active x backs https://www.active-x.co.uk Specialising in back pain and sciatica Thu, 25 Apr 2019 06:52:19 +0000 en-GB hourly 1 https://wordpress.org/?v=5.1.1 Back Pain Clinic Principle 5 – “It’s all connected” https://www.active-x.co.uk/back-pain-clinic-principle-5/ https://www.active-x.co.uk/back-pain-clinic-principle-5/#respond Thu, 25 Apr 2019 06:52:19 +0000 https://www.active-x.co.uk/?p=10399 Back Pain Clinic Principle 5 - "It's all connected" This may seem a bit like that old children's song "the knee bone's connected to the hip bone" etc. Of course it's all connected.  But sometimes things are connected in ways that aren't immediately obvious. A case study... I had seen Iona (not her real [...]

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Back Pain Clinic Principle 5 – “It’s all connected”

This may seem a bit like that old children’s song “the knee bone’s connected to the hip bone” etc. Of course it’s all connected.  But sometimes things are connected in ways that aren’t immediately obvious.

A case study…

I had seen Iona (not her real name) a middle aged woman with recurrent sciatica occasionally over a period of 5 years.  Her pain had always resolved quickly with appropriate sciatica treatment.  She wasn’t very good at following my advice and I had thought this was why it kept recurring.  There were no other symptoms, but a quick check of her lower limbs revealed that the arch of her foot on that side had collapsed.  She also had a bunion on the opposite foot which made walking painful at times.

Although her sciatic pain was aggravated most by sitting, it could also become more sore after walking more than a mile.

We fixed her up with exercises to strengthen the muscles supporting the arch of her foot.  And gave her an arch support to wear.  I also mobilised the opposite foot, aiming to improve the function of the foot generally.  That’s 2 years ago now, and her sciatic pain has never come back.

How does Back Pain Clinic Principle 5 work?

Your body is constantly adapting to its environment.  That includes the internal environment. If there’s a problem in one bit, your Central Nervous System will know about it.  It may not bring it to your conscious attention.  After all, you’ve got important things to do.  If your subconscious mind can orchestrate things without interrupting you it probably will.  Many things happen reflexively…  Not even reaching the brain, but being automatically processed by the spinal cord.

And remember of course that you really are completely connected at a physical/mechanical level.  Iona’s collapsed arch caused her knee to knock in a little. This led to more tightness in the muscles on the outside of her hip.  These pulled on muscles in the lower back causing them to tense up.  Which ultimately led to strain on the joints and the resulting “non-nerve compression sciatica“.

Of course this connectedness can make things complicated.  It’s not always obvious why you have developed a pain.  As an author of two books on lower back pain, and an osteopath in Edinburgh for nearly 30 years, I have seen thousands of people whose pain did not have an obvious initial cause.  This is often because everything’s connected, and due to the effects of cumulative loading.

Help is at hand

If you’d like help unravelling the mysteries of your own back pain or sciatica, you can book an osteopathy appointment online, or just give Andreea or Paula a ring to arrange to see one of our Edinburgh osteopaths.

Here’s a link to Principle 4

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Back pain clinic for golfers – banish pain and swing free! https://www.active-x.co.uk/back-pain-clinic-golf/ https://www.active-x.co.uk/back-pain-clinic-golf/#respond Wed, 17 Apr 2019 10:23:01 +0000 https://www.active-x.co.uk/?p=10343 Back pain clinic for golfers What would the ideal back pain clinic for golfers be like?  It would be staffed by people who understand three things: golf, backs, and pain. A clinic staffed by people that understand golf I had my first set of lessons from Bill Bennett at Schawpark Golf Club outside Alloa [...]

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Back pain clinic for golfers

What would the ideal back pain clinic for golfers be like?  It would be staffed by people who understand three things: golf, backs, and pain.

A clinic staffed by people that understand golf

I had my first set of lessons from Bill Bennett at Schawpark Golf Club outside Alloa in 1977.  Although I have never been a great golfer (too many children spread over too many years), I enjoy golf.  I understand your obsession.  I understand the rules, I love the etiquette.  And I understand the demands golf puts on your back. I don’t know if there’s a single pro-golfer who hasn’t experienced back pain.  If you play a lot of golf, that amounts to a repetitive strain on your back.  But not any old strain.  A strain pattern that’s particular to golf.  There is a pattern which can be seen in most golfers with sore backs.

A clinic that understand backs

Backs are our business.  I myself have studied how backs – and the rest of the body – work for 30 years now.

A back pain clinic for golfers that understands pain

I’ve been an osteopath in Edinburgh for 27 years.  Back in 1997 my first book on lower back pain was published.  Gavin Hastings OBE is in all the pictures.  He’s more photogenic than me (and a bit better known).  And he’s a much better golfer than me.  During my Masters Degree in Pain Management I focused on lower back pain during my dissertation.  Following the Masters I wrote another book on low back pain which was published in 2017.  It’s a major upgrade on the first.  A lot had changed in the treatment and management of back pain in the intervening 20 years.  Here’s a video of Ian Rankin OBE interviewing me at the launch of the book at the Sheraton Hotel in Edinburgh.

Aside from understanding golf, backs, and pain, it’s important to recognise that it’s not just your golf that may be affecting your back.  There are usually a number of contributing factors.  And of course, we can work out what your specific risk factors are for back pain.  Then we work out an exercise program designed to initially relieve your back pain.  And then follow that up with a program to strengthen your back to thrive on the golf course.  Manual therapy will help you to progress faster, but it won’t cure you in itself.  Remember, it wasn’t a lack of treatment that caused your back pain.  So treatment alone isn’t going to prevent it from recurring.

A back pain clinic with a lot of experience of treating golfers

We’ve treated a lot of golfers all ready.  Not just hundreds, but thousands.  We’ve been in business since 1993, and we’ve always had a focus on sport.  Rugby, golf and cycling are the main ones.

The clinic should be accessible

The ideal back pain clinic for golfers is 5 minutes from Haymarket railway station, in the heart of Edinburgh’s West End.

If you’d like to book an appointment with an osteopath specialising in back pain and golfers, you can book an osteopathy appointment online, or just call Andreea or Paula and they can arrange it for you. Why suffer?  Let’s banish that pain and get back to swinging freely.

How do we work?

We aim to relieve and prevent lower back pain and sciatica in golfers – here’s how we do it.

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Prevent lower back pain golfing? Is that possible? https://www.active-x.co.uk/prevent-low-back-pain-golfing/ https://www.active-x.co.uk/prevent-low-back-pain-golfing/#respond Wed, 17 Apr 2019 10:17:30 +0000 https://www.active-x.co.uk/?p=10350 Prevent lower back pain golfing?  Is that possible? Would you like to prevent lower back pain golfing? If you're like 28% of the golfing population and suffer low back pain after every round, you might think it sounds a tall order.  It might be.  It depends on 2 things.  How long you've had low [...]

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Prevent lower back pain golfing?  Is that possible?

Would you like to prevent lower back pain golfing? If you’re like 28% of the golfing population and suffer low back pain after every round, you might think it sounds a tall order.  It might be.  It depends on 2 things.  How long you’ve had low back pain.  And how much effort you’re willing to put into solving it.  Practising osteopathy in Edinburgh for 27 years, I’ve met a lot of golfers.  And so, I have a lot of experience of golfers with back pain.

Your ability to prevent lower back pain golfing depends how long you’ve had it

If you’ve only had it for a couple of weeks, this will be a lot easier than if you’ve had it for years.  Why?  Because your nervous system has a nasty habit of learning things.  It learns movement patterns, which is great if those are good movement patterns.  Not so good if they’re bad ones. It also learns pain.  The longer you’ve had pain, the more likely it is that you’ve developed something called Central sensitization.  This is where you Central Nervous System becomes overly sensitive and generates continued pain, even in the absence of injury.  Chronic pain is widely regarded as pain that lasts beyond its usefulness.

Your swing is something you’ve learned and has become automatic.  Overcoming that is difficult.  It’s possible that if you’re used to pain during or after playing, you may have learned that too.  But don’t worry, just as you can change your swing, so you can prevent lower back pain golfing.

Preventing lower back pain golfing also depends on how much effort you put in

I often say to golfers that “This is 80% your effort and 20% mine.”  It’s important to understand that osteopaths do not fix backs.  You fix your own back.  And you make it stronger. And your actions determine whether you re-injure it or not. I know we’d all like someone else to do the work for us.  But it just doesn’t work that way.  Take it from me… It was only when I started following my own advice that I solved my own recurring Lumbar 4/5 disc herniation. Many osteopaths and one chiropractor had tried.  But treatment doesn’t fix, it just helps. And the best clinicians are teachers (note the original derivation of the word “doctor” is from the Latin docere = to teach).

If you put in the work, you will reap the benefits.  If you cover up the pain with painkillers and try to battle on, you will probably never improve. Remember, the purpose of pain is a biological alarm system.  Covering it up just makes it more sensitive.

How to do it

Accept full responsibility

Your back pain / sciatica is your problem.  It’s not mine.  As an osteopath, I’m very keen to help you, but ultimately if you want to get better and stay better, you have to commit. Remember that 60% of lower back pains recur within a year.  That’s because people don’t change what they do.  If you want a different result, you have to do different things.

Stop making it worse

The first thing is to find the things that make your back pain worse.  Then stop doing them (unfortunately this may include golf).  At least for now.  You need to give your lower back time to heal and to become less sensitive.  To put it bluntly… If you want your back to get better, stop doing things that make it worse! Don’t worry, this isn’t forever.

Move more, hurt less

I’m not saying “Do nothing“.  Far from it.  You should do as much movement as possible that doesn’t make your pain any worse.  This is summed up by our number 1 rule: “Use it or lose it, but Don’t abuse it.”  Movement is really important to bring fresh oxygenated blood into the area.  Without movement, inflammation builds up and muscles weaken.  You’ll be more stiff after inactivity, and probably more sore too.  So don’t do nothing.

On the other hand, as noted above, avoid things that increase your pain.   If you’re aggravating it, it’s not going to get better.

Moving more may mean walking, dancing, swimming, yoga, etc.  Basically any movement that does NOT increase your pain is a good thing.

Follow a tailor-made rehab program

This may include some hands-on treatment, but that may not be necessary.  What is certainly necessary is being sure what you are aiming for.  Is it 18 pain-free holes once a week, twice a week, four times a week?  Whatever your goal is, we need to be clear about it from the beginning.  We always ask people what their goal is.  Without clarity on this issue, you may manage to get pain-free for a little while.  But if we don’t know what you need your back to be able to do, we won’t prepare it for that.  So get clear on your aims.

You also need to know where you’re starting from. What do I mean by this?  It’s worth quantifying how much pain-free movement you have in different directions.  It’s also worth noting which movements hurt and which don’t.  This may not be immediately obvious, due to delayed pain.  But don’t worry, we can help you work this out.  Part of the approach we take is to determine whether your back dislikes bending forwards or backwards.  Or, perhaps it makes no difference.  Of the last 800+ low back pain people we’ve seen, 72% are worse for sitting and bending forwards.  Knowing this informs which exercises we prescribe as well as which movements to avoid.

You may need to alter your daily movement patterns and postures.  You may need to alter your golf swing… I know, nightmare!  As you know, there are a lot of moving parts in a golf swing. Understanding how the whole swing is impacting your back, and how it is aggravating your pain is part of the art of what we do.

What do we do?

Check out what a back pain clinic for golfers could be like, by clicking the link.  And if you’d like to arrange to see an osteopath specialising in how to prevent lower back pain and sciatica in golfers, you can book an osteopathy for golfers appointment online.

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Lower Back Pain with Nausea – Causes and Treatment https://www.active-x.co.uk/lower-back-pain-nausea-causes-treatment/ https://www.active-x.co.uk/lower-back-pain-nausea-causes-treatment/#respond Wed, 17 Apr 2019 08:54:40 +0000 https://www.active-x.co.uk/?p=10381 Lower Back Pain with Nausea - Causes and Treatment Just last month I saw a lady who had been suffering the combination of lower back pain nausea and fatigue for about 6 weeks.  Sudden back pain and nausea is relatively common.  But to have this combination for so long isn't normal.  What was going [...]

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Lower Back Pain with Nausea – Causes and Treatment

Just last month I saw a lady who had been suffering the combination of lower back pain nausea and fatigue for about 6 weeks.  Sudden back pain and nausea is relatively common.  But to have this combination for so long isn’t normal.  What was going on?  For an Edinburgh osteopath for 27 years, the search was on…

Lower back pain with nausea – causes

There are three possibilities to consider.

  1. The lower back pain and nausea could have separate causes; they may have just happened to start around the same time.
  2. They could have a common cause.
  3. Or the pain could cause the nausea.

Separate causes

Lower back pain has many possible causes and I’ve written a lot about this topic.  Nausea can also have a number of causes… Infection, some medications, early stages of pregnancy, alcohol consumption, intense pain, emotional stress, some cancers, gall bladder disease, inner ear problems to name a few.

Common cause

Could some of the above be causes of lower back pain AND nausea?   Yes.  It’s possible to have infections that cause lower back pain. Early stage pregnancy – especially where the fetus has implanted in the wrong place – can cause lower back pain and nausea. Cancers affecting the abdomen and lower back can cause nausea and lower back pain. Gall bladder disease tends to cause mid back pain and nausea, rather than lower back (and can refer pain to the tip of the right shoulder).

Lower Back Pain causing nausea

As listed above, pain can certainly cause nausea.  Quite commonly a sudden onset of severe pain can cause nausea.  This is mediated by the Sympathetic nervous system.  If you are in pain, the fear/flight/fight mode kicks in.  Your body may determine that it’s helpful to eject the contents of the stomach.  To lighten the load so that you can run faster.  Also to ensure that none of your precious energy is spent digesting food.  All energy is needed for running away.

Lower back pain with nausea – treatment

It’s vitally important to treat the cause and not just the symptom.  Prolonged symptoms of lower back pain and nausea – such as this lady had – require further investigation.  The fact that she had fatigue also could be relevant, but could be irrelevant.  Long-lasting pain is very tiring.  Fatigue is so common, it’s difficult to pin down cause and effect.

You can treat the nausea with anti-nausea medication called antiemetics (“emesis” means being sick).  Ginger is also meant to be good for nausea.

Lower back pain can be relieved in a number of ways, best summed up by my number 1 rule “Use it or lose it, but don’t abuse it.”  Medication is an option for relief.  But as Edinburgh osteopaths we add most value by looking at the risk factors and reducing those in order to prevent recurrence. If you’d like a brief overview of how to recover quickly from lower back pain, check out this article.

Lower back pain with nausea – causes and treatment summary

Establish the cause first.  The treatment will then follow.

Although the woman answered “no” to all our other questions designed to detect disease processes, my gut was telling me she was unwell.  That this wasn’t another case of mechanical back pain. This combined with the long period of nausea and fatigue indicated it was appropriate to seek more information and reassurance for her and me.  Unfortunately we discovered she had a cancerous tumour in her large intestine which was almost certainly causing her symptoms of lower back pain with nausea i.e. a common cause.  She is now undergoing appropriate treatment.

If you would like help with your back pain, just book an osteopathy appointment online and judge for yourself whether we are the best osteopaths in Edinburgh.  😉

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Back Pain Clinic Principle 4 – “Movement is life” https://www.active-x.co.uk/back-pain-clinic-principle-4/ https://www.active-x.co.uk/back-pain-clinic-principle-4/#respond Tue, 16 Apr 2019 21:05:17 +0000 https://www.active-x.co.uk/?p=10373 Back Pain Clinic Principle 4 - "Movement is life" A case study... I'm reminded of a woman I went to see in her home about 25 years ago.  I'd been an osteopath in Edinburgh for only 2 years then.  She had severe lower back pain with pain down the front of her thigh as [...]

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Back Pain Clinic Principle 4 – “Movement is life”

A case study…

I’m reminded of a woman I went to see in her home about 25 years ago.  I’d been an osteopath in Edinburgh for only 2 years then.  She had severe lower back pain with pain down the front of her thigh as far as her knee (sciatica goes down the back of your thigh, not the front). She had been in her bed due to the pain for 4 weeks.  Only leaving her bed to use the portable toilet next to her bed.  Actually that isn’t entirely true.  She had been her bed because a consultant Orthopaedic surgeon at the local private hospital had recommended this course of action. Or should I say inaction.

Prior to that she’d been struggling on. Since taking to her bed she had lost her appetite, lost some weight, lost all zest for life and become constipated, dependent on laxatives and depressed.  Her pain had also increased, along with the increasing amounts and varieties of medication she was on.

What advice to offer her?

What to do?  It was simple.  I asked her husband and son to move a single bed into the living room on the ground floor.  I helped her to see that total rest was in fact making her pain worse.  And that if she carried on in this way it seemed unlikely that she would recover any sort of normal life.  She was only 61 years old. I also encouraged her to do some very minimal movements.  Movements that didn’t hurt.  Initially that was very little, just moving her legs up and down in the bed.  I also encouraged her to start contracting and relaxing her pelvic floor muscles (which activated her abdominal muscles a little too).  She committed to get out of bed and walk around the room with a walking stick at least every hour.

I called her after 4 days.  She reported that although she still couldn’t sit due to the pain, she was feeling 50% better and was exceptionally grateful for all that I’d done.  I pointed out to her that as she’d been in so much pain I had done nothing to her.  I had merely helped her to see that she needed to move.

How does Back Pain Clinic Principle 4 work?

Remember from Principle 3 that your body can heal itself.  However, to heal itself it needs certain conditions.  It needs adequate nutrition, and rest and movement. The first two may be obvious, but the third is just as important.  Without movement any inflammation that is present tends to build up.  This is often why your pain is worse first thing in the morning… Lack of movement leads to an increase in swelling locally. Movement brings fresh blood into the area and washes out the old venous blood and lymph fluid, taking with it the inflammatory fluid.  This fresh blood and tissue fluid is full of nutrients – oxygen, glucose, hormones and other chemicals essential to healing.

Without movement your muscles weaken and waste very quickly.  This probably accounted for the lady’s weight loss.  She was actually losing muscle mass due to lack of stimulation and demands.  Even if your pain does lessen, the loss of muscle mass and conditioning significantly increases the risk you’ll have another bout of back pain within 12 months.

Movement is absolutely vital to good mood too.  If you want to feel depressed, try lying around in your bed for days.  On your own. Depression increases your perception of pain.  That’s no help is it?

Summary

Remember my Number 1 rule (not the same as Principle No. 1)?   “Use it or lose it, but don’t abuse it“.  The use it or lose it bit is all about the importance of maintaining movement in order that you don’t ultimately lose capacity.  The movements that you can do without aggravating your pain may seem small and insignificant.  But I promise you, they are worth doing.  Any movement that doesn’t hurt is worth doing.  You will heal more quickly and more fully if you adopt this approach.

If you’d like tailored help in-person or via skype consultation, or to see “an osteopath near me“,  book an appointment with an Edinburgh osteopath. Or call us on 0131 221 1415 to arrange to see one of the team.

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Back pain caused by anxiety – is it possible? https://www.active-x.co.uk/back-pain-anxiety/ https://www.active-x.co.uk/back-pain-anxiety/#respond Wed, 10 Apr 2019 12:58:39 +0000 https://www.active-x.co.uk/?p=10325 Back pain caused by anxiety - is it possible? Yes, it's possible.  As an osteopath in Edinburgh for 27 years now, I have seen many people who have had back pain caused by anxiety.  Before I explain fully, let's just deal with "anxiety". What is anxiety? Anxiety is a persistent/recurring unease often without an [...]

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Back pain caused by anxiety – is it possible?

Yes, it’s possible.  As an osteopath in Edinburgh for 27 years now, I have seen many people who have had back pain caused by anxiety.  Before I explain fully, let’s just deal with “anxiety”.

What is anxiety?

Anxiety is a persistent/recurring unease often without an apparent cause.  This is different to stress.  In stress it’s obvious what the causes are.  And feeling stressed goes up and down as the stressors go up and down.   Some people are prone to anxiety.  It’s been said that anxiety is worrying about the future.  As opposed to depression which is worrying about the past.

Back pain caused by anxiety – what’s the evidence?

You can read in the scientific literature that people who have a history of anxiety more often experience back pain (and other pains).  This is true for depression too.

Isn’t it that anxiety is caused by back pain?

There’s no doubt that if you have recurring back pain you may become anxious.  How is that?  Because repeated sudden onsets of back pain are particularly likely to make you worried about future episodes.  However, coming back to the science… Long-term prospective studies have shown that people who have pre-existing anxiety are more likely to develop long-term back pain. (A prospective study is one that asks a group of people questions at the beginning.  Then it follows up – often over a number of years – and asks them the same questions to see what’s changed. And how different people at the beginning differ at the end).

So how is back pain caused by anxiety?

Remember the purpose of pain?  It’s an alarm system.  The centres in your mid and hind brain that are involved in pain have huge overlap with the mood parts of your brain.  Anxiety – like stress – can act as a volume control on your pain.  I’ve written about this many times before.  But this is not the same as saying “It’s all in your head”.  No, I’m simply saying that your head does influence how much pain you experience.  It might seem like a stupid thing to say, but it’s true to say “no brain, no pain.”  Essentially, if your alarm system is on alert, you are more likely to experience more pain.

Is this true causation?

So, am I really saying that you can experience back pain caused by anxiety, and only by anxiety?  I think that’s unlikely.  It’s more likely that you have had a physical problem with your back that has initiated the problem.  But a future episode or episodes of back pain could be entirely triggered by anxiety.  Rather than by some physical event. I hope that makes sense…

If you’d like to consult an Edinburgh osteopath specialising in back pain, via Skype or in-person, you can book an osteopath appointment online.

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Back Pain Clinic Principle 3 – “The body can heal itself” https://www.active-x.co.uk/back-pain-clinic-principle-three/ https://www.active-x.co.uk/back-pain-clinic-principle-three/#respond Mon, 08 Apr 2019 21:07:04 +0000 https://www.active-x.co.uk/?p=10308 Back Pain Clinic Principle 3 - "The body can heal itself" The technical term is "homeostasis".  The body will attempt to return to its normal healthy state. As an Osteopath in Edinburgh for the last 27 years, I've spent most of my time helping people's bodies to establish their homeostatic normal.  This principle is [...]

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Back Pain Clinic Principle 3 – “The body can heal itself”

The technical term is “homeostasis“.  The body will attempt to return to its normal healthy state. As an Osteopath in Edinburgh for the last 27 years, I’ve spent most of my time helping people’s bodies to establish their homeostatic normal.  This principle is one of the original founding principles of osteopathy – the body is capable of self-regulation and self-healing.

How does Back Pain Clinic Principle 3 work?

Your body has many many feedback loops in it.

First it has cells that are specially adapted to sensing very specific things.  Like damage, or high temperatures, or cold, or physical pressure.  These are sensory systems.

Then it has communications systems.  Like your nervous system, your hormonal system and your circulatory system.

And of course it has systems for changing the internal or external environment in response to the messages carried in those communications systems. We call these the “effectors”, because they effect changes.  As the environment changes, the sensing parts detect, this which then continues the feedback loop.

Back Pain Clinic Principle 3 in detail

Sensory systems

Perhaps the most relevant part of your sensory systems are nociceptors.  Nociceptors are little nerve endings distributed throughout your body that respond to noxious input. They are what a lot of people refer to as pain nerve endings.  However, if we were being neurologically precise, there are no such things as “pain nerves”.  They are nociceptors.  These nerves fire when the nociceptor endings are exposed to certain inputs.  This can be high temperature or very low temperature.  Or extreme pressures – like when someone squeezes you hard or punches you. They can also fire in response to changes in concentrations of some chemicals. Inflammation and its very early chemicals (which are released as soon as tissue is damaged) can stimulate nociceptors to fire.

Communications systems

Nociceptors feed into your spinal cord and then your brain.  The activity of these pathways feed forward to affect the Effector systems.  Your circulatory system and hormonal system are widespread communication systems.  Of course, all of these communications systems communicate with one another too.

Effector systems

Internal effectors can be found in your immune system.  It has cells that scavenge dead or damaged cells (e.g. macrophages).  There are other cells that are responsible for laying down new tissue of almost every type.  So if you have damaged muscle, there are myoblasts that make new muscle cells.  There are fibrocytes that lay down new collagen which is a big part of cartilage.  You also have osteoblasts that lay down new bone, and chondroblasts that lay down other parts of your cartliage. All of these processes continue throughout life so long as you have sufficient nutrition and are not chronically stressed.

External effectors include muscles.  When you experience pain some muscles prepare for flight.  This is to remove you from the source of threat.  Note that if you don’t get away from the threat (and the painful thing), your stress levels climb which heightens your pain perception.

Summary

So you have the ability to heal yourself of most traumas.  This is not the same as saying you can return to your pre-injury state.  You can recover from injury, but things are likely to be subtly different depending on what you damaged. If you cut your finger moderately deeply, you can see the scar many years later.  It’s subtly different.  If you prolapse a disc, it is visible that this damage has occurred years after the pain has resolved. But yes, so long as you don’t “get in the way”, your body can recover from most damage.

Don’t get in the way – “Don’t pick the scab”

The most likely reason for not healing is that you are doing things that prevent or dramatically slow-up healing processes. If you’ve had a recent injury your best guide is pain.  If it hurts, don’t do it.  What I have seen a lot of with lumbar disc prolapses and sciatica treatment is that people are doing things that prevent the disc from healing fully.  They do too much too soon. This is akin to “picking the scab” before it has dropped off.  “Don’t pick the scab” you will hear me say.  Give your body time to heal.  And the best over-all rule to guide you is my “Use it or lose it, but don’t abuse it” rule.

If you’d like tailored help in-person or via skype consultation, or to see “an osteopath near me“,  book an appointment with an Edinburgh osteopath. Or call us on 0131 221 1415 to arrange to see one of the team.

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Back Pain Clinic Principle 1 – “Pain is a warning system” https://www.active-x.co.uk/back-pain-clinic-principle-one/ https://www.active-x.co.uk/back-pain-clinic-principle-one/#respond Thu, 04 Apr 2019 11:19:32 +0000 https://www.active-x.co.uk/?p=10299 Back Pain Clinic Principle 1 - "Pain is a warning system" This is the first of our principles.  The first few are pretty health/medically orientated.  The last 2 less so. I believe they are all very important, otherwise I wouldn't publish them on our Active X Backs Homepage.  I've been an Edinburgh Osteopath for [...]

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Back Pain Clinic Principle 1 – “Pain is a warning system”

This is the first of our principles.  The first few are pretty health/medically orientated.  The last 2 less so. I believe they are all very important, otherwise I wouldn’t publish them on our Active X Backs Homepage.  I’ve been an Edinburgh Osteopath for 27 years now.  And for at least the first half of those I didn’t think very hard about our operating principles.  Of course, I did have some, but I didn’t explicitly articulate them.  I think it’s really helpful to be transparent about how we approach things and how we make decisions.

We are all confronted with many many decisions to make every day.  And as clinicians specialising in back pain and sciatica treatment, the Active X Backs team are constantly reaching conclusions and making decisions.  Without a reference framework to measure things against, we would be like virgins every day we came to work.

So what about Back Pain Clinic Principle 1?

“Pain is a warning system”.  Think about it… If you put your hand on something very hot and it wasn’t painful, you might just leave it there.  Eventually the smell of burning flesh might encourage you to remove it, but by then the damage is severe.  This is because the evolutionary and biological purpose of pain is to protect us.

So when you first get back pain or sciatica, this is your body’s way of alerting you to danger. And the body’s pretty smart too.  It will often warn you before you’ve actually incurred any damage. This could be why your back spasms.  It’s a warning.  “Don’t go there Betty.  Don’t do that.  Be careful.”

What if you ignore pain?

That would be really silly. If the fire alarm bell rings at work, would you ignore it?  Would you just turn it off and not bother to find out why it was ringing (taking painkillers)?  I’d recommend you investigate why you have pain, and deal with the cause, rather than treating the symptom.

What about chronic pain?

If you have pain for more than 12 weeks, this is classified as chronic pain. Around this time it’s likely your pain has outlived its usefulness.  And it’s now likely that 1 or both of the below have happened:

  1. You’ve continued to do things which are actually preventing healing from progressing, meaning you’re stuck in the inflammatory stage of healing.
  2. Your spinal cord and brain have become sensitised.  This is called central sensitisation and is all-too common. Essentially your nervous system can learn pain.

I’m not going to explore this further here.  This post is simply meant to be a place to elaborate on our first principle.

Is there more coming?  What about Principle 2?

All of our principles are listed on the Active X Backs homepage.  And more detail on each one will follow in subsequent blogs.  Here’s the second one if you want to skip straight to the detail.

Meantime, if you’d like to see how we can help you with back pain or sciatica treatment, or to see an “osteopath near me“, just book an appointment with an osteopath.

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Back Pain Clinic Principle 2 – “You become what you do” https://www.active-x.co.uk/back-pain-clinic-principle-two/ https://www.active-x.co.uk/back-pain-clinic-principle-two/#respond Thu, 04 Apr 2019 07:37:23 +0000 https://www.active-x.co.uk/?p=10275 Back pain clinic Principle 2 - "You become what you do" There may be a more eloquent way of saying this.  And others have certainly said similar things in the past.  As an Edinburgh osteopath and Chief Back Officer I am not claiming to break new ground with our principles.  I'm simply stating them [...]

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Back pain clinic Principle 2 – “You become what you do”

There may be a more eloquent way of saying this.  And others have certainly said similar things in the past.  As an Edinburgh osteopath and Chief Back Officer I am not claiming to break new ground with our principles.  I’m simply stating them clearly so that we – the Active X Backs team – and you understand what guides us.  They are our operating principles.

Why do we have principles?

Having a framework to work to helps when you/we have to make a decision.  We all make many decisions every day.  If you don’t have established reference points to guide you, every decision has to be made as though you are the first to come across this problem. And as though you are the first person to have to make this decision.  It’s unlikely that either of these is the case.  Having principles makes life easier for an osteopath (and for you I’ll bet).  We tend to crave consistency in ourselves and very definitely in others.

One day you ask me why I am giving you a particular exercise to do, and I explain that to you.  What if the next week I give you a very different exercise and you ask me why again.  The answer this time is entirely at odds with the answer the first time you asked.  You will find this unnerving and are less likely to trust me.  Principles help us to remain consistent in our approach and actions, and consistency breeds trust.

We have principles in order to keep us on a straight path and so that you will find us worthy of your trust.

What about back pain clinic Principle 2 – “You become what you do”

Watch a toddler bend over to lift something heavy.  It is a work of art.  They move easily, and naturally bend and lift as any seasoned power-lifter would be proud to do. Send them to school for just two years and that same child will no longer bend and move as easily.  They have been moulded by sitting in a chair for 20+ hours each week.

In a work environment, if you sit on your bottom for 8 hours a day, 5 days a week and move around very little you will change shape.  Your bottom will become flatter due to loss of gluteal muscle mass.  Your hamstrings and hip flexors will tighten and shorten.  At the front, your abdomen will start to sag as your belly muscles lose conditioning.  You will become well-adapted for sitting in your chair.  But not much use for other things.  Your physical activities (and lack of them) have moulded you into what you are now.

What’s the science behind back pain clinic Principle 2?

The word is “mechanotransduction“. Look it up. Essentially, your cells will respond to the forces exerted upon them.  More forces will result in more tissue being created.  Whether that be more muscle, bone, cartilage or whatever.  Although there has to be sufficient rest periods from those forces.  It’s during the rest times that the tissue grows stronger.  This is where our 1st rule “Use it or Lose it, But Don’t Abuse it” also comes from.  If you don’t use it, the tissue will weaken. This leads to a loss of capacity.  You don’t just become what you do.  You also lose the ability to do that which you avoid.

Is there more coming?  What about Principle 3?

All of our principles are listed on the Active X Backs homepage.  More detail on each one will follow in subsequent blogs.

Meantime, if you’d like to see how we can help you with back pain or sciatica treatment, or to see an “osteopath near me“, just book an appointment with an osteopath.

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Is the pain in my buttock sciatica? (AKA butt pain) https://www.active-x.co.uk/pain-buttock-sciatica/ https://www.active-x.co.uk/pain-buttock-sciatica/#respond Wed, 03 Apr 2019 05:18:11 +0000 https://www.active-x.co.uk/?p=10261 "Is the pain in my buttock sciatica?" As an Edinburgh osteopath, and a past sufferer of sciatica, I can give you a pretty good answer. But let's clear up the obvious first... Where is my buttock (AKA the butt)? Your buttock is the area between your lower back and the back of the upper [...]

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Is the pain in my buttock sciatica?” As an Edinburgh osteopath, and a past sufferer of sciatica, I can give you a pretty good answer. But let’s clear up the obvious first…

Where is my buttock (AKA the butt)?

Your buttock is the area between your lower back and the back of the upper thigh.  In anatomical terms, it’s the bit between your iliac crest (top of the hip bone) and the crease at the bottom of your bottom. It’s predominantly made up of your your gluteal muscles, and fat.

What is sciatica?

I’ve gone over this many times before. But here it is again.  Sciatica is a description and not a diagnosis.  It describes pain and/or pins and needles in the distribution of your sciatic nerve.  The sciatic nerve doesn’t directly supply sensation to the skin.  But it does through the “terminal branches” that come from it.  And these are the superior gluteal nerve, the inferior gluteal nerve, the sural nerve, deep fibular nerve, superficial fibular nerve and the medical calcaneal branches of the tibial nerve.

What is pain?

It’s amazing I haven’t written more on this topic.  It’s covered heavily in my latest book for lower back pain sufferers.  And there’s a lot on it in our online course for lower back pain and sciatica.  So, the text-book definition of pain is “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”  Anyone who works in the field of pain agrees that this is currently the most useful definition.

So, is it sciatica?

Assuming you have pain in this region of your body, how do I answer your question “Is the pain in my buttock sciatica?” What are the possible causes of pain in the buttock?  Which are most common?  Is sciatica likely?

What are the possible causes of pain in the buttock?

You could strain a muscle.  Although this could still cause “non-nerve compression sciatica” (see blog on this), I would classify this as a strained muscle rather than sciatica.  However, straining a gluteal muscle isn’t actually that common in practice. I rarely see it.  Perhaps because these are really big strong muscles and most people don’t do enough strenuous exercise to really strain one.  You’re far more likely to strain a hamstring muscle.  A strain to the very top of the hamstring – where it attaches to your “sitting bone” – could cause buttock pain.  There are other obscure causes of pain in the buttock, but they’re so rare that I’m not going to worry you with them!

Which are the most common causes of pain in the buttock?

All sorts of lower back problems can cause buttock pain.  And lower back pain is exceptionally common.  Would this be classed as sciatica?  Yes. If it’s a pain and it’s in your buttock, and that part of your buttock is supplied by the sciatic nerve, it could be described as sciatica.  If you have lower back pain AND pain in your buttock, it’s 99% likely I’d call that sciatica.

Want to know more about the treatment of the two types of sciatica? Then read this.  OR if you’d just like to book an appointment with an Edinburgh osteopath, or an “osteopath near me“, click the link.

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