Are you suffering from back pain? Sciatica? Not sure what to do? Read on.

Injuries come in many forms, but most can be rectified by osteopathic consultation, treatment, and appropriate patient care plans. Therefore, always seek medical attention whether that is with your local osteopaths here at Valerian Osteopathy, with physiotherapists or with chiropractors. You can also see your local GP, but this may take longer.

Why does my back hurt?

Common reasons why you have back pain are:

• Of musculoskeletal origin. What does this mean? This means pain that originates either from the joints of the spine and pelvis or from the muscles, ligaments and tendons surrounding those areas. These tend to be the most common and result from lifting things incorrectly, or they happen when we are doing normal everyday things like putting on socks and shoes, making the bed, picking up your baby and generally moving awkwardly that causes muscles to spasm, which can, in turn, affect your joints. You may have sustained injuries whilst at work (sometimes just from prolonged sitting at a desk), and after a road traffic accident. All of these and more, contribute to the reason you may be in pain.

• Arthritic conditions, which are still of a skeletal origin. Sometimes, as we age, our discs, joints, neck, hands and feet undergo ‘‘wear and tear’’, mostly from overuse, and repetitive strains gathered over the course of our lives which takes its toll on our bodies. When discs undergo wear and tear they sometimes lose their height. This means that the bony elements of our spines get a little closer together. When this happens, the cartilage wears down and brings joints closer together. The bone then can meat bone, causing friction, sometimes bony changes and unwanted arthritic pain. At this point, it is more likely to be diagnosed as osteoarthritis. This also happens in other joints in the body.

• Sciatica. There is often confusion related to what constitutes ‘‘sciatica’’. Sciatica relates to any pain, tingling, pins and needles, and weakness that manifests along the path of the sciatic nerve. What does this mean? Sciatica generally starts in your low back; this may be from an injury sustained that causes a disc to bulge, herniate, or prolapse and begin to press on pain-sensitive structures like your nerves. When this happens, you will feel pain, and sometimes that pain will travel into your buttocks, around the hip, into your thigh and can go past the knee into your lower leg and foot. Quite often, patients will feel it in their calf and into the foot, with feelings of a burning nature, gripping or cramp-like feeling with sensations of tingling, pins and needles in the foot. At this stage patients sometimes will feel less pain in the back but more in the leg. Other times, and generally due to being older in years, when the discs and joints have more wear and tear in them, the nerves can be compromised and cause the same issues. This is known as LATERAL STENOSIS (a narrowing of the area where the nerves exit the spine and travel into your legs). It is paramount that you get these issues seen to as quickly as possible. The longer you wait, the harder and longer it can be to heal quickly. So don’t wait.

  If your pain is so bad, your osteopath may refer you to your GP for medications like Naproxen (an anti-inflammatory drug) to take the edge off so you can move better and with less discomfort. It can take anything from 6-8 months to heal, but longer without any intervention. Here at Valerian Osteopathy, we have track records of getting you out of pain and moving better within 3 months, sometimes in less time. Surgery is usually a last resort, and is based on the inability to recover, or if there is muscle weakness that is not improving or getting worse. Don’t hesitate to book your appointment today. Links are on the website.

• Spondylolisthesis. This is where a certain vertebra in the spine (most commonly in the lumbar spine, the lower back) slips forward. This often occurs due to an over-extension injury, meaning when you may overarch the spine backwards, forcing the vertebra forward. It may put pressure on your nerves giving you low back pain, and sometimes pain in your leg/legs. If spondylolisthesis is suspected, our osteopaths conduct a thorough examination, we will treat if treatment is safe, and provide you with an appropriate exercise program to help reduce any discomfort you may be experiencing. Otherwise, we will refer you for more investigations by another medical professional.

• Cauda Equina Syndrome (CES). This is an acute neurological disorder of the lumbar spine, often resulting from an acute injury to the spine, causing compression of the spinal cord. Some of the symptoms that occur with this condition are urinary retention, and bowel or bladder dysfunction in relation to the back pain/injury sustained. The pain may radiate into your lower extremities with sensations or tingling, pins and needles, and weakness in the muscles of the back and limbs and you may also have a loss of sensation or a difference of feeling in the saddle area (typically noticed when wiping after a bowel movement). If these symptoms are noted, an IMMEDIATE referral to A&E for emergency imaging will be advised. If you note these symptoms at home, it is advised that you seek emergency medical attention right away.

• Cervical (neck) sprains/strains. These often result from whiplash injuries following a road traffic accident (RTA’s), or other traumatic injuries affecting the neck. These injuries can cause soft tissue damage to ligaments, muscles, tendons, intervertebral discs and other tissues surrounding the neck. Injuries like this can change the integrity of the curve of the neck, resulting in neck pain and sometimes headaches. Provided that no fracture of the neck is suspected, or found in X-rays or MRI scans, osteopathy can help relieve the pain and discomfort found in the neck and surrounding structures.

• Cervical (neck) facet joint syndrome (irritation of the joints of the neck). We see this a lot in the clinical setting. It can also happen in the lumbar spine and other areas of the spine. This can result from whiplash injuries (in more serious cases of whiplash the discs can be involved undergoing bulges, herniations causing pain and other sensations into your arm, forearm and fingers - more on this in another blog soon), osteoarthritis, repetitive stress, poor posture at work and in general. The muscles, ligaments and tendons surrounding the joints of the spine tend to become tight depending on your daily activities (or lack thereof), causing the joints to become tighter and subsequently causing irritation in the joints and at the point where muscles attach around them. These joints have pain referral patterns associated with the level of the neck affected. That pain can then refer to the shoulder, to the elbow, a little way down the back, under the armpit and into the head (known as cervicogenic headaches), There will be a blog on headaches soon. Osteopathy is great for relieving symptoms of neck pain alongside exercise therapy to help prevent future episodes as well.

How to prevent back pain

• Being more active and getting regular exercise is key. More and more these days sedentary occupations are taking over. More people are working from home and for longer hours.

• Trying to maintain a good weight will help prevent overloading on the spine.

• If you do work at a desk, try to get the set-up correct with desk ergonomics. You may have an occupational therapist within your company that can help with this.

• Rather than worrying too much about your posture, it is better to take regular breaks from sitting at the desk.

• We believe that if you need to warm up for certain exercises, then why do we not warm up for our work? So try to warm up before work so that you don’t start to work with cold and unprepared muscles.

• We all know we need to lift things properly, so it is best to keep this in mind before carrying out heavy lifting.

What Else Can You Do at the moment of injury?

In most cases, as mentioned in the beginning; it is advised to seek help sooner rather than later. Osteopathy is a great place to start. However, even before that, there is a lot you can do for yourself before that visit. We have devised a list below of things for you to try before you try to book that appointment.

1. Stay calm, and breathe. Coming back to the breath is so important. Breathe in for 4 seconds, and out for 8 seconds until you feel slightly calmer.

2. Try not to fear movement. Easier said than done. Depending on what you are feeling, it is important that you try some very basic movements of the spine, neck or other joints involved. This can highlight as well exactly where you feel the pain, but more importantly, it helps teach the spine that movement is still okay and ultimately aims to slow down any compensations that may result from the injury. The only time not to do this is if a fracture is suspected.

3. If you have an ice pack or hot water bottle handy, or someone is with you to help you, you can place that on the affected area to help settle some of the initial acute pain or tenderness. This will help you focus on what next to do.

4. Make that call to your local osteopath, chiropractor or physiotherapist. You may wish to call a GP, however, they are usually very busy and it may take longer than you would like.

Here is a great video showing a yoga sequence to help you with lower back pain. This was performed by our clinic director Aude Membribe. Let us know in the comments what you think.

The above list is a basic list to get you started. If you are worried as to what you may have done or injured, please get in touch with us at Valerian Osteopathy Ltd. We will do our best to ease any back pain or discomfort you may be experiencing. Provide you with quality rehab plans with home and lifestyle advice to speed up your recovery and get you back to your lives and loved ones.

Pictures taken from Getty Images & Vizniak.