Neck Pain - An Osteopaths approach

Neck pain is common in people of all ages and is often caused by how we use our necks.
Working all day bent over a computer, driving long distances, poor posture while standing or sitting, stress and tiredness are all factors that can cause the muscles in the neck and upper back to become tight and the joints to become stiff which can contribute to ongoing neck pain.

Sometimes a nerve in your neck can become irritated or “trapped” and cause pain in the arm going down into your shoulder or the hand, and may be accompanied by pins and needles and numbness.

Some headaches can be the result of tension or stiffness in the neck and upper back.
Osteoarthritis or age-related wear and tear in the neck can also cause muscular pain from the neck into the shoulder as well as some stiffness in moving the neck.

How can an Osteopath help?

Osteopaths can use a wide range of gentle manipulations depending on your age, fitness and diagnosis to reduce muscular tension in the neck and improve movement in the joints of the neck and upper back. We may gently massage the soft tissues or rhythmically “rock” the joints to release tension and sometimes we may gently manipulate the neck to move the joints and you may hear a “click”.

Treatment is different in every individual and sometimes it might involve treating other areas in the back and shoulders as well as the neck.

We may offer advice on your posture at work or in the car and give advice on exercise and stretching to help keep your neck and upper back muscles and joints relaxed.

X-rays, scans and other tests are sometimes required to make a diagnosis and your osteopath may refer to your GP or a specialist for any additional investigations or treatment.

Read more here

What do Osteopaths treat? - Back pain

Back pain is a very common problem, with reports suggesting as many as eight out of ten of us will suffer from it at some point during our lives (1). Around 5.6 million working days in the UK are lost each year due to back pain, second only to stress (2, 3).
Back pain can affect anyone at any age, and can often be the result of a sprain or a strain of the structures of the back such as the muscles, ligaments, joints or damage to the discs. Osteoarthritis or wear and tear in the back can also be a reason.
Most of us know that back pain can be painful and inconvenient, but it’s not usually serious and will often resolve on its own within a few weeks. However, many people seek osteopathic treatment to address it quickly(4) and at a time and place of their own choice; and osteopaths are skilled at helping prevent back pain from becoming a chronic, long-term condition.

For more information from the Institute of Osteopathy click here

Sources:

1. Palmer KT, Walsh K, et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000;320:1577-1578
2. www.backcare.org.uk/factsandfigures
3. www.nhs.uk/Livewell/workplacehealth/Pages/backpainatwork.aspx
4. Gurry et al. (2004) looked at a multidisciplinary setting within Plymouth Primary Care Trust (PCT)46. It found that the return to work time was quicker using this service which included osteopaths than GP and physiotherapy services alone.

New Years resolutions don't need to end with an injury...we can help

Back Pain Relief: Self Help Tips & Advice

Here are some tips and advice from Chart Clinic Osteopath, James Clapham on how to prevent and manage low back pain.

In the unfortunate event that you suffer with some problems, you may notice that your back feels tender, bruised or inflamed. The muscles in your low back may feel stiff or could possibly go into spasm and perhaps even a combination of the two. If this is the case for you, in this article you will find some self-help tips and advice that should help to offer you some relief. Also detailed is a list of some pain relief medication to help you prior to your appointment with an Osteopath.

The reasons for back pain are many and should you suffer with back pain, then the following self-help tips will be of use.

Disuse

If you neglect to use your back without due care and attention you may run into difficulties. For example, maintenance of poor posture in a sustained positions e.g. sitting slumped or slouched with poor posture in front of the telly. This can stretch and strain the muscles, ligament and delicate structures supporting your spine in your low back. This can be avoided by: 

1 - Ensuring that your low back is supported with a pillow or cushion to help maintain the natural curvature in your low back

2 - Take regular breaks, avoiding sitting in one position for too long is helpful. Just getting up from your seat to get a drink or briefly stand and move about will help – it doesn’t have to be a long break.

      Misuse

There a many ways in which you can misuse your back. A classic example is lifting without with poor posture i.e. bending your back to do all the lifting. For example lifting a heavy bag or suitcase, moving some heavy furniture or carrying small children – these are some of the ways we see people who have hurt their back. 

Top tip for lifting: The key thing here is to lift properly – bend your hips and knees as opposed to just your back and keep the weight as close to your body as possible.

Something new, overdoing or abusing it

These can all come together and overlap in some ways, for example this could be a return to and/or starting a new sport, a long very hard day in the garden in spring or challenging the kids to a game on the Kinect or Wii! Potentially here we can overdo it or abuse our bodies.

It’s fine to do all these types of things but just follow this advice

1- Take regular breaks 

2- Vary the type of activity or game you are playing

3- Don’t keep going on and on, always stop so you feel you could do more.   

     If something does go wrong – here is how you can get out of trouble…

Move it or lose, just don’t abuse it

Firstly make sure you keep moving, allowing your back to move is highly beneficial to most types of back pain. Movement reduces inflammation and stiffness. If you rest your back completely this will encourage stiffness, increase inflammation and lead to muscle weakness.

Feeling stiff, tight or muscle spasm?

HEAT is generally the best application here. Use a hot water bottle, wheat bag or heat pack. It should never be so hot it could scald you. Apply heat as required ensuring you protect the skin to avoid burns. Generally we don’t advocate topical heat creams and pads, on occasion inflammation may be present and heat could possibly make your problem worse – so it easier to take a heat pack off than a cream or gel.

Feels inflamed, bruised, swollen or hot?

COLD is your best option here. An ice pack, cold compress or bag of frozen vegetables are good options. It is well debated as to what the appropriate length of time and intervals to apply ice. I find that placing an ice pack on the affected area for 10 minutes of every hour or when the skin warms up again (whichever comes first) throughout the day is most useful for my patients.

Never place an ice pack / frozen veg in direct contact with the skin, always use a damp tea towel or cloth. This will prevent ice burns. Avoid exceeding the recommended icing time and prolonged use and actually cause more inflammation.

Feeling stiff AND inflamed?

Contrast bathing using a combination or hot and cold is the solution for you. Follow these rules:

1-  Always start and finish with an application of cold.

2- Use each one for 4-5 minutes.

3- Always ensure ice is wrapped in a damp cloth. 

4- Apply as above following a routine of cold-hot-cold, applying more changes if  required. 

Medication

As an Osteopath, I don’t offer advice on what medication to take, but if you do want help to feel more comfortable then the following drugs can be brought without prescription. The following are simple guidance to what the differing types of medicines are for.

Anti-inflammatories: Aspirin, Ibuprofen. Avoid taking without medical advice if you are asthmatic or suffer with stomach complaints such as ulcers. These help ‘mop up’ the pain causing chemicals and reduce inflammation.

Pain Killers: Paracetemol, Codeine. These change the pain signals reaching your brain.

Muscle Relaxants: these can help ease muscle spasms by relaxing the nerves rather than the muscles themselves, these may be prescribed in short doses for low back pain and muscles spasms but are not available without prescription, so you should seek GP advice. 

As with all medication it is very important to seek the advice of your pharmacist for proper guidance.

Disclaimer: The information within this article is intended for information only and should never replace medical advice. As with any injury, if in doubt get checked out by a medical professional.

"Sciatica"... Cleared Up.

Sciatica is a term that gets bounded around for a whole host of signs and symptoms, so we at Chart Clinic would like to offer our knowledge in helping to understand this.

So what is Sciatica?

Sciatica is when the Sciatic nerve (that runs from your low back/ pelvis, all the way down the back of the leg and into the foot) becomes compressed, stretched or inflamed. This leads to pain in the low back and back of the leg and foot, often accompanied by pins and needles, numbness and/ or weakness in the leg. It is important to note that the leg pain is often worse than the low back pain. Another common symptom of Sciatica is the inability to pull your foot up when you walk, giving the appearance of dragging the foot when walking.

The Sciatic nerve is one of the most common nerves to injure in the lower extremity due to the many sites of potential injury. 

What causes it?

The most common reason for Sciatic nerve pain is from trauma or surgery around the hip. It has been documented that 1-3% of all hip replacement surgeries result in Sciatic nerve injury. Hip fracture and dislocation are also reasons for potential Sciatic nerve entrapment.

Piriformis Syndrome, another term you may have heard of, is another area where the Sciatic nerve can become irritated. If the muscle, Piriformis (which is located deep to the buttock muscles), is overly tight then this can lead to buttock tenderness and pain into the back of the thigh. Prolonged sitting, bending forwards and certain hip movements can exacerbate these symptoms, often accompanied by numbness into the back of the thigh. 

The nerve then traverses down in between the hamstrings where a muscle strain here can compress the nerve. The Sciatic nerve then divides behind the knee where one branch wraps around the top of the Fibula bone. A fracture here can then lead to pain into the calf and foot, along with pins and needles, numbness and/ or weakness of the ankle and foot.

What can you do?

This is entirely dependant on the reason why the Sciatic nerve is being compressed. As physical therapists, we are trained to diagnose the reason for a patient’s signs and symptoms through special tests. This is where it is important to differentiate between nerve root irritation (where the nerves come out the spine are inflamed) and peripheral nerve entrapment (where the spinal nerve roots converge) as the signs and symptoms are similar but not the same. 

If the Sciatic nerve is being compressed by muscles or tendons, then physical therapy can be very effective in helping to alleviate these symptoms. Very specific stretches and the use of ice and/or heat can also help.

Due to the vast number of causes for low back pain and leg pain, it is best to speak to a manual therapy specialist to help diagnose and treat the area in question as it is important to identify where the origin of pain lies so it can be treated accordingly.

The above Information is not designed to replace medical advice. Serious Injuries should be managed with assistance from your Physical Therapist or Health Professional. With any symptoms that cause concern or doubt, get them checked out.