Lower Back Pain

Lower back pain… Can manual therapy help??

As an Osteopath, we are commonly thought to be back experts, which is probably why most patients we see present with back pain. There are various therapies that can resolve or manage your back pain and the treatment plan will depend on diagnosis. It’s very common for patients to have 3-4 treatments with an Osteopath and feel like they don’t need another session, on the other hand, it’s also very common for a patient to have treatment every 4-6 weeks to manage the pain and maintain optimal function.

60-90% of the population will experience lower back pain in their lifetime, so if you haven’t yet, its likely you are going to at some point. Fortunately, 40% of the time, your back pain will resolve within the week, with the right management. For those not so lucky, around 44% of people will experience chronic lower back pain which can greatly affect daily tasks and is a common cause of days off work. So, who can help?

I’m sure everyone has experienced disappointment when hearing the waiting time to see a doctor is sometime in the next 3 weeks and even then, it is likely that you’ll be prescribed pain killers and may be referred to an NHS physiotherapist, which involves more waiting…

 So why not try an Osteopath? The National Institute for Health and Care Excellence advise “manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica.” This should also be accompanied with prescribed exercises tailored to your needs, all of which an Osteopath is trained to do. I’m not saying avoid pain killers and GPs but waiting times can be avoided and there is strong evidence for manual therapy and the reduction of back pain (Hidalgo et al., 2013).

In my experience, I often find the longer you put up with pain the longer it takes to resolve. I’ve had so many patients put up with the pain for months to years then finally do something about it. After seeking Osteopathy, there’s usually a good improvement within a few sessions. Don’t put up with pain, book in now…

Hidalgo, B., Detrembleur, C., Hall, T., Mahaudens, P. and Nielens, H. (2013). The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews. Journal of Manual & Manipulative Therapy, 22(2), pp.59-74.

Spinal Manipulation: What's the crack?

Spinal Manipulation

I’m sure many of you have watched videos that circulate social media of people having their backs ‘cracked’. But what makes that satisfying sound and what does it achieve?

Osteopaths often combine various techniques tailored to your needs, one of which may include a spinal manipulation. Also known as an ‘adjustment’, the technique has been practiced for over 2000 years and involves a quick thrust to a joint over a very short amplitude, thus the name high velocity thrust (HVT).  This technique, commonly used by Osteopaths and Chiropractors for neck and back pain, is often associated with an audible ‘crack’ or ‘click’ (which often feels very satisfying) and can be applied to various joints in the body. Contrary to the old wives’ tale, there is no evidence to suggest that this technique can cause arthritis, which I’m sure many parents have told their children, probably to stop them clicking their fingers at the dinner table. In fact, Dr Donald Unger spent 60 years cracking only the knuckles of his left hand. At the end of which, there was no degenerative differences or ailments. He was awarded an Ig Nobel Prize in 2009 for this trivial research.

Another outdated belief is that the click is produced by bone rubbing on bone. Again, this is not correct. The sound is created within the synovial fluid of a joint (a lubricant within the joint capsule which reduces friction), so no, there is no contact between adjacent bones. This click is produced when the joint slightly separates, creating gas filled cavities or air bubbles which then rapidly dissipate.

What can spinal manipulation achieve?

·         Reduce the swelling of a joint capsule.

·         Reduce muscle tension.

·         Release endorphins (modulate inflammatory processes, promoting analgesia).

·         Increase the range of movement.

·         Relieve back pain.

Does this technique realign your bones or put them back in place?

This is the oldest theory of spinal manipulation and not very accurate. Osteopaths use manipulations every day with various patients, the myth that spinal manipulations crack your bones back in place is only a myth. This was believed many years ago before it was certain what caused the sound during the technique. Practitioners did believe they were ‘putting the bone back in place’, which is believable with the relief that often follows. In my clinical experience, patients who think their bones need popping back in are often often suffering from acute back pain with associated muscle spasm or a restricted joint of the spine, of which manual therapy can help. Don’t worry, your bones won’t pop out!