Osteopathy, isn't that just for 'bad backs'????????

We Osteopaths, have a justified reputation for resolving back problems and I spend a lot of time explaining that we can treat so much more including necks, shoulders, elbows, hips, knees etc..

Having said that, this newsletter is a 'bad back' special covering the structure of the spine, some causes of back pain and what you can do if it hurts.??

When you Google 'bad back' you get over 9,410,000,000 results which shows what a common problem it is. The downside of this volume of information is that it makes finding the useful stuff very difficult if you don't know where to look.

Due to the complexity of low back pain and all of the factors that might be involved in causing a problem, this is a longer than usual newsletter that still only provides the most basic information.

I hope that you find it useful and if there is any additional information you need or a 'burning' question that I haven't answered please get in touch.

What your spine looks like...

Your spine is a very complex structure consisting of a number of interdependent?components and problems can occur when something affects one or more of these components. To keep things simple I haven't included the potential impacts of the hormonal, circulatory, digestive, pulmonary or any of the other systems!

Structurally the spine is made up of 33 vertebrae which form 5 sections as follows:

1) Cervical?- 7 vertebrae forming the neck and upper back supporting the weight and movement of your head

2) Thoracic - 12 vertebrae forming the mid-back?

3) Lumbar?- 5 vertebrae supporting the weight of the body

4) Sacrum - 5 fused vertebrae forming the base of the spine and attached to the ilium of the pelvis forming the sacroiliac joints

5) Coccyx - 4 fused vertebrae which form?the 'tailbone'

There are 4 curves with "c-shaped" curves at the neck and lumbar spine and "reverse c-shaped" curves of the mid-back and sacrum/coccyx. These curves play a very important role in maintaining balance and helping us to stand upright and any issues with these curves, such as scoliosis, can have an effect on the rest of the body.?

There are 31 pairs of spinal nerves?and they are 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal. Each pair of nerves connects with a specific region of the body and?consists?of a mix of sensory and motor fibres which are responsible for muscle control, pain and temperature sensation.

If you want to know more you can find a very comprehensive explanation of spinal anatomy here

Causes of Back Pain...

Back pain where there is no obvious cause is called "non-specific" while "mechanical" pain is where it originates from the joints, bones or soft tissue in and around the spine.

There are many different causes of back pain but I have listed the more common ones that I see in my clinic.

Sprains and strains - Injuries to ligaments, muscles, and tendons that support the spine and its joints can lead to back pain. There is usually an obvious cause like lifting something and twisting at the same time or as a result of a car accident or sports injury.

Osteoarthritis -?With OA the cartilage and vertebrae show signs of "wear & tear" resulting in inflammation and nerve irritation which can result in back pain.

Sciatica - This is a general term meaning "inflammation of the sciatic nerve"?and can be caused by a number of different issues including piriformis muscle spasm, irritation of various nerve roots from L3 - S5 or a bulging disc.?

Herniated (slipped) discs - Discs don't physically "slip" but they can herniate i.e. some of the disc fibres tear,?following an injury or due to general wear and tear. If a significant number of fibres are torn?the disc can bulge resulting in nerve compression and sometimes pain.?

Spinal stenosis -??Stenosis refers to the narrowing of the spinal canal due to bony outgrowths (spurs) from the vertebrae. The spurs can compress the spinal nerves. which in turn can cause?pain, cramping, weakness or numbness in the back and down the legs.

Pregnancy - Weight?gain together with the changes in body shape and hormones can result in back pain due to the additional strain on the muscles, ligaments and tendons.

Less-common causes of back pain include?Kidney stones?and infections,?Endometriosis (a buildup of uterine tissue outside the uterus) and?Fibromyalgia.

If the above isn't enough, you can find a?more comprehensive list of potential causes of low back pain here .

So?you have back pain, now what?

Google "back pain advice" and you get 982,000,000 results with the quality of information varying from excellent to awful.

Here are some simple tips that will help you get moving better and recover faster.

Stay positive -?This is the most important piece of advice for anyone with back pain! Although it can be difficult, it really helps if you stay optimistic and recognise that your pain will get better. People who manage to stay positive despite their pain tend to recover quicker.

Keep moving - Stay as active as your pain allows because as this will help speed up recovery. When you are in pain it is natural to want to rest but this does not help and could potentially make things worse.

Heat - If your back feels tight and you are experiencing muscle spasms, heat from a hot shower, hot water bottle or microwavable wheat bag will help your muscles to relax and keep you moving. The key advice is to wrap the heat source in a towel and not apply it directly to the skin (unless you are in the shower) and don't make it too hot.

Cold -?Using cold for back pain is a personal preference and has no advantage over heat. For some people cold can actually make their muscles go into spasm due to the 'shock' when it is applied. If you prefer to use cold never apply the cold source directly to the skin and don't use for more than 5 minutes at a time with a 40-50 minute gap between applications.

Anti-inflammatories -?Ibuprofen, naproxen or paracetamol can be very effective for managing your pain but check with your pharmacist if you are concerned about possible side-effects.

The key thing to note from the above is that back pain usually gets better on its own and you can generally manage the symptoms without the need for additional support.?If the pain doesn't improve after a few weeks, it's stopping you doing your normal activities or it seems to be getting worse consider contacting your GP or a healthcare professional i.e. me, for advice.

If you have back pain with any of the following symptoms you need to contact your GP or call NHS 111 as soon as possible.

• numbness or tingling around your genitals or buttocks or?difficulty peeing
• loss of bladder or bowel control
• unexplained weight loss
• a high temperature of 38C or above
• swelling or deformity in your back
• pain that is worse at night and you can't find a comfortable position
• if it started after a serious accident,?such as a fall or car accident?

Although serious back problems?are rare it is always worth getting professional advice if you have any concerns.

...And Finally...a ban on straws is not just good for the environment!

Let me know what you think and if there are any other topics that you would like to see covered in the future.

Feel free to share this newsletter with anyone you think might be interested, especially if they are in pain and could benefit from a chat with their friendly neighborhood osteopath.

Thanks again for reading and take care until next time.

Bob Allen