax. Try it for short bursts to see if it helps. If it is aggravating, stop and try again in a day or two. Apply heat with a wheat bag, hot pack, hot water bottle or hot shower or bath.

You may get a better result alternating between hot and cold. Experiment to see what works best for you.

Do what you did last time that helped.


Antinflammatories or other painkillers may be a big help. If you are on other medications make sure that they are compatible. For example you cannot take antinflammatories if you are on blood thinners like aspirin or warfarin or if you have gut problems – always check with your doctor of chemist first.

Brace it

For low back pain a flexible brace may be a big help worn for short periods or times of greater strain.

Go and see your osteopath or other manipulative or massage therapist.