What many healthcare professionals arent telling you…

Every healthcare practitioner who works with musculoskeletal pain and injury (Chiros, Physios, Massage Therapists, Osteos etc) will tell you they provide results that last (honestly, what kind of professional wouldnt tell you they provide the best service?). They will tell you their treatments work and that your chronic pain can be solved through their ‘insert hands on treatment modality’. Generally, it all starts well and the pain subsides, but after the 6th/7th/8th appointment the improvements stop, the symptoms come back and you are back to square one.

I used to be a practitioner who sold long term results with my ‘magical hands’. But that all stopped when I became the one with the chronic lower back pain. All of a sudden the tables had turned and I was now the one laying face down on the treatment table, the practitioner had become the patient. 

I saw ‘the best’ Chiros, Physios and Massage therapists all who provided me with excellent hands, short term care and all who genuinely cared for my well being. However, my short term pain was not my concern, I was wanting a long term solution, I wanted to get back to exercise, back to driving without back pain, back to being able to stand at the pub with my mates and enjoy a beer without having to sit down after 5 minutes. 

What I came to realize was that short term modalities such as hands on therapies (soft tissue work, manipulation, dry needling etc etc) and simple non challenging exercises (stretching, mobility, activation exercises) provide short term relief ONLY. Their role is to provide short term changes so you can cope better for the next few hours or days. 

So what gets long term results?

I was fortunate enough to stumble upon a strength and conditioning coach who knew all of this. My results ultimately came from someone who wasnt specifically trained in musculoskeletal care (ironic), however, he knew that to get the body to change we must learn to alter its ‘perception’ of what is painful and slowly build back up the qualities of strength and movement variability. 

This approach is inline with the current  research;

  1. Have an achievable plan of action

  2. Developing strength and capacity

  3. Learning to move in different ways 

And are essential to create changes at the local tissues (site of pain) as well as centrally at the nervous system which leads to long term change.

This graph below is one that I show many patients, that we can provide short term relief and that is beneficial, however, once the pain is gone (or at least tolerable) we MUST be putting in the effort to change how we move, to become stronger and more resilient and to address other aspects of our health that may impact our pain experience. We call this ‘above the line’ treatment and this includes, exercise, strength, resilience as well as addressing social and environmental changes.

The issues most healthcare practitioners face is that their systems and education do not prepare them to provide long term results. I had to go back to Uni and do another Masters degree (Masters of Exercise Science (Strength & Conditioning)) to develop an understanding of how to get a body to adapt for long term change, this information is not provided in current Chiropractic and Physiotherapy courses.

So what arent healthcare practitioners telling you?

They arent telling you that their hands on treatments are only going to provide short term results as many dont have the knowledge or systems to implement movement and exercise strategies that have been shown to be the most effective way to resolve chronic pain. 

So what to do if you are experiencing chronic pain?

Find a practitioner who focuses on exercise, who will give you a clear plan of action and will support you throughout your recovery… Or just book in at Scope (shameless plug!) as this is what our entire business was built to do.

Tips for Effective Recovery

How important is post-exercise recovery?

 Whether you are a recreational athlete, professional sportsperson, fitness enthusiast or gym junkie, you may find yourself placing a great deal of emphasis towards training or performance variables. For instance, the type and frequency of training that you are doing, or how long you are doing it for, or what intensity you are aiming to achieve for that given load. 

However, it is essential to remember that the most important aspect of training isn’t necessarily what is happening on the field – it’s what you do when you get home that is just important, and can also reap more positive fitness outcomes.

More specifically, it is how you recover which also matters. 

Why is recovery important?

When we exercise, the muscle glycogen (energy) stores which provide our muscles with the fuel it needs to perform begin to deplete. Additionally, the muscle tissue breaks down in response to the physical stress placed on the body during exercise. Therefore, a sufficient recovery time post-exercise allows these energy store to replenish, and it allows the muscle tissue the opportunity to repair, rebuild and strengthen following a work load. Hence, it prepares the body for a much better performance during the next training load, as well as reduces the potential for injury or overtraining. 

Continually, physical activity – especially during intense or frequent training periods, loads stress on the body. Therefore, and by principal of progressive overload, it is fundamental to let our bodies rest and recover. This will ultimately absorb the stress and allow physical adaptations to occur, so that our body can become more efficient during the next training phase.

Tips for effective recovery

1. Active recovery

Active recovery involves a period of low-intensity physical activity, that encourages increased blood flow to the muscles which promotes venous return. This is necessary to remove the waste products which can accumulate during exercise e.g. lactic acid. Active recovery can be achieved through activities such as swimming, jogging, walking or cycling.

2. Sleep

Sleep is an important aspect of recovery. During the sleep cycle, our body increases the activity of the human growth hormone, which is critical for muscle tissue repair. It also improves glycogen synthesis which is necessary for refuelling muscles energy stores, as well as modulate levels of the stress hormone, cortisol, which can lead to improved performance.

3. Nutrition and Hydration

As part of an effective recovery, it is also essential to consider what we put into our body. To improve recovery, it helps to hydrate with adequate amounts of water and consume nutrient dense foods post-exercise. This can assist in refuelling the body’s energy stores and replace fluid loss, which can reduce the instance of fatigue and improve recovery.

4. Rest

Within a given exercise week, it is important to give your body the opportunity for a full rest day for the reasons discussed above.  

For more tailored advice on recovery, book an appointment with one of our physiotherapists today!

By Lauren Kendall – Physiotherapist and Clinical Pilates Instructor

Low Back Pain Mythbusters

Low back pain (LBP) is a very common condition. In fact, it is estimated that up to 75% of people will experience low back pain at some time in their lifetime (Fatoye, Gebrye & Odeyemi, 2019). For up to 30% of this population, LBP can become persistent and debilitating, however, rarely is it considered a dangerous condition.

LBP can be divided into three different categories. The first category is LBP that is attributed to a serious or systemic pathology such as cancer, inflammatory disorders or infections, and it accounts for only 1-2% of LBP patients. Next, there is LBP with a specific pathology, such as spondylosis or spondylolisthesis, bone fractures or disc prolapse with radicular pain, which is experienced by 5-10% of the LBP population. Finally, a huge 90% of LBP patients experience “non-specific LBP” which describes LBP with no pathoanatomical contribution.  Fortunately, acute LBP has a favourable natural history with up to 80% of episodes resolving in 3 weeks. 

Unfortunately, there are a lot of negative misconceptions regarding low back pain which may instill fear and worry in patients, and heighten their pain experience. Let’s debunk common misconceptions about low back pain, and empower patients to tackle their pain. 

Misconceptions #1 #2 #3

“Rest is the only solution” … 

… “Bending my back is bad”

… “I have to avoid heavy lifting”

In some instances, relative rest may be required during the first couple of days following an acute episode of low back pain to avoid aggravating intense pain during this early recovery phase. However, beyond this timeline, rest is counterproductive both in acute and chronic LBP. 

There is strong evidence that suggests that prolonged rest and avoidance of activity for people with low back pain actually leads to higher levels of pain, greater disability, poorer recovery and longer times spent away from work (Gordon & Bloxham, 2016). Additionally, more research shows that physical activity and regular exercise is especially helpful for improving low back pain, and is effective in the prevention of future episodes. 

Unfortunately, the body loses muscle strength and endurance much faster than it can regain it. Therefore, it is so important to stay as active as possible – start slowly, and build up the amount and intensity of the activity in a gradual manner. 

Misconception #4 – “Pain equals damage”

It is important to remember that the back is a strong and resilient structure that is not easily damaged. Rather, the pain experience is a product of various contributing factors, and not necessarily attributed to anatomical changes which may or may not have been revealed on clinical imaging.  

Overall, pain is a good thing – it is a protective mechanism, and warns the body about any threats of harm. However, if pain has been occurring for long periods of time – particularly in chronic low back, central sensitisation can occur. In this instance, the  central nervous system becomes amplified and makes people much more sensitive to pain. Therefore, activities or movements that would normally not be painful, become painful. 

Additionally, the perception of pain may become amplified due to:

  • Poor sleep

  • Stress 

  • Fear-avoidance behaviours 

    • It can lead to reduced physical activity which can prolong pain as outlined above, and may also contribute to muscle guarding and restricted movement patterns which contribute to pain chronicity (Synnott et al., 2015

  • Research also suggests that a lack of social support and demanding jobs are also associated with musculoskeletal back pain.

Misconception #5

“I have to get an X-ray and MRI to tell me what the problem is”

Among health care professionals, there is an overreliance of medical imaging for LBP. However, current research indicates that LBP does not correlate with the structural abnormalities that may be reported on an X-ray or MRI. Rather, imaging findings are often attributed to normal age-related changes, and are not necessarily the primary reason for LBP (Morgan et al., 2019).

Interestingly, some literature also report that degenerative changes are present in nearly 37% of 20 year olds, 66% of 50 year olds and 96% of 80 year olds of individuals who do not experience LBP, and who lead pain-free and active lives (Brinjikji et al., 2015).

Additionally, the outcome of medical imaging may often contribute to low back symptoms and prolong recovery. This is because it can contribute to psychosocial factors of pain, including catastrophic thoughts and beliefs, unhelp expectations, poor motivation, perceived disability which act as catalysts for chronicity, contributing to poorer recovery, prolonged disability (Synnott et al., 2015).

Misconception #6 

“Surgery is the only way to fix a ‘slipped’ disc”

Research suggests that over 85% of patients with acute lumbar herniated discs experience resolution of symptoms within 8-12 weeks (Dydyk, Massa & Mesfin, 2020), with a lot of literature suggesting that physiotherapy is effective in controlling disc herniation-related pain and help reduce and eliminate pain.

Image source: Pexels (4506109, 7218596, 4498158)

References:

Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173

Dydyk, A. M., Massa, R. N., & Mesfin, F. B. (2020). Disc Herniation. StatPearls [Internet].

Fatoye, F., Gebrye, T., & Odeyemi, I. (2019). Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatology international, 39(4), 619-626.

Morgan, T., Wu, J., Ovchinikova, L., Lindner, R., Blogg, S., & Moorin, R. (2019). A national intervention to reduce imaging for low back pain by general practitioners: a retrospective economic program evaluation using Medicare Benefits Schedule data. BMC health services research, 19(1), 1-10.

Synnott, A., O’Keeffe, M., Bunzli, S., Dankaerts, W., O’Sullivan, P., & O’Sullivan, K. (2015). Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review. Journal of Physiotherapy, 61(2), 68-76. doi: 10.1016/j.jphys.2015.02.016

Wertli, M. M., Eugster, R., Held, U., Steurer, J., Kofmehl, R., & Weiser, S. (2014). Catastrophizing—a prognostic factor for outcome in patients with low back pain: a systematic review. The Spine Journal, 14(11), 2639-2657.

Posture vs. Pain

Seemingly, there has always been much emphasis on our posture. But how important is it?

From early childhood, your parents may have encouraged you to “sit up straighter” or “stand taller”. In the work place (and especially amidst COVID-19 times) companies are providing ergonomic assessments for their employees, with the purpose of developing more posturally ideal work stations and desk set-ups. 

This postural focus in people’s day to day lives may have instilled a public perception of what ‘good’ posture is, and comparably, what the consequences are if you assume a ‘bad’ posture. As such, it is broadly reinforced that such ‘bad’ posture can lead to pain. 

But, does posture even matter? 

Amongst the literature, there is less of a correlation between posture and the frequency and/or intensity of pain compared to what is initially thought. For instance, one study explored the relationship between sitting posture and neck pain and/or headaches. The 1100 subjects were grouped into one of four postural categories, including upright, intermediate, slumped thoracic + forward head posture, and erect thoracic + forward head posture. It was revealed that people in pain don’t have different postures to those that aren’t in pain. 

Therefore, research would largely deny a link between posture being a primary cause for pain. An important reason for this being that pain is multifactorial, and that contributing factors such as stress and poor sleep for example, can increase muscle tension and cause discomfort. 

The biggest problem is not necessarily of posture (although there is a time and a place for posture to be specifically addressed), but rather of movement. Posture only matters if you are unable to move from that position, or are in a position e.g. sitting or standing for a prolonged period of time. 

Interestingly, the body has Acid Sensing Ion Channels which detect a change in the pH levels of the tissue. Prolonged static positioning may cause reduced blood flow, which may increase the acidity of the tissue. These channels sense this pH fluctuation, and can cause a sensation of discomfort or pain.

Therefore, it more important to understand that your next posture is your best posture!

So then, what is a ‘good’ posture. Currently, there is no agreed upon gold standard of the most optimal static posture in the literature. Individual variability is normal, and there is no one size fit all approach. One’s own best posture, is one where they are most relaxed, comfortable and pain-free.

By Lauren Kendall, Physiotherapist and Clinical Pilates Instructor

Physiological and biomechanical changes in the aging runner

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The New Year often brings resolutions to be more active. Runners who gather renewed resolve to hit the trail may register for an upcoming race to inspire their training. Statistics show that the age of those participating in races is increasing dramatically. From 1980 – 2000, the New York City Marathon showed an almost 200% increase in runners over the age of 40 years(1). When researchers drilled down into the specific age groups, they found that the over 60-year-old brackets quadrupled their participants during that time span(1).

 Researchers attribute the increase in numbers to two likely causes. The first is that aging runners chose to maintain a running program throughout their lifespan. The second reason being that some people decide to start running later in life. Either way, while research and resources typically focus on young elite athletes, the reality is that the runner coming to seek your services will likely be over 40.

 Physiology of aging

 As the body ages, it undergoes changes in function. One change anyone with an aerobic training background knows immediately is the decrease in maximal heart rate recommended during aerobic activity (220 – age = Max Heart Rate (MHR)).  This in turn lowers overall cardiac output (Heart Rate (HR) x stroke volume) and the body’s ability to take in and utilize oxygen during exercise (basic calculation for VO2max = 15.3 x (MHR/Resting HR). There’s no getting around it, aging decreases endurance. Not only that, the lower VO2 max associated with aging is a known risk factor for chronic diseases1. Therefore, running later in life is an effective strategy to decrease one’s risk of declining health due to age(1).

 Better with age

 Knowing that the aging process takes a toll on the cardiac system and therefore, endurance, how does one explain athletes who perform better as they age? The key may be their ability to maintain or improve their running economy. Running economy (RE) is the rate of oxygen consumed during sub maximal running(2).  Good RE requires less energy and therefore less oxygen. Unlike VO2max, age doesn’t seem to effect RE.

 For the aging athlete with less than optimal RE, perceived effort increases as VO2max decreases. Due to the rise in exertion required, runners may lower their training volume or intensity. With a drop in training stimulus, VO2max suffers a further decline. Therefore, the consequential easing off of training from having to work harder magnifies the changes already taking place in the cardiovascular system of the aging athlete.

 Holding back the years

 Though sparse, longitudinal studies of elite runners show that runners who train at more intense thresholds throughout their life span show less decrease in VO2max over time than those who’s training levels off or declines(1). Training to increase VO2max requires near maximal effort over a sustained period of several minutes. Repeated training allows adaptation of the cardiovascular system as it becomes more efficient. While nothing can turn back the clock, training, even in Master athletes, can improve VO2max and stall the effects of aging. Therefore, encourage older runners to train at volumes and intensities at the limits of their abilities.

 Reference

 1.Sports Med Arthrosc Rev. 2019 March;27(1):15-212.Sports Med. 2004;34(7):465-85

 

 

 

Lower back and pelvic pain during and after pregnancy

Roughly 50% of pregnant women suffer from lower back pain or posterior pelvic pain; this increases towards the end of the pregnancy and through the first year after giving birth. The most widely accepted explanation for this is that these areas provide the most compensation for the increase in weight in the abdomen.

This research study is a systematic review, meaning it incorporates a large number of existing studies to draw the most accurate conclusions. This includes unpublished theses, and studies not written in the English language.

Does osteopathy work for lower back and pelvic pain associated with pregnancy?

Osteopathy provides significant reduction of pain, and improvement in function, for lower back and pelvic pain associated with pregnancy.

The key findings were:

  • Osteopathic Manual Therapy (OMT) was significantly more effective than usual care alone, or no treatment.
  • There were no serious side effects of OMT. Tiredness after treatment was a minor side effect.

Techniques that fell under the umbrella of OMT included structural, visceral, and cranial techniques. Specifically, structural techniques were listed as soft tissue manipulation, stretching, joint mobilisation, muscle energy techniques, and spinal manipulation. It is important to note that these techniques were used along with the philosophies of osteopathy. They were not just applied locally to the lower back and pelvis, but holistically, wherever needed to improve the body as a whole.

The study recognised that there was a limited amount of high quality evidence, but that the papers analysed were still significant with regards to OMT. Evidence was low to moderate for the benefit of exercise for pain and function. There was also low quality evidence to support craniosacral therapy, use of a lumbopelvic belt, and acupuncture. Due to the low quality of the evidence, it was difficult to compare to osteopathic treatment. The authors suggested that further research on the topic should involve more long-term follow-up for better quality evidence.

In the discussion, the point is raised that although there is clear benefit of osteopathic treatment, the exact reasons why are unclear. The authors draw the hypothesis that, as manual techniques have repeatedly been shown to reduce pain sensitivity, that these mechanisms allow for better neuromuscular function and control. This leads to the patient beginning to feel better, improving pain beliefs, and and allowing for further pain reduction and benefits to function.

—Franke, H., Franke, J., Belz, S. and Fryer, G. (2017). Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. Journal of Bodywork and Movement Therapies, 21(4), pp.752-762.

WHAT NEW BACK PAIN RECOMMENDATIONS MEAN FOR YOU!

Ditch the pills. That’s what updated clinical guidelines[1] from the American College of Physicians revealed in early 2017. It’s so easy to head straight for the medicine cabinet when a twinge in your lower back has you howling, but a comprehensive review of randomized, controlled trials and systematic reviews on back pain relief is recommending clinicians encourage patients up nonpharmacological routes instead.

Why nonpharmacological treatments?

Regardless of treatment, most acute or subacute low back pain has actually been shown to diminish over time. The risks of popping over-the-counter pain relievers or even prescribed opiates far outweighs the risks of simply letting your back heal on its own.

Expediting the healing process, however, and obtaining relief from pain, enhancing your overall day-to-day functionality, and being able to return to work (if low back pain has prevented you) is possible with noninvasive practices. Surprising to some, the American College of Physicians first recommendation includes heat therapy, massage, acupuncture, and spinal manipulation. If medicinal aids truly are needed, skeletal muscle relaxants or nonsteroidal anti-inflammatories should be administered.

How do those treatments work?

Acute or subacute back pain is typically the result of overused, strained or inflamed muscles. Heat therapy is the simple application of hot packs, warm compress or heating pads to the affected area of your back (a warm bath counts too). Heat therapy helps relax swollen muscles, boost blood flow to the affected area, and eliminate lactic acid waste buildup which, in turn, relieves pain. Unless otherwise indicated by your doctor, heat should be applied for up to 20 minutes at a time, around three times a day.

Massage combines the power of tactile sense with targeted pressure, rubbing, and muscle manipulation to relieve low back pain. A 2011 study[2] found that participants who received one hour weekly massages over 10 weeks experienced low back pain reduction, a boost in functionality, and a reduction in the amount of anti-inflammatories they were taking. Massage therapy should be conducted by a trained and licensed therapist who knows the proper muscle groups to target and manipulate to alleviate back pain.

Acupuncture, while hotly debated at the turn of the century, has picked up steam as a short-term pain reliever for back pain sufferers. This ancient Chinese practiced involves super thin needles being inserted into the body’s skin and tissues at key points (meridians) which affect your body’s natural flow of energy (qi). Researchers believe the practice in fact stimulates a nervous system response which turns on opioid receptors and results in an analgesic effect.

Spinal manipulation which involves jolting and moving joints, massage, and applied pressure can help reduce inflammation, relieve pressure on joints, and improve nerve function. When used in combination with exercise, a 2015 randomized clinical trial[3] found that manual-thrust spinal manipulation reduced acute and subacute low back pain at up to 4 weeks of treatment.

What If My Back Pain is Chronic, Not Just Acute?

Treatment of chronic low back pain goes a step further with the ACP recommending more physical activity as treatment[4] – exercise, yoga, tai chi, multidisciplinary rehabilitation, motor control exercise, and progressive relaxation, for example. Regular physical fitness when completed daily for at least 30 minutes helps increase blood circulation, reduce muscle inflammation, loosen stiff joints, and boost feel-good endorphins.

Mindfulness activities including yoga practice and tai chi weave in meditation, deep breathing, and relaxation techniques to foster positive feelings of self-awareness and peace, also helping relieve stress and anxiety which might be amplifying back pain. Additional treatment incorporating spinal manipulation, biofeedback, and behavior therapy are also in the guidelines for treating chronic low back pain.

What Happens When None of Those Treatments Work?

Inadequate response to nonpharmacological treatments can be frustrating and stressful for both patient and treating clinician. With opioids having a high risk for abuse and addiction, the ACP recommends them as the last, last choice in treating chronic back pain.

Instead, NSAIDS (nonsteroidal anti-inflammatories) like aspirin and ibuprofen can be helpful pharmacological aids when taken in the directed doses. On a chemical level, NSAIDS actually block an enzyme in the body which produces compounds that lead to swelling and inflammation. Acetaminophen, commonly known in the US as Tylenol, is not an NSAID and is not recommended in efforts of reducing painful back muscle inflammation.

It is important to note that the updated guidelines do not address topical therapies (i.e. arnica or capsaicin cream), injection therapies, or the benefits of wearing a back brace for lower back pain. As pain is defined as electrical signals sent from your nerves to your brain, the noninvasive and nonmedicinal treatments that work for you may vary from those that work for the next patient. Treatment that works for you without creating unhealthy behaviors like overeating or not exercising, and with low risk to your organ health (i.e. your heart, brain, and kidneys) is always a good place to start.

LOW BACK RE-ALIGNMENT - HOW DOES IT WORK?

Low back pain (LBP) is such a common problem that if you haven’t suffered from it yet, you probably will eventually. Here are a few facts to consider:  1) LBP affects men and women equally; 2) It is most common between ages 30-50; 3) Sedentary (non-active) lifestyles contribute a lot to causation; 4) Too much or too little exercise can result in LBP; 5) A BMI around 25 is “ideal” for weight management, which helps prevent LBP; 6) Causes of LBP include lifestyle (activity level), genetics – including, but not limited to, weight and osteoarthritis; 7) Occupation; 8) Exercise habits, and the list can go on.

Let’s next look at how an adjustment is done.

When spinal manipulation is performed in the low-back region, the patient is often placed in a side lying position with the upper leg flexed towards the chest and the bottom leg kept straight. The bottom shoulder is pulled forwards and the upper shoulder is rotated backwards at the same time the low back area receives that the manipulation is rotated forwards. This produces a twisting type of motion that is well within the normal range of joint motion. When the adjustment is made, a “high velocity” (or quick), “low amplitude” (a short distance of movement) thrust is delivered often resulting in “cavitation” (the crack or, release of gases). So, WHY do we do this?

Most studies show that when there is back pain, there is inflammation. In fact, inflammation is found in most disease processes that occur both within and outside the musculoskeletal system. We know that when we control inflammation, pain usually subsides. That is why the use of “PRICE” (Protect, Rest, Ice, Compress, Elevate) works well for most muscle/joint painful conditions. We have also learned that IF we can avoid cortisone and non-steroidal drugs (like aspirin, ibuprofen, naproxen, etc.), tissues heal quicker and better, so these SHOULD BE AVOIDED! If you didn’t know that, check out:

MASSAGE ALONE IS NOT ALWAYS THE ANSWER

Often we get calls from people who are looking for a massage. When the receptionist queries their problem often the person is in pain and thinks that a massage will sort it out. The receptionist then explains that osteopaths do massage but they also look for the root cause of the problem.

What do I mean by this?

Often I see people who have back or neck issues which are persistent and some have had massage therapy which has helped but short term. The reason for this is that the spinal mechanics are altered. If the muscles in the back or neck become tight or spasm they will have an effect on the areas where they run to or from, namely the joints in the spine. Also if the joint becomes locked in position known as a “facet lock” this will cause the musculature around the area to contract.

In this situation the muscle is held tight, massage may give some temporary relief but if the joint is not released the tightness and pain will return. Therefore both the muscles and the affected joints need to be worked on in order to achieve total resolve.

So if you are suffering aches and pains then don’t delay and give us a call on 0871260384 and let us get you back on the road to recovery.

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HAVE you NOTICED A NEW buzz WORD IN HEALTH RECENTLY ? text neck

Children and teens are especially at risk for suffering symptoms of text neck.


Peter one of our Spine-health registered osteopaths, mentioned he is seeing more and more patients with this condition, so I asked him a few questions about this new spine health concern.

Below you’ll find my questions in bold, with his answers following.

What is text neck?

Text neck is the term used to describe the injuries and pain sustained from looking down at wireless devices for too long. The symptoms associated with text neck are:

I believe, as some studies suggest, text neck may lead to the early onset of arthritis and the potential for decreased lung capacity. Of course, text neck does not occur only from texting. For years, we've all looked down to read. The problem with texting is that it adds one more activity that causes us to look down more than in the past. This is especially concerning because young, growing children could possibly cause permanent damage to their spines as they grow.

How often do you see cases of text neck in your own practice?

Studies suggest that 79% of the population, ages 18-44, have their cell phones with them for 22 hours per day. Most of my clients fall in this age range, so I see several cases each day. Recently, a patient came in complaining of severe upper back pain. He woke up and was experiencing severe, acute, upper back muscle strain. I told him I believe the pain is due to the hours he was spending hunched over his cell phone: Diagnosis text neck.

How do you treat text neck?

Prevention is key. I instruct patients to hold their phones at eye level as much as possible. I also remind them to take breaks from their phones and laptops throughout the day. It is also important to practice good office ergonomics.

I also recommend a series of core exercises to help strengthen neck and back muscles. These exercises can help mitigate some of the effects text neck.

Finally, we come up with a comprehensive treatment plan which includes regular adjustments, massage therapy, and cold laser therapy.