Rotator Cuff and Shoulder Pain

Continuing with the back pain series we are moving up to the shoulders, looking at problems that can occur with tightness around the shoulder blades.

Rotator Cuff

The shoulder blade (scapula) is covered in a muscle group known as the rotator cuff.  This is a group of 4 muscles that help hold the humerus (upper arm bone) into the shoulder socket and facilitate the wide range of movement that such a shallow joint allows.

These muscles need to have a certain tightness to allow them to hold the joint in a stable position, but when the rotator cuff becomes excessively tight the muscles can shorten and become easily strained or torn.

This can lead to problems such as localised pain or deep dull ache, feeling tight and uncomfortable in the back and front of the shoulder and across the collarbone or down the arm, numbness, weakness and restricted movement of the shoulder and arm.  Left untreated this can develop into what is commonly known as ‘frozen shoulder’ where the surrounding muscles tighten, the joint capsule ‘locks’ and movement becomes severely restricted and painful.

Tight rotator cuff muscles generally respond extremely well to massage and physical manipulation, although working them can be somewhat painful. The opposing muscle group to the rotator cuff are the Pectoralis (pecs) muscles at the front of the upper chest, running below the collar bones.  These can get tight due to lifestyle and poor posture – sitting at a computer for long periods, carrying heavy bags always on the same shoulder, sitting hunched fowards etc – and when these tighten and shorten they pull the shoulders forward into a round shouldered posture which places the already hard working rotator cuff group under additional strain.

Treatment for pain in the rotator cuff should therefore also include examination and work on the upper arm, shoulder and pectoralis to release the whole area in a balanced way.  Gentle stretches and strenghening exercises will then continue to release tension or build strength where needed.

To prevent overusing the rotator cuff, practise engaging the larger and stronger surrounding muscles to assist with shoulder strength – the latissimus dorsi that wraps over the lower part of the shoulder blade and down towards the ribcage, the rounded deltoids of the outer ‘corners’ of the shoulders and the large percotralis muscles of the upper chest.  A simple exercise to help align the shoulders correctly and release tension is to draw the shoulder blades together towards the spine, then downwards.  This also engages the larger muscles of the back to help with strength which can help rest the smaller muscles and avoid overstraining.

Also try laying on your back (with only a small or no pillow) and allow gravity to drop your shoulders backwards towards the floor which will gently stretch out the pectoralis muscles.

If you are struggling with pain in your shoulders or any of the pain patterns mentioned above come for an assessment and discuss what treatment options would be most appropriate for you.  Both Massage and Dorn Method can be beneficial for such pain.

 

 

 

Thoracic Outlet and Carpal Tunnel Syndromes

In this next installment of the Back Pain Series we jump up a little to the upper back and problems associated with tightness and misalignment in this area, and the similarity to the more localised Carpal Tunnel Syndrome.

Thoracic Outlet Syndrome

Most common in women between 20 and 50 years of age, Thoracic Outlet Syndrome (TOS) is an umbrella term to encompass pain in the neck, shoulder and arm.  For this article we will look at non-specific TOS which is usually triggered by trauma to the upper body or repetitive strain/overuse injury.

The pain is usually a dull, aching pain felt anywhere from the neck, through the shoulder to the arm and hand.  It originates from compression to the nerves and/or veins running between the neck and the upper ribs, through the clavicles (collar bones) and down through the armpit.  The compression may occur along any of these points and pain or tenderness may be felt locally at the compression site or radiate down into the arm and/or hand.  This may be accompanied by pins and needles or tingling in the 3rd and 4th fingers, the palm of the hand and in extreme cases a weakening of hand grip.

The pain associated with non-specific TOS usually worsens with activity and improves with rest.  Physical therapies to help release overtight or strained soft tissues can be beneficial as can a programme of gentle stretching, strengthening and using hot and cold therapy.  If poor posture is the cause then learning correct posture can improve symptoms by removing the stresses on the soft tissues.  A postural assessment and necessary correction can also help by realigning the body and therefore reducing the presure on overcompensating areas.

Symptoms of Thoracic Outlet Syndrome are similar to those more commonly associated with Carpal Tunnel Syndrome:

Carpal Tunnel Syndrome

Another repetitive strain/overuse injury, Carpal Tunnel Syndrome (CTS) also presents with pain, numbness, tingling and pins and needles in the hand, thumb and 1st and 2nd fingers.  It is usually caused by compression to the medial nerve in the front of the wrist.  This runs through a small compartment called the Carpal Tunnel and if this becomes inflamed due to overuse it reduces the space for the nerve to pass through and pinches it.  Due to the similarity in symptoms of CTS and Thoracic Outlet Syndrome it is important to check the neck and shoulders on any client presenting with these symptoms even if the pain is felt locally at the hand/wrist.

Rest is often advised for CTS with the wearing of a splint to keep the wrist stable and prevent overuse, however this may in turn lead to loss of muscle and strength in the arm and wrist which can lead to further problems.

Cold packs can be applied to help reduce inflammation of the wrist and massage of the arm, shoulder and neck can help to relax muscles that may also be involved.  Depending on the level of inflammation, gentle massage directly over the carpal tunnel area may also help to release, soften and stretch out the soft tissues that are contributing to the compression.  This can be particularly beneficial in the very early stages before the swelling becomes too bad.

 

As with any symptoms that persist or worsen there is no substitute for medical advice and you should check with your GP if you are concerned about your health.

 

Degenerative Disc Disease, Osteoarthritis and Spinal Stenosis

In this second part of Lumbar problems we are looking at the more serious conditions of Degenerative Disc Disease, Osteoarthritis and Spinal Stenosis.

Degenerative Disc Disease

The term Degenerative Disc Disease sounds frightening and permanent.  However, it is not as serious as it may suggest.  As we get older our spinal discs start to degenerate.  For some people this will result in chronic pain, most commonly in the lower back or neck, yet for others there will be no physical discomfort at all.  The ‘degeneration’ occurs as the disc’s water content reduces and it starts to lose its spongy quality and shrink.  This subjects it to greater pressures from the vertebrae which can lead to tears and the build up of scar tissue.

There is some debate within the medical community as to the actual cause of pain with this condition, with some suggesting that the pain is due to inflammation of the soft tissues surrounding the damaged disc, and others looking more to the vulnerability of the nerve roots in the affected area.  The pain pattern reported is often a persistent low to moderate ‘baseline’ pain with intermittent high pain flare-ups (described as the back ‘giving out’) following particular activities.  Acute episodes can last a few days to a few weeks before settling back into the low level chronic state.  The pain may stay localised in the lower back or there may be pain, numbness and/or tingling down the leg.  This makes it a very difficult condition to identify as the pain pattern can be similar to Sciatica and Piriformis Syndrome.

This seems to be a condition that is more common amongst the 30′s and 40′s age group, and whilst the disc will continue to deteriorate the pain usually does not get any worse over time.

Treatment for Degenerative Disc Disease includes physical therapy such as Dorn Method and McTimoney Chiropractic, both of which gently help realign the spine and rebalance the body to help minimise irritation to the surrounding soft tissues and nerves.

Spinal Osteoarthritis

Osteoarthritis of the spine is a more serious and permanent condition, most common in people over 50. It is associated with Degenerative Disc Disease as the stresses placed on the vertebrae of the affected area can, over time, develop into osteoarthritis.  The under-lubricated joints rub against each other leading to damage of the protective cartilage and the formation of painful bone spurs.  That is not to say however that one will automatically lead to the other.

Symptoms commonly include pain and stiffness in the affected joints which can also lead on to secondary muscular tension and restricted mobility.  Lower back pain is typically worse first thing in the morning aftar prolonged immobility overnight, easing off during the day with normal movement and then worsening again as the day goes on and the joints become inflamed.

Risk factors for osteoarthritis include ageing, being overweight and physical trauma or prolonged stressing of the joints over time. There may also be a genetic disposition.

Osteoarthritis also occurs in the facet joints of the spine, small joints that assist with flexibility and stability of the spinal column wihch can lead to Spinal Stenosis.

Spinal Stenosis

Most common in the over 50′s, Spinal Stenosis occurs when extra bone is laid down as a reaction to physical repetitive stresses on the spine. When this is laid down between two vertebrae and where the nerve exits the spinal cord, then eventually the nerve is compressed and extreme pain on extension is felt .

The name comes from the Greek word  meaning ‘choking’.  In the neck (cervical spine) pain in the arms is experienced due to the nerve compression.  In the lower back this can lead to sciatica and leg pain, which worsens when walking.  The symptoms may fluctuate in severity, easing when at rest or when leaning forward - for example leaning on a shopping trolley to get relief from the pain is a classic sign of spinal stenosis.

Spinal Stenosis pain management includes ice for the inflammation and heat to help relax the surrounding muscles.  Massage therapy is also very effective to help release the muscles associated with back and leg ache.

 

Need a reason for Massage?

In the words of Gerry Pyves, NO HANDS Massage creator, a great reason for having a massage is NURTURANCE!

“From the moment of birth until our death we experience less and less touch.  You could say that our ‘touch quota’ steadily reduces from the moment we are born!

Yet touch is one of the primal needs of every human being.  Safe touch that demands nothing of us is probably the most powerful touch there is.  That is why NURTURANCE is one of the major reasons to have a Massage.  We all need to top up our touch quota.

There is nothing that soothes the mind or soul more powerfully than Massage.  You can take all the therapies in the world and wrap them up in a sack and bung them into the river when it comes to finding anything that comes even close to the rich smorgasbord of touch that is Massage.

Massage quite literally represents a tsunami of sensory nerve stimulation to the body and mind.  As a consequence of so many nerve endings being stimulated at the same time, we experience literallly hundreds of benefits.

Perhaps the most important reason for giving yourself the nurturing power of Massage and touch is simply getting a bit of extra support on this difficult journey called life.  No matter how you look at it, being human is tough.

Massage can soothe your journey.  Every human being needs and deserves the support that Massage can provide on life’s journey.  It’s really that simple.”

 

If you need a reminder of how nurturing a Massage can be, or you want to try it for the first time, book yourself in for a NO HANDS Massage treatment with Natalie at Ananda Clinic.  Click here for more details.

Sacral and lumbar problems

So, continuing with the Back Pain series, we move up to the sacrum – the large flat bone right at the base of your back and then up to the lumbar vertebrae, the five large flexible bones at the bottom of the spine.

The sacrum consists of five bones that are fused together to form a flat, triangular shape.  This is a very important part of the spine as it is a connecting point for the back of the pelvis bones on either side, the base of the spinal column at the top and the coccyx below.  There is little movement within the sacrum itself but each of the joints to the other bones are under a huge amount of stress as they form part of the pelvic girdle upon which our whole upper body is supported.

The sacrum is an attachment point for many of the deep muscles in the buttocks, particularly the gluteus group, the piriformis, the core stabiliser muscles of the lower back and the hamstrings of the back of the leg.  As you can imagine, if any of these muscles tighten and shorten there will be an effect on the sacrum, often a tilting pattern that then puts the lumbar area under strain.

Pain in the sacrum may be a hot, sharp pain or it may feel more a dull ache.  If the pain has been caused by muscular tightness – poor posture or a sedentary lifestyle can be contributors to this – then a physical therapy may be all that is needed to give those muscles a hand in releasing the tight holding pattern they may have got stuck in.  Highly effective treatments include Massage, using a TENS machine or a regular exercise and stretching programme to encourage the muscles to release and relax back to ‘normal’ function.

Sacral pain may also be due to damage to the ligaments that hold the structures in place and keep the attachment points strong.  The ligaments that connect the sacum to the illium of the pelvis – the sacroilliac joint – can be susceptable to the usual soft tissue injuries of strains, tears and inflammation.  Sacroilliac joint pain commonly presents as pain in the very lower back, the buttocks and sometimes radiating down towards the knees.  It may also refer as groin pain in the front of the pelvis.  These type of injuries may be the result of a trauma such as a fall landing hard on one buttock, jarring or occur over time due to a leg length discrepancy or repeated, long term, poor posture.

Again physical therapy plus gentle stretching can be beneficial – particularly Massage Therapy, Dorn Method and McTimoney Chiropractic.

The lumbar section of the spine has to be strong enough to support the weight of the body above as well as flexible to act as a shock absorber during movement, so these five lumbar vertebrae are larger than the rest of the bones that make up the spine.

Due to the extreme stresses this section of the spine is exposed to, it is a common area for back pain to occur.  Muscularly, the quadratus lumborum and erector spinae take a lot of the strain and these often become extremely tight, or hypertonic.  Muscle spasm frequently occurs as a protective reflex and the back ‘locks’ up.  Massage is extremely effective at treating this, especially NO HANDS massage which gently helps these muscles to release at a deep level and find a more neutral holding pattern in their own time.

More serious problems of the lumbar spine include slipped (prolapsed) or herniated discs, spinal stenosis, arthritis, degenerative disc disease, infections and tumours.

Prolapsed discs occur when the disc, which acts as a cushion between the vertebrae, gets squeezed out of place - one article I read described it as being like a burger sliding out of the bun!! – and presses against the spinal cord.  Herniated discs are similar but the strong outer casing of the disc tears and the soft tissue bulges out.  Both can cause severe symptoms – including pain that spreads to the buttocks and legs, tingling or numbness, muscle spasms or weakness – but equally both can present no pain symptoms at all.

The severity of the prolapse or herniation will determine the treatment required – low level prolapse can be manipulated back into place through stretches or physical therapy such as Dorn Method or McTimoney Chiropractic.  If more severe, surgical intervention may be required to repair the damage and prevent reoccurance.

As well as disc herniation and prolapse it is possible for the vertebrae themselves to slip, a condition called Isthmic Spondylothesis.  We are lucky enough to have a guest blog from Caroline who has kindly written about her experience of this, the initial symptoms, the gruelling treatment that followed and finally the surgical intervention and life afterwards.  Caroline has been a massage client of mine for a number of years now as well as receiving regular osteopathy, both of which help manage her pain and mobility.  You can  read the blog here.

In the next installment we will look closer at other pathologies of the lumber spine including degenerative disc disease, arthritis and spinal stenosis.

 

Excellent understanding from a great client!

I received this lovely email from a client following the newsletter on Sciatica and Piriformis Syndrome.  Paul has been coming for regular treatments for a while now and shows a real understanding of the importance of allowing things to heal and repair at their own rate.  As impatient as we might be, we cannot hurry the body’s own processes along and gradual release and realignment can often lead to much longer term results than a quick fix.  Well done Paul, a great client!

 

Hi Natalie,

Thanks for your email.

The Sciatica or Piriformis article is interesting, It seems to make me feel better just knowing where the muscles are and how they work in relation to nerves etc. sort of gives you the feeling of being in the “driving seat” rather than just a victim of random pains!

I think that just knowing these things makes a big difference to how we feel about what’s going on in our bodies, and as I said, gives us more of a feeling of being in charge of them, or at least some understanding of why things are happening.

I’ve been doing lots of the stretches that you mentioned along with other stretches most days now and I am pleased with the results.

I think that was a good thing you said about “gradual progress” when we last met. I was definitely being too impatient and the funny thing is that, along with the massage treatment, since I relaxed about the whole idea of increasing flexibility back to what it used to be the progress has been a lot more rapid.  It seems like I am a good 10% looser now.  Funny how it works isn’t it?

Thanks for a great treatment last time, I felt really good following that and think I have experienced some differences since; particularly last week when I noticed a lot of changes in posture/muscle tension and I am really pleased with how things are going!

Having a great week so far this week, hope you are too.  Looking forward to my treatment on Friday.

 

Isthmic Spondylothesis – a first hand experience

This guest blog has been kindly written by Caroline to share her experience of Isthmic Spondylothesis.  Her journey has been a long and painful one but she always has a smile on her face and is a constant reminder that even the toughest challenges can be overcome with determination and a positive outlook.  Huge thanks for this Caroline.

 

I’ve always been healthy and without any major injuries.  I do remember that I always had back ache, just a niggle, occasionally annoying.  It didn’t stop me doing anything, I regularly attended a gym, took part in spin classes, kick boxing, cycling, aerobics, rowing, trim trail circuits, climbing walls, you name it, I tried it.  I was never a GI Jane contender, but I was willing to give it a go and have a laugh and enjoyed being active.  There were degrees of discomfort, but a good stretch, a twist or even lying on the floor, throwing my legs over my head always released vertebrae’s with a satisfying cracking noise.  I’d move on and forget about it until the next time.

In January 1993, at the age of 25, I joined the Metropolitan Police.  Various injuries on and off duty, were dealt with and recovered from.  Although a major left ankle injury in 1999 took numerous surgeries and a fairly long time to recover, it’s never been quite right since.  While waiting for public transport in early December 2005, (I’d been out for an early Christmas drink!), I realised I couldn’t straighten my leg or place my left foot on the ground properly.  My whole leg and lower back hurt.  It felt like a sharp stabbing numbing painful sensation,  which I’d ignored for such a long time, as it wasn’t interfering in my everyday life too much, until now, it was no longer possible to ignore, I was in pain and I didn’t know why.  I went to see a work physio, he examined me and immediately declared me unfit for duty and shipped me off to get medical treatment.  I saw my GP, who referred me to a Consultant Othopedic Surgeon, which I saw within days, as fortunately I had private medical insurance.  A must for a serving Police Officer, injuries are an occupational hazard, a definite case of when not if!

My diagnosis following extensive prodding and poking, x-rays and and scans found that I was suffering from a condition called Isthmic Spondylothesis of L5/S1 with back pain and L5 nerve root pain.  My L5 vertebrae had slipped forward, over my S1 vertebrae by about 3mm.  My lower back was completely in spasm, even a gentle touch would make the muscles pulse and jump, hospital doctors would bring their students into see my quivering back muscles.  I deteriateted quickly, the pain was unbearable, the  pressure on my spinal cord, the nerve endings, the mis-alignment of my spine eventually made it impossible for me to stand up straight, I was bent forward, and  I had no feeling from the waist down, I couldn’t function.  I was soon on a cocktail of painkillers, muscle relaxants and other stuff.  I was confined to bed, my mobility became extremely limited.  I’ve never known anything like it.  My orthopaedic surgeon admitted this condition was outside his field of  expertise and thus I was referred onto an orthopaedic specialist in London.

Further extensive examinations followed.  It was decided that I move into London Bridge Hospital for observation and comprehensive physiotherapy treatments , it was thought that they would try a non-surgical route.  With the treatments and a serious of spinal nerve blocks, the condition may correct itself. I spent the next five months either in hospital or at the Police convalescent home.  Both were great, I underwent physiotherapy twice a day, mobility and exercise classes, massage, hydrotherapy, acupuncture, and numerous epidurals.  It wasn’t successful.

In July 2006, I underwent a L5/S1 instrumented fusion with Click X and Gill procedure with decompression of the bilateral L5 nerve roots with bone grafting.  No, I didn’t know what it meant  either, but it sounded serious, it hurt like hell, and I was unable to sit down for 8 weeks after the surgery, and had to learn to walk all over again!

I was extremely lucky to be able to return to the Police Convalescent Home for post op care and three further in patient stays to get me back on the road to health.  I was off work for about 18 months.  My life had changed.

My mobility was drastically reduced, I gained weight, and I was really grumpy!  I was advised to start doing pilates to strengthen my core stability muscles, so as to protect my back.  I learnt to swim with the aid of floats, so as not to move my back too much.  I started walking/hiking, eventually I was achieving many miles, I even volunteered to take a neighbour’s dog along with me, it seemed such a waste to not share the exercise with a more than willing companion.

My physiotherapist helped me, but most importantly, introduced me to Natalie and BMoreNatural.  As my muscles were easily fatiguing, going into spasm and locking up, even after doing  a small amount of activity, I needed her help.  I was also fortunate to find an absolutely fabulous physiotherapist, Annabelle, who I trust completely.  So with the help of Annabelle and Natalie, participating in Yoga, walking, swimming, having regular maintenance treatments and a lot of hard work, I’ve improved.  It’s not been all plain sailing by any means.  I had a relapse in 2008, after having a violent sneeze, which required minor surgery, numerous more trips to the convalescent home.   I’m not pain free either, my L3/L4 vertrebraes are permanently swollen,  as they’re under extreme pressure and taking strain through the spine which their not meant to perform, but I manage, I’ve adapted to my condition.  I’ve been educated, and continue to learn about my body and its workings.  Humans are amazing machines.  I try to explore new avenues and keep and open mind, like trying The Dorn Method with Natalie.

Unfortunately, my police career ended in June this year, after I had been declared unfit due to ill health to perform the role of an officer.  I don’t know what the future holds for me, but nor does anyone else!

Stretches for Piriformis Syndrome

These are stretches I commonly suggest to my clients who present with Piriformis Syndrome. I have used these very successfully myself and continue to do so when I get a recurrence of this condition.

With all these stretches ensure you go into them slowly, hold the stretch without bobbing or rocking and slowly release.  You are only looking to take the stretch to the point where you feel a gentle pulling or replicate the symptom – if any other pain occurs or the original pain worsens then stop doing that stretch.

Seated Piriformis Stretch

The simplest of these is to sit on a chair (dining chair is a good height) with your feet flat on the floor.  Cross one ankle over the opposite knee and slowly start to lean forward until you feel a gentle stretch.  Hold for 5-10 seconds then gently release.  Repeat 2 or 3 times on each side.  You may find that one side is more flexible than the other but it is important to always stretch both sides.

Laying Piriformis Stretch

Lay on your back with your knees bent and your feet flat on the floor.  Bring the ankle of one leg up to rest over the knee of the opposite leg (as with the sitting version) and gently pull the thigh of the ‘knee’ leg towards your chest.

Hip Flexor and Hamstring Stretch

As well as the piriformis muscles it is important to stretch out the opposing muscle groups.  This is easiest done with a small knee cushion in front of a chair seat for support.  Kneel on the cushion with your left knee and place your right foot in front of you.  Keeping your right knee directly over your toes (no further forward) gently slide the left leg backwards until you start to feel a stretch in the front of your thigh/hip.  Use the chair or sofa arm to support yourself.  This stretch can be extended by raising the arm on the side of the back leg upwards (eg left leg back, left arm reaching up).

Hold the stretch for 5-10 seconds and then place both hands on the floor either side of your front foot.  Gently rock backwards (keeping your knee on the floor) to stretch out the back (hamstrings) of the forward leg.  This is a very deep stretch so go into it slowly and gently.  Repeat the whole stretch 2 or 3 times each side.

Frequency

I would suggest trying to do these stretches at least twice a day after you have warmed the muscles up a bit – avoid stretching as soon as you get out of bed in the morning, move a bit first, walk around and get the muscles moving before stretching them out.  Always work to your limits and go into each stretch slowly, hold still for 5-10 seconds and come out slowly.

Sciatica or Piriformis Syndrome?

Low back ache. Pain or dull ache in the buttock. Stinging, aching, tingling or throbbing down the back of the leg and possibly into the foot….  You can feel the symptoms all right but what is the problem?

Sciatica and Piriformis Syndrome may present with all or any of the above, which may be on one side or both.  They both affect the sciatic nerve but the origin of the problem is different for each condition.

Sciatica includes the above symptoms but the pain is generally on one side only and is more intense in the leg than the back, particularly the front of the lower leg.  Additional symptoms of sciatica include sharp pain rather than a dull ache, numbness and weakness in the affected area which is determined by the location of the compression.   This compression may be caused by a misaligned vertebrae, tightness in the surrounding muscles of the lower back, or a slipped or herniated disc.

Piriformis Syndrome develops when the piriformis muscle becomes tight and shortened and irritates the sciatic nerve that runs behind it.  The piriformis muscle is a deep muscle running horizontally from the sacrum at the base of the spine to the inner edge of the thigh bone. The sciatic nerve runs vertically behind it and may in some cases run through the fibres of the piriformis muscle.  As you can imagine, if this muscle becomes tight it will cause a compression on the sciatic nerve which results in any or all of the above symptoms.  In Piriformis Syndrome the symptoms include increased pain after sitting and when walking up stairs or an incline.

Treatment for both can include physical therapy such as deep tissue massage and spinal manipulation, such as Dorn Method or chiropractic.  These work to release soft tissue tension and where necessary allow the realignment of bones.  Once the muscles have been released and the body has realigned the symtoms usually reduce or disappear quite quickly.  Piriformis Syndrome can also be helped with a stretching programme to release the affected muscles and reduce pain.  See the ‘Stretches for Piriformis Syndrome’ page for more information.

In most cases the above treatments can be effective in treating and eliminating pain from Sciatica and Piriformis Syndrome.  However, if things do not improve after the recommended course of treatment (usually 1-3 sessions) then it may be necessary to be referred to your GP.

There are a few more symptoms that should be assessed by a medical professional as soon as possible as they may indicate potentially serious conditions.  These include dysfunction of the bowel or bladder (inability to control) and loss of sensation in the legs.  If weakness or numbness persist then medical attention should also be sought.  If in any doubt consult your GP.

To book a consultation for Dorn Method or Deep Tissue Massage (Natalie) or McTimoney Chiropractic (Janet) please call Susan on 01732 850 695 or use the above links for more information.  Please ask for the Practitioner you wish to see by name to ensure you are booked with the right person.

Back Pain

‘Back pain’ is a very general term that can be used to describe a diverse range of symptoms.  Back pain falls into the sub-categories of lower back pain, mid back pain, neck and/or shoulder pain, sciatica, chronic, acute….  there can be soft tissue damage, disc movement or herniation, misaligned vertebrae, other illness or disease… as you can see there are many possible reasons why you have back pain.

Often trying to pinpoint the actual pain site can prove difficult and frustrating for the sufferer, especially when there are referrals to the limbs, the opposite side of the body or the pain only hits when carrying out a very specific movement.  The pain can hit in an instant and trying to work out what the trigger was may be difficult.

For a client coming for treatment for ‘back pain’ it can be very confusing if they are unable to locate where they are feeling the pain.  They know it hurts but they can’t at that moment put their finger on it.  They just want some relief from the pain.

There is also a fear about the level of pain they might be feeling.  It can therefore be a surprise to discover that higher level pain does not necessarily equate to a more serious problem.  For example, a simple muscle strain can be extremely painful as the soft tissues surrounding the injury site become fatigued from the protective spasm and the pain site stiffens resulting in the tight muscles compressing other soft tissues and nerves.  What might be a relatively small muscle tear then becomes a big problem resulting in high levels of pain, immobility, inability to find comfortable positions to sit and sleep and all the associated problems that brings.

Compare this to a more serious herniated disc that may cause no pain at all and go unnoticed for a long period of time.

Acute pain

This is generally considered a short term pain that can last from a few seconds to hours over a period of a few weeks.  These are typically injuries such as muscle strains, misaligned vertebrae and general postural muscle tightness.  If left untreated, acute pain can become chronic.

Chronic pain

This is pain that persists for more than three months and may have a very gradual onset that gets progressively worse over time.  It may come and go and the level of pain may vary each time.  This type of pain is common in low back issues especially.

I have had many clients coming for treatment for ‘back pain’, both acute and chronic, who find a great deal of relief from a massage or Dorn Method treatment.  Both of these approaches work to release the soft tissues that might be protecting an injury site to allow access to the deeper levels.

By slowly releasing the muscles a layer at a time with massage and gently working with the body to realign the spinal vertebrae we are not forcing anything or ‘fixing’ the problem, rather you as the client and myself as the practitioner are working together with your body to help it find it’s natural state of balance.  Only when the body is in better balance can it start to let go of the holding patterns that might be causing the pain.

Referred Pain

It is extremely important during these sessions to work on both sides of the body, not just in the area where you are feeling the pain.  This is because pain can sometimes be ‘referred’ pain – for example, the muscles in the left side of your shoulder have tensed up because of poor posture or overdoing an activity.  You might not feel pain in your left shoulder but because they are overtight you will start to get a body imbalance.  This means the muscle on the right side will have to work harder to correct the imbalance resulting in fatigue and overcompensation injury.  You will then feel the pain in the right side although the root of the problem is actually the left.

In many cases soft tissue work such as massage and gentle spinal realignment like Dorn Method can quickly reduce your pain.  Ideally you would need to come for 2 or perhaps 3 sessions no more than a week apart to allow the release and rebalance to begin.  Once you are out of pain regular sessions can continue the recovery stage and help you return to a state of balance and wellbeing in the long term.  These follow on sessions may only need to be 3-4 months apart but will prevent you getting into a ‘feel better/stop treatment/relapse’ cycle (for more on this see the post ‘Road To Recovery’).

 

As with all things health related there is no substitute for medical attention and if symptoms start to worsen or do not improve over time then you are strongly advised to visit your GP.  In more serious cases back pain may indicate an underlying issue such as disc degeneration, tumour or other illness so if you notice any of the following in addition to lower back pain then consult your GP: bowel or bladder dysfunction; severe abdominal pain; vomiting; fever; pain, numbness or progressive weakness in legs; sudden weight loss or history of trauma to the pain site.

Reference taken from the article “What causes lower back pain” at ilowerbackpain.com with thanks.