What protocol should I follow if I suspect I've hurt or done some damage to my back or neck? In other words, what should I do, and what shouldn't I do when I have hurt my back or neck? These are questions that have been asked of me so many times over the years, and if answered correctly, the responses play a major role in the likelihood of a speedy recovery. As a consequence of any sudden traumatic episode, whether it be an injury like a fall, an impact injury, a compression incident that affects the spine, or for pretty much any other episode that has persuaded you to suspect a trauma has occurred, there are two matters that should be considered urgently.

The first matter is the likelihood of the spine being compressed due to the trauma. Either the weight-bearing effect has caused a compression of the spinal column vertically, or the muscle fibres have spasmed and contracted [shortened] across one or more vertebra. This is common, and if not addressed soon after the episode, invariably results in further spinal compression. Although this phenomenon is generally reversible with appropriate action, failure to do so can and does result in potentially degenerative and painful spinal consequences. Both of these factors can and generally do occur simultaneously.

The second matter relates to the high possibility that the episode may have produced an inflammatory response where the body may have also dumped fluid into the affected region to protect and immobilise that region. The sooner this possibility is determined, the sooner the inflammation can be dealt with and the sometimes tricky process of rehabilitation can begin. It is widely [and wisely] considered that the presence of inflammation and/or fluid must be addressed before any other steps are taken to commence a recovery strategy. Failure to do so can, and generally will, delay the likelihood of genuine progress, and in truth, is likely to prolong that process substantially.

As we look more closely at matter number one [that of possible, and often probable spinal compression], we realise that if handled in an appropriate manner, the inflammatory phase can be avoided completely, or in the very least, may be short-circuited by de-compressing the spine as a matter of urgency. As a general rule, the sooner this is done, the better. The manner in which this is carried out is critical to the chances of rehabilitation and needs to be done before the spinal compression has time to have a degenerative effect. As stated, the elimination of spinal compression within a short period of time after the episode can avoid inflammation in the affected region, and in the majority of cases, this de-compression process can be achieved without medical intervention, or the need for specialised equipment provided of course that the spinal column and its component structures have retained their integrity. Catastrophically, it has been the failure to reverse the effects of prolonged compression that has caused spinal degeneration, rather than the initial traumatic episode.

The means of achieving spinal de-compression is a crucial one, and generally should be done utilising the person's own body weight. This needs to be done in accordance with a proven de-compression strategy encompassing the three essential elements of rehabilitation; 1) restoration of body symmetry, 2) restoration of the spine's three movement functions, and 3) restoration of specific spinal support strength. The loss of strength issue reduces the capacity of muscles to support the spine as the muscles begin to atrophy within days of the trauma. The de-compression method should be performed in a non-weight bearing position and with the spine in a horizontal aspect. Alternatively the spine may be vertical but in a buoyant medium such as water, provided this is done with the water kept below body temperature.

The second matter, as stated above, relates to the likelihood of inflammation being present, a response which often occurs after the sorts of traumas detailed above occur and when spinal de-compression has not been effectively performed quickly enough after the trauma. This matter cannot be overstressed, and should be considered as a matter of absolute urgency as soon as possible after the episode has occurred. Even as a precautionary measure, if sufficient trauma has occurred, a protocol that suspects inflammation should be followed.

Directly after spinal de-compression has been accomplished, and ideally before the body cools down after the episode, it is advisable to follow the I.C.E. protocol. The I part of the acronym, Ice is a natural analgesic and is a safe and natural way to reduce and minimise inflammation. The C or Compression part of the ICE acronym is an effective means to reduce fluid and the E or Elevation part is useful to help in drainage of the fluid to be eliminated from the body. Various forms of medication, whether prescribed or otherwise, are also possible considerations, however if the episode can be treated naturally and without synthetic medication being introduced into the body, it is generally considered preferable. If inflammation and fluid is present, again this is the first and highest priority to be addressed before any other strategy is commenced.

Having eliminated the inflammation and fluid from the affected area, an effective strategy of on-going spinal de-compression and restoration of the three movement functions of the spine should immediately be undertaken provided it can be modified to suit the individual and can be performed within a controlled pain regime. In the past, the mind-set of 'plenty of bed rest and the problem will take care of itself', though surprisingly still proffered by many has had little or no discernable benefit for most sufferers. Bed rest, particularly bed rest with a de-compressed spine and with atrophying muscle fibres is an almost guaranteed recipe for a painful failure. The sooner any sufferer is able to address both of the matters detailed above [albeit within a respectful consideration of possible inflammation and the presence of fluid], the better the person will be positioned to make a complete and rapid recovery from the hazards of back and neck pain.