Lower Back Pain;
Osteopathy is best known for treating low back pain. This can be an acute injury that results from trauma such as lifts, twists or falls or pains that build up over time from poor posture or difficult working environments.
Osteopathic principles can be applied to any part of the body, which is why it can help with the following conditions:
The most common presentations are stiff necks that prevent you from turning your neck fully. These are often acutely painful and can be associated with headaches or pain referring down the arm. They often seem to occur during sleep when you awake with a ‘cricked neck.’ There is commonly an underlying postural element such as a desk job or driving.
Acute whiplash should be assessed medically in the first instance to exclude the risk of fracture.
At the clinic we treat chronic whiplash injuries for a number of insurance companies. Quite often they have not responded to exercise prescription and require manipulation. Whiplash usually affects the whole spine, not just the neck where it is felt most acutely. For effective treatment the whole spine must be assessed and treated. It is important to get the strain pattern from whiplash removed as it can go on to cause further problems if it is not resolved.
The level of improvement that can be expected depends on the severity of the whiplash and the individual body type. Generally women are affected worse than men due to the laxity of their ligaments. If ligaments are torn or stretched there is the possibility that there will be a tendency for the neck to stiffen up over time as the body seeks to stabilize the excessively mobile levels. In cases such as these regular exercises combined with maintenance treatments is the best approach.
Repetitive Strain Injury, RSI
Repetitive strain injuries are often associated with the workplace but they can occur just as easily through sports or hobbies. There is usually an element of overuse of one joint or muscle that is being used in a non-physiological way. Recovery can depend on re-modelling the activity that caused the problem as much as treatment of the structures affected.
A general term that is usually applied to a pain that follows the course of a nerve, the pain is often sharp or deep like toothache with pins and needles or other altered sensations i.e. heat or running water. Nerves can be trapped anywhere along their pathway and a through examination is necessary to determine the true cause.
True sciatica is an inflammation of the sciatic nerve which presents as an acute pain from the buttock or base of the back down the back of the leg to the foot. It may be accompanied by paresthesia (pins and needles) and anesthesia (numbness). If the origin of the pain is muscular then Osteopathic manipulation stands a good chance of correcting the problem, dry needling (medical acupuncture) is often a very helpful adjunct to treatment.
Osteopathy can help maintain the function of joints that have been damaged in the past depending on how severe the problem is.
Knees: Obviously acute meniscal tears and ligament ruptures are the domain of the Orthopedic surgeon, but there are many knee conditions that benefit form improving the function of the low back and hip, maintaining the movement of the lower leg and ankle.
Hips: can can be problematic due to underlying developmental problems. Some people are born with one head of the hip smaller than the other, which can result in pelvic strains. Common problems can result from ankle injuries or pregnancy, where the weight distribution is altered.
Ankles: Clicking ankles, sprains and strains can all benefit from a rebalancing of the lower leg, which is often strained during ligament, sprains. If an ankle is not recovering at the rate you expect there is usually some underlying reason that needs addressing.
Shoulders: The shoulder is a complex joint that requires excellent muscle balance to function well. Most commonly problems are initiated by a breakdown in biomechanics that occurs through the thoracic spine, treating the shoulder joint directly is often futile as all the muscles acting on the region must be assessed and treated.
Frozen Shoulders: Many frozen shoulders are misdiagnosed, if you are in agonizing pain, you can’t bear your arm to be touched and have been for many months then you have been correctly diagnosed! The progression of these shoulders can be accelerated but the treatment is painful and not for the squeamish. Shoulders that are not fully frozen usually respond well to osteopathic treatment.
There are a number of conditions that can cause facial pain that are potentially serious and require medical investigation. These include temporal arteritis and various forms of cancer, similarly pain in the jaw or sinuses may have origins in the jaw or gums and should be investigated by your dentist.
If a clear pathology cannot be found it is possible that Osteopathic manipulation maybe of use.
Jaw Dysfunction: Clicking of the jaw or locking is often associated with the temporomandibular joint (TMJ), which is mechanically influenced by the joints and muscles of the upper neck . In some cases restoring function to the cervical spine can reduce symptoms significantly. It is particularly worth considering if you have a history of headaches and neck pain or you have been involved in a traumatic incident that has effected the head or neck.
Pain radiating up the side of the neck and face: These pains can vary from constant deep aches to superficial tingling or transient pins and needles. Quite often they are accompanied by really tight muscles at the side or front of the neck. If you can feel local tenderness at the front of the neck or are aware that your neck is stiff then there is a good chance that manipulation may help.
Pain radiating across the face: Pain can follow the course of the facial or trigeminal nerve. It more commonly branches down from just behind the ear into the cheek but can also course down to the jaw from the ear or curve up round the eye. Trigeminal Neuralgia is a particularly debilitating condition that is acutely painful, manipulation does not have a good record at resolving established cases, but if the symptoms are intermittent or it is not true trigeminal neuralgia then there is more scope for change.
Sinus Pain: Is a very distracting pain sensation experienced in the sides of the nose or forehead. Most people have experienced it in some form during a cold, though others that can be recurrent and aggravated by nasal polyps it can occasionally be the result of irritation to the nasal membranes due to trauma such as broken noses, teeth extraction or tension through the top of the neck and skull.
Sometimes the patient complains of sensations that are not painful like pins and needles, numbness, fluttering or heat, if these symptoms have been investigated and no medical origin discovered then they may also fall into the categories above.
Many people suffer with a headache that affects the back of their head and pulls round behind the eyes, often associated with tight shoulders or long hours at a desk. These tension-type headaches usually respond well to osteopathic treatment. Releasing the muscular tension in the upper back and stretching the muscles of the neck can have rapid results. To ensure longer lasting benefit you also need to address the causes of the problem by making sure that your workstation is set up correctly and that you are doing your best to unwind the tension in your upper body when you get the chance.
Migraines are thought to be associated with the neurological control of the blood supply to the brain; they are complex and not fully understood. They are characterised by visual auras, blurred vision, unilateral pain, nausea and photophobia. If on examination your osteopath can find significant mechanical problems then there it is likely that treatment may help to reduce the symptoms.
Any sport requires the body to exert itself more than it may do in everyday life, this can be due to forces that are applied through the body or the uneven way that the body is used to get results i.e. the one sided swing of golf or right-sided dominance of some racket sports. Theses patterns can build up through the body over time and lead to postural problems, over use injuries and recurrent strains.
Quite often local treatment of the effected area does not yield significant result because the overall pattern of strain has not been addressed. Similarly if you have experienced a previous injury you may have a weakness or instability, it is important to make sure that the whole of the body is compensating for this weakness as it is to rebuild the local weakness.
Sprains, strains, pulled muscles, spasms etc… all respond well to Osteopathic treatment, these may be the result of falls, over zealous stretching, intense exercise or just sleeping awkwardly.
When you have been in pain the last thing you want is a re-occurrence, your osteopath will have explained what your problem is and why you are suffering from it. In many cases the acute injury will be the result of previous trauma or issues that need to be resolved such as your posture at work, how you perform certain tasks or your general level of exercise.
In some cases a full recovery will be dependent on making a long-term commitment such as losing weight or living a healthier life style. Others will need to reassess their expectations, if you want to play rugby past 40 you maybe able to but it could require a lot of osteopathic treatment to keep you on the field and it may lead to problems in the future (decreasing muscle mass and slower recovery times are more likely to lead to chronic injury).
Disclaimer: Treatment refers to hands-on therapy and does not necessarily imply cure. Many conditions can benefit from osteopathic management but that does not mean that there will be a total resolution of symptoms in all cases.