What we treat
Back pain, particularly lower back pain, is one of the most common complaints we see. The back has many structures that can become vulnerable due to wear and tear or injuries, such as the discs, muscles, ligaments, tendons, nerves and joints. Due to this, the back may require a fair amount of testing to work out what the problem may be. For this reason, we usually recommend patients see our osteopath for their initial assessment, to be able to give you a diagnosis and treat based upon this. Please note, deep massage in certain areas can aggravate some issues, such as disc prolapses in the acute phase, which is why diagnosis is important.
Common back issues we see:
- Disc prolapses / disc bulges / disc herniations / "slipped disc"
These injuries tend to happen over time, through the slow breakdown of the outside layer of the disc, between the vertebrae, before it 'goes', though sometimes it can occur as the result of an injury. The disc may bulge, or even tear and leak out its contents, it doesn't actually 'slip' anywhere. They are most likely to occur in the low back.
Sciatica is just a general term for pain from the sciatic nerve, which runs from the lower back, down the back of the leg to the foot. Compression or irritation of the sciatic nerve usually gives symptoms of pain, pins and needles, numbness and/or weakness in this area. Irritation of the nerve can be as a result of disc prolapses, muscle tightness, sacroiliac (SI) joint issues, lumbar facet joint irritations and other issues.
- Facet joint irritation / dysfunction
The facet joints are the joints that sit between the vertebrae and are present both left and right. These joints are typically irritated with extension movements and this movement compresses these joints, though it may happen as a result of poor posture. Irritation of these joints can cause inflammation, which can cause the local muscles to tighten.
- Sacroiliac / SI joint sprain or dysfunction
Towards the bottom of the spine there are two large joints (one each side) between the spine (sacrum) and the pelvis. There is typically very little movement at these joints as there are very strong ligaments across these joints. These joints can become too loose (sprained) or restricted (dysfunctional) and either of these issues can cause pain and other symptoms.
This is general wear and tear of the back. Over time, the discs (which act as shock absorbers between the vertebrae) narrow and then can cause increased friction of the facet joints. Although, it is quite a normal part of ageing, treatment can still help to relieve a lot of the symptoms associated with this problem.
- Muscular complaints
There are lots of muscles in the back and so overuse of these can often lead to muscular strains and chronic tightness. Muscular issues can normally be relieved with massage, which helps to breakdown areas of tension. However, muscular tightness can often accompany other injuries, so if you are not sure, we suggest you book in a free 15 minute consultation to get things checked first.
Neck pain is very common especially in desk-based workers, those that do a lot of lifting (such as weight-lifters, factory/warehouse workers and manual labourers), motorcyclists/cyclists, drivers and those with lots of stress.
A lot of neck complaints are down to tension, due to this being the area a lot of stress goes into. When pain is felt as a muscular type ache into this area, we normally suggest some massage to help relieve things. If there are any sharp pains, referred pain (usually into the arms or head) we usually suggest osteopathic treatment. If you are not sure who to see, please feel free to book in a free, 15 minute consultation for more individual advice.
Common neck issues we see:
- Muscular tension / Upper Crossed Syndrome
Muscular tension is very common in the neck, especially in the upper trapezius muscles / "traps". This is often from overuse but also postural issues. A common type of posture we see is referred to as 'Upper Crossed Syndrome" which presents as a forward head positioning and rounded shoulders. This is very prevalent amount desk-based workers in particular but there are lots of different muscular issues that can occur around the neck for different reasons.
- Spondylosis / 'Wear and tear' / Osteoarthritis
The discs between the vertebrae can narrow as we age (spondylosis) and this can then cause the joints to have more friction. This increased friction can then cause increased wear at the facet joints at the back of the vertebrae in particular, leading to bony changes - arthritis. As this becomes worse, an individual may experience pain or restriction.
- Trapped nerves
Nerves exit from the spinal cord in little gaps between the vertebrae, when there are any issues nearby to this, it may cause impingement or irritation of those nerves. The nerves in the neck can refer up into the head causing cervicogenic headaches, into the shoulder or down the arm. These issues can often be relieved with work on the joints and muscles around the neck.
- Facet joint irritation / 'tweak in the neck'
The facet joints sit at the back of the neck. They can either become irritated from long-term wear and tear or by issues with posture, sleeping position or simply moving awkwardly. Patients will often describe this problem as a 'tweak in the neck' as the joint will often cause pain when it is approximated and cause a reduction in movement.
Headaches / Migraines
Headaches and migraines can be caused by many factors, one of which being issues in the neck. Cervicogenic headaches are those caused by tension and dysfunction in the neck. Often the muscles around the neck can get very tight and knots, known as trigger points can form. These trigger points are specific areas of tension within the muscle that can generate pain in other areas, including the head, face and jaw/TMJ.
We recommend patients to see our osteopath if they are suffering with headaches or migraines that they believe could be caused by pain or dysfunction in the neck. Our practitioners will thoroughly assess you to make sure that the neck is the cause of the problem and check the nearby nerves. We can then treat this with techniques such as soft tissue work, mobilisations, acupuncture and/or manipulations/adjustments.
The shoulder is very complex as it is made up of 4 joints: the ball and socket joint (glenohumeral joint), the joint between the collar bone and the shoulder blade (AC joint), the joint between the collar bone and the sternum (SC joint) and the 'joint' between the shoulder blade and the ribcage. This means there are a lot of structures that can go wrong and cause problems. A thorough examination is required to work out which area(s) in the shoulder or elsewhere are causing the problem.
Common shoulder issues we see:
- Rotator cuff injuries / tendinopathies / tears
The rotator cuff muscles are the muscles that cause rotation at the shoulder. They are made up of 4 muscles: supraspinatus, infraspinatus, subscapularis and teres minor. These muscles, particularly subscapularis, can become damaged when used incorrectly. When the tendon becomes irritated, this is a tendinopathy, or a tendinitis if there is inflammation present. When the strain becomes too much on that muscle/tendon, it was cause it to tear.
- Shoulder impingement
Supraspinatus (one of your rotator cuff muscles is particularly prone to impingement as it passes though a small space in the shoulder before it attaches onto your humerus (arm bone). Due to this if that space narrows for any reason, such as poor posture or bony spurs, the tendon or other structure in that space can become impinged. The impingement can then cause inflammation and swelling, which narrows the space further, creating a vicious cycle.
- Osteoarthritis / Wear and tear
Arthritis can occur in a few areas of the shoulder complex and can be brought about by excessive wear and tear, especially when the joints are compromised by being in a bad position for long periods, such as with poor postures or repetitive movements associated with certain jobs or sports. Although osteoarthritis is not reversible without surgery, the treatments we offer can help to reduce the symptoms, such as pain and restriction. Some people with severe arthritis can still get to a point where they are pain-free.
There are many types of arthritis, with the most common being the wear and tear type - osteoarthritis. Studies have shown that the amount of osteoarthritis in a joint does not directly correlate to the amount of pain at that joint. This is because the other soft-tissue structures around the joint are often the cause of a lot of pain. We can therefore have a lot of success with treating arthritic joints, even when they have severe levels of wear and tear. We can sometimes also help with easing the symptoms of other types of arthritis.
Tennis and Golfers Elbow
Tennis elbow (lateral epicondylitis/epicondylopathy) and golfers elbow (medial epicondylitis/epicondylopathy) comes from the overuse of the tendons in the forearm. Various tendons that control the wrists and digits attach onto two points of the elbow - the medial and the lateral epicondyle. When the extensor tendons become overused such as with lots of using hand-tools repetitively, lots of fine, repetitive hand movements (such as with sewing), instrument-playing and sports such as tennis, this can cause the these tendons to become very tight and pull on the area they originate from on the outside of the elbow, all of these tendons pulling on the same spot can cause the area to become irritated and sometimes inflamed. This is called Tennis Elbow.
With Golfers Elbow, the cause is very similar but with the flexor tendons that attach into the medial/inner part of the elbow. Overuse of these tendons can cause pain/tenderness in this area.
We would normally recommend you see the sports massage therapist initially for this issue and then possibly the sports therapist, though this will depend on the circumstances with which this problem occurred.
Stress, Anxiety and Depression
Some of the most common mental health issues affecting people today are stress, anxiety and depression, with many people suffering with more than one of these at the same time. We have mental health care professionals who can help you deal with these and help you learn to address factors that may be playing a big role in why problems may be occurring or helping you learn to cope in an effective manner. We can offer different means of support, whether that be through means of counselling, psychotherapy or hypnotherapy as traditional means or acupuncture or reflexology if you are looking at more alternative methods. It may be advised that you also consult your doctor before having treatment with us. However, our practitioners will be honest with you about what level of support they can provide you and advise you on the best route forwards.
It is now known that physical and mental health can directly affect one another, therefore feelings of stress, anxiety and depression may contribute to physical symptoms. Therefore one of our physical healthcare practitioners may suggest getting treatment for these issues if they feel it may be of benefit to the physical symptoms you are having, or just your overall wellbeing.
Other problems that we treat
There are lots of musculoskeletal and other issues that we can treat. If you are still unsure as to whether we can help you, please contact us on the chat feature or book in a free 15 minute consultation (book via phone or email) with one of our practitioners and we will be happy to help.