Overview
Back pain, particularly lower back pain, is something that we frequently encounter and treat in our patients.
Back pain symptoms can vary - ranging from stiffness and aching to sharp, more intense pain, and they can affect people of all ages and lifestyles. In fact, most people will experience back pain at some point in their lives.
The root causes of back pain are numerous and diverse, but the most prevalent ones include:
- Facet joint pain
- Muscle strains
- Nerve irritation (such as sciatica)
- Disc Injuries (disc bulge or prolapse)
Some causes of back pain are more rare, and Osteopaths are trained in medical screening to determine if onwards referral is a more appropriate intervention.
Our clinic specialises in diagnosing and treating back pain using a range of evidence-based therapies blended with the age-old wisdom of Osteopathic medicine. The NICE guidelines for lower back pain recommend manual therapy (ie, osteopathy) as a 'recommended therapy' alongside exercise.
For some people, back pain can become chronic if it has lasted longer than 3 months, or has lasted longer than the expected healing time.
Cheryl has expertise in treating chronic pain using an integrative approach - ie, utilising manual therapy, stress management techniques, and pain education.
Understanding facet joint pain
Each vertebra in your spine articulates (moves) with the segment above and below it via small joints called facets. These joints are designed to allow for free movement of your spine.
Facet joints have an excellent nerve supply; these nerves provide information to the central nervous system (brain) about positional awareness - ie, where and how your body is positioned and how it’s moving. This means that the brain places great importance on these joints.
These nerves, which obtain their information from a joint capsule surrounding the joint, also link to, and supply, the surrounding deep spinal muscles.
Sometimes these facet joints can “lock up”. There are numerous reasons why and how this can happen - either through injury, or if your brain senses overloading of the tissues in your back due to unusual stresses (such as from moving house or heavy gardening). Interestingly, these joints can also "lock up" and become sensitive simply because you’re not moving enough – such as when you’ve been sitting for long periods.
If one or more of your facet joints become sensitive then their movement will be restricted by the surrounding muscles, which will contract or ‘tense’ in a protective manner - this is your nervous system protecting you from potential harm. So although no tissues have been injured, it can certainly feel like you've done some damage!
At Live Well Osteopathy we employ a variety of techniques to swiftly alleviate your pain, ranging from deep soft tissue massage to joint manipulation.
We may also give you exercises to enhance your spinal mobility or strengthen the surrounding muscles, as well as advising of possible little changes you can make to minimise the chance of recurrence.
Disc Herniation & Bulging Disc
AKA 'Slipped Disc'
The term “slipped disc” is a misnomer, and leads people to think that discs are vulnerable and can pop in and out. Thankfully, our discs and ligaments surrounding the discs are incredibly tough and strong, and it takes a lot for them to become injured - either through a strong force, or many repetetive smaller forces.
Spinal discs are made of a gel-like substance and separate the vertebrae (bones) in your spine. They provide cushioning along the length of your spinal column, help to absorb forces from above and below, and help your spine perform essential movements such as bending and twisting.
If excessive pressure is put on a disc (by lifting or twisting, for example), it can lead to a “bulging” disc. The is where the innermost material inside the disc can slightly bulge into the outer parts of the disc. If the bulge worsens, this can cause the outer material of the disc to tear, resulting in a herniated/prolapsed disc (AKA “slipped disc”). If this protrusion presses onto a nerve, or the resulting inflammation from the injury irritates the nerve, pain can intensify significantly and even cause symptoms down your leg, such as sensory loss, weakness in the foot or leg, and/or pain in the leg.
Our osteopathic treatments for disc injury include soft tissue massage, joint articulation, and gentle stretches to reduce pain of the surrounding region, and to potentially relieve pressure on the disc and/or nerves.
We might use gentle movements, such as sciatic nerve neurodynamic exercises, to help your recovery and, if required, we may refer you for further investigations, such as an MRI scan, to determine the best course of treatment and recovery time frames.
Typically, most cases of disc herniation resolve between 6-12 weeks following the injury. Osteopathy treatment can help to reduce the intensity of the symptoms, and can improve your confidence in getting moving again - which is paramount for recovery.
If you have still have pain more than 3 months after the onset, or recurrent episodes of pain after a disc injury has healed, most of the time this is to do with factors unrelated to tissue damage and injury. Ongoing pain signals despite lack of tissue damage are just part of the equation - stress, anxiety, depression, and a reduction/change in physical mobility (often due to fear of injury) can all have a large influence.
Cheryl has expertise in chronic pain and recurrent pain recovery - see the Chronic Pain page for more information.
*It's very important to note that disc bulges or herniations are present in the majority of the adult population, but only 1-3% become symptomatic. Seeing a qualified Osteopath helps to determine if the cause of your pain is indeed from the disc, or if there are other factors involved.*