Active 10 Campaign

Physical inactivity is a major cause of disease and disability for adults in the UK. It negatively impacts the health, social and economic outcomes of individuals and costs the NHS millions every year.[i]

Active 10 is the latest physical activity campaign from One You.  Launched in March 2016, One You from Public Health England is the first nationwide programme to support adults in making simple changes that can have a huge influence on their health, could help prevent diseases such as type 2 diabetes, cancer and heart disease and reduce risk of suffering a stroke or living with dementia, disability and frailty in later life. It aims to inform, energise and engage millions of adults, especially those in the 40-60 ‘middle aged’ group, to make changes to improve their own health by eating well, moving more, drinking less and quitting smoking. One You also provides information on free health checks and how people can reduce their stress levels and sleep better.  It is estimated that habits such as poor diet, excessive alcohol, smoking and a lack of activity – are responsible for around 40% of all deaths in England and costs the NHS more than £11 billion a year.

Active 10 has a free app you can download which includes tips and encouragement to help you fit ten-minute brisk walking sessions into your daily routine. It also tells you how much brisk walking you are currently doing as well as helping you to slowly build up from just 10 minutes of exercise per day to the Chief Medical Officer’s recommended 30 minutes a day, by providing regular rewards, challenges and encouragement.

 

 

 

 

 

 

Apple Store: (https://itunes.apple.com/gb/app/one-you-active-10-walking-tracker/id1204295312?mt=8)
Google Play Store (Android): https://play.google.com/store/apps/details?id=uk.ac.shef.oak.pheactiveten&hl=en_GB

Take the Quiz: www.nhs.uk/oneyou/hay
This 10-minute quiz will give you an indication of where you could make improvements to support your health.

Osteopathy is a profession that focuses on creating an environment for supporting the health of our patients and the One You campaign, with its focus on positive messages for overall optimal health, is a campaign that aligns well with our osteopathic principles. Osteopaths are ideally placed to provide health advice and guidance to aid people to make the changes proposed by One You, and demonstrate that there is far more to osteopathic practice than just treating backs.

 

 

 

 

[i]Public Health England, 2014; Scarborough et al., 2011

Supporting National Back Care Awareness Week

Sharon and colleagues, together with The British Osteopathic Association (BOA) are giving their full support to this year’s National Back Care Awareness Week, which takes place from 8th to 12th October.

The theme, this year, is “Builder’s Back Pain”.  National Back Care Awareness Week aims to raise awareness of the causes and treatments of this debilitating condition.

 Back pain accounts for half of all chronic pain people suffer and is the leading cause of sickness absence from work.

 The financial burden of back pain is enormous, costing the UK economy £37 million, £13 million in disability benefits and the NHS £1.3 million EVERY DAY.

That’s a staggering £19 billion every year.

This year’s campaign is focusing on the construction industry which generates 30,000 new back injuries each year. Most back injuries for construction workers are typically sprains and strains which occur in the lower back due to activities involving lifting, lowering, carrying, pushing, or pulling.

The risk of injury increases with repeatedly carrying heavy loads and twisting the back, or when working bent over or in awkward position.

An osteopath can identify and tackle the underlying musculo-skeletal problems that cause pain. Osteopaths work with their hands using a wide range of treatment techniques, such as soft tissue and neuromuscular massage, joint mobilising techniques and corrective manipulations, all of which are designed  to improve the mobility and range of movement of a joint.

If you’re not in the vicinity of our clinics, the first step to finding an osteopath in your area is by searching on the website: www.osteopathy.org

 Top tips for preventing back pain on a building site

  • Cut down on carrying. Have materials delivered close to where they will be used.
  • Try to store heavier materials at waist height.
  • Raise your work to waist level, if you can.
  • Make sure floors and walkways are clear and dry. Slips and trips are a big cause of back injuries.
  • Take rest breaks. When you are tired, you can get injured more easily.
  • Use carts, dollies, forklifts, and hoists to move materials—not your back.
  • Use carrying tools with handles to get a good grip on odd-shaped loads.
  • If materials weigh more than about 50 pounds, do not lift them by yourself. Get help from another worker or use a cart.
  • When lifting or carrying materials, keep the load as close to your body as you can.
  • Try not to twist when lifting and lowering materials. Turn your whole body instead.
  • Lift and lower materials in a smooth, steady way. Try not to jerk to lift.
  • When you pick up materials off the ground, try supporting yourself by leaning on something while lifting.
    Also don’t bend over; instead, kneel on one knee and pull the load up on to your knee before standing. Make sure to wear knee pads when you kneel.

“Can we fix it? Yes, we can!”
If you think we could possibly help you and you would like to book an appointment at our Devizes, Pewsey or Amesbury Clinics or you’d like some further information, please call us on 07737 416906.

Aches and Pains in Pregnancy

I have a special interest in treating pregnancy related aches and pains, having suffered with acute pelvic pain when i carried my first child.  The good news is that you don’t have to suffer silently – most forms of manual therapy may be of benefit, even if you gave birth years ago.

I have undertaken specialist training courses with Pelvic Partnership, a charity who aims to provide women and healthcare professionals with information about best practice for the treatment and management of pregnancy-related pain, and to enable and empower women to access the right treatment.

You can access them in full here, or below I have summarised their information on the most common areas where women experience pain:

Pelvic pain in pregnancy affects up to one in five women. Pelvic pain is also known as Pelvic Girdle Pain (PGP). It is also is known as:

  • Symphysis Pubis Dysfunction (SPD)
  • pelvic joint pain
  • twisted hips
  • pelvic relaxation
  • pelvic arthropathy
  • osteitis pubis

All of these describe pain in the pelvic joints related to pregnancy.

Quick facts

  • Pelvic girdle pain during or after pregnancy is common but not normal so don’t put up with it.
  • Symptoms of pelvic girdle pain include pain at the front and/or back of the pelvis, pain when walking, climbing stairs, turning over in bed and standing on one leg (e.g. getting dressed).
  • Pelvic girdle pain is usually caused by an asymmetry or change of normal movement or alignment in your pelvic joints – a mechanical joint problem not a hormonal one.
  • Pelvic girdle pain (PGP) is very treatable both during pregnancy and afterwards – get treatment for your pelvic pain as soon you get symptoms.
  • Treatment for pelvic girdle pain involves assessing the joints and muscles in and around the pelvis and returning them to normal function, usually using manual therapy techniques.
  • Pelvic girdle pain can be treated by a Chartered Physiotherapist, Registered Osteopath or Chiropractor with experience in manually treating pelvic girdle pain.

Myths about pelvic girdle pain:

Women are often told that their pelvic pain is due to:

  • round ligament pain
  • hormones
  • sciatica
  • trapped nerve
  • normal aches and pains of pregnancy
  • low back pain
  • nerve irritation; and that it is not treatable and will get better on its own, or as soon as the baby is born.

Many women have discovered later that it was pelvic girdle pain and could have been treated as soon as symptoms occurred.

PGP is really treatable at any stage of pregnancy or postnatally as soon as you feel able to visit your therapist.  There used to be ideas that you had to wait a few weeks “for the hormones to settle” but now that we know it is not the hormones causing the problem, this is no longer the case.  As soon as you feel able to see your therapist postnatally, you are ready for treatment.

The aim of treatment is to assess the position and the symmetry of movement of your pelvic joints, especially the sacro-iliac joints at the back of the pelvis. Find out which one is causing the problem, and then treat it.  The treatment is not usually painful, so it is nothing to be worried about, and you should expect to feel an improvement or some relief of your symptoms after each treatment.  Keep going until you are completely pain-free after you have had your baby.  We get a lot of calls from women who just had a few niggles in their joints after one pregnancy but just put up with it because it was much better than it had been, then develop symptoms very early in their next pregnancy because the underlying problem has never been resolved.  This can be prevented or at least minimised by making sure that you are pain-free through getting treatment after your baby is born.

Treatment involves a combination of joint realignment or mobilisation and soft tissue or muscle treatment.  This is because the muscles often become tight or compensate when you have a lot of pain, and this tightness has to be released to allow the joint to move normally and prevent the problem from happening again as soon as you leave the therapist’s room.

Manual treatment involves the realignment of joints which are not working symmetrically. Gentle hands-on techniques are used. This can be done by a physiotherapist, chiropractor or osteopath with training and experience in treating PGP.

There are varying approaches to treating PGP, but the main things you should expect from your therapist are:

  • The therapist will ask you about your PGP and how it affects you.
  • They will ask you to undress down to your underwear.
  • They will look at and feel how the joints at the back and front of your pelvis move when you move (e.g. standing on one leg, bending forwards etc).
  • They will feel how symmetrically the joints move when you are lying down on your back and your front (or your side if you are very pregnant).
  • They will discuss their findings and agree a plan of treatment with you, explaining what they are going to do.
  • Treatment is likely to include realigning joints which have moved slightly, so that they move symmetrically again. This may need to be done at each visit, until your muscles become strong enough to keep them in place without treatment.
  • You may be given gentle exercises to help your pelvic stability.

As you recover, your exercise programme will be adapted to suit your individual needs until you get back to normal.

Resources:

 

Lower Back Pain

Back pain is very common – according to a survey published in 2000 almost half the adult population of the UK (49%) report low back pain lasting for at least 24 hours at some time in the year.  It is estimated that four out of every five adults (80%) will experience back pain at some stage in their life. (1)

In most cases it is very difficult to identify a single cause for back pain. In about 85% of back pain sufferers no clear pathology can be identified. (2)

The following factors could contribute to back pain:

  • Having had back pain in the past, smoking and obesity. (3)
  • Physical factors such as heavy physical work, frequent bending, twisting, lifting, pulling and pushing, repetitive work, static postures and vibrations. (4)
  •  Psycho-social factors such as stress, anxiety, depression, job satisfaction, mental stress. (3, 5)

Nearly 40% of back pain sufferers consulted a GP for help.  10% visited a practitioner of complementary medicine (osteopaths, chiropractors and acupuncturists). (6)

Common causes of low back pain include:

  • Muscular strain – sometimes you can ‘pull a muscle’ in your back, resulting in a small tear or sprain in your muscle.
  • Disc problems – sometimes the discs between the vertebrae may become weaker and bulge out.   In extreme cases, this may lead to a prolapsed disc.
  • Spinal stenosis – the spinal column runs through a narrow opening in your vertebrae.  If this opening becomes too narrow, the nerves may become trapped, which causes pain.
  • Collapsed vertebra – the vertebrae give much of the structural support to the spine but these may become damaged as a result of disease or injury.  Severe osteoporosis may result in a vertebra collapsing and by doing so, disturb the surrounding structures.
  • Inflammation of sacro-iliac joints, or lumbar spine facet joints
  • ‘Wear and tear’ ie arthritis/spondylitis of the lumbar spine

If you have a physical job, sit or stand for long periods, or are in poor physical condition, you are at greater risk of developing lower back pain.

Most people associate back pain with physical risk factors such as heavy lifting, twisting and bending and awkward postures.  These can contribute to back pain or exacerbate any existing pain. Therefore you should pay attention to controlling these factors by, for example, using manual handling aids (lift, hoists etc) and ergonomically assessed workstations.

Other risk factors of a physical nature include vibration (for example the vibrations that a driver experiences when driving a car or truck), repetitive work and static postures.

Emotional stress and long periods of inactivity can also make symptoms appear worse.

Structure of the spine:

Understanding a little basic anatomy can help you understand the nature of your pain and where it’s arising from.

Your back consists of many different structures that all have to work together.

Your spinal column is comprised of 33 vertebrae, with discs (like shock absorbers) in-between them.  You have 7 in your neck (Cervical vertebrae), 12 in your middle back (Thoracic vertebrae), and 5 in your lower back (Lumbar vertebrae). You have 5 vertebrae which are fused together to form your Sacrum, attached to which are 4 vertebrae, which are also fused, that form your Coccyx (tailbone).

The shape and size of these vertebrae changes from the top to the bottom of the spine – cervical vertebra are small, and are designed for movement and flexibility, whilst lumbar vertebrae are much bigger, being responsible for the weight bearing of almost all of the upper body.

As the vertebrae stack up one on top of the other, a small gap called a foramen is formed.  Pairs of spinal nerves branch away from the central spinal cord and travel through these foramen to supply organs, limbs etc.

The spinal cord is encased in a ring of bone formed by the front and the back of the vertebra, and this runs from the base of the brain to the bottom of the spinal column.

The discs between the vertebrae are more formally known as intervertebral discs.  They are made up of a soft jelly like substance called the nucleus, which is held inside a tough, elastic and fibrous outer casing known as the annulus.  The vertebrae and the discs together are known as the spinal column.  This is supported by many muscles, tendons and ligaments.  Their function is to provide strength and stability to the spinal column.

The muscles are connected to your bones with tendons – when a muscle contracts, the forces are passed on to the skeletal system via the tendons. This ensures that a muscle contraction results in a movement of a certain body part. The role of a ligament is to provide stability to a joint – however, ligaments are also flexible to a certain degree, so they can stretch or contract when the joint moves.

It could be thought that any abnormalities in the structure or functioning of your back will result in pain, but this is not necessarily true.  People have very different backs and it is difficult to define a ‘normal’ structure. Some people with severe deformities may not experience any back pain while others who appear to have ‘normal’ backs experience severe pain.

Osteopathic Treatment for Lower Back Problems:

Although lower back pain is often very painful, the good news is that few people have a major problem with the bones or joints of their backs.

A good proportion of lower back problems can be resolved using non-surgical methods.  Manipulation by a specialist practitioner followed by mobilisation and exercises has been proven to be the most effective treatment for acute low back pain (UK BEAM BMJ 2004; 329; 1377)

Prevention is better than cure, and it is often easier for an osteopath to treat underlying stresses and strains when there is no current back pain. You do not have to have the pain on the day of the treatment.

Likewise, you do not have to wait for a particularly painful episode to settle before visiting an osteopath.  Most back pain is easier to treat in its early stages. It is also important for the longer term to minimise the potential for structural damage or arthritis, which can be caused by wear and tear through strain on weak areas of the spine, by getting treatment when it is needed.

During your consultation, the osteopath will take a full history of your condition, and also ask questions relating your current and past state of health.  It is helpful if you could bring a list of any medications you may be currently taking.  Once a diagnosis had been made, the osteopath will discuss it with you and outline what the best course of treatment would be.  Occasionally, further diagnostic tests may be required, such as x-rays, MRI scans or blood tests  – for these you be referred back to your GP/Specialist.

Osteopathic treatment of lower back pain may include one or more of the following techniques:

  • High velocity low amplitude thrusts (HVT) – the osteopath applies a high-velocity low amplitude thrust to the joint to reduce any restricted movement.  This is painless and makes a small ‘clicking’ or ‘popping’ sound.
  • Myofascial Release – The osteopath may use this soft tissue therapy to release muscular shortness and tightness.
  • Muscle Energy (MET) – The osteopath applies a counterforce to the muscles while they are being used in a specific position and direction, such as when flexing.
  • Soft Tissue Mobilization / Massage – The osteopath uses rhythmic stretching, deep pressure or traction techniques to engage the muscle area around the spine.

The average patient usually responds positively within three to six treatments, but more, or indeed fewer treatments may be required depending on the nature of what is being treated and the individual’s circumstances and past history of the condition.  A chronic lower back problem may well take considerably longer to resolve.

After your treatment, you may well be given a series of exercises to do, and/or postural advice if your osteopath feels this would be of benefit to you.

 

Treating lower back dysfunction Photo copyright of Kampfner Photography

 

References:

(1)    Palmer KT, Walsh K, et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000;320:1577-1578.

(2)    Nachemson AL, Waddell G, Norlund AI. Epidemiology of neck and low back pain. In: Nachemson AL & Jonsson E (eds). Neck and back pain: The scientific evidence of causes, diagnosis and treatment. Philadelphia: Lippencott Williams & Wilkins, 2000.

(3)    Burton AK, Balague F, et al. European guidelines for prevention in low back pain. Eur Spine J 2006:15(suppl 2):S136- S168

(4)    Andersson GBJ. The epidemiology of spinal disorders. In: Frymoyer JW (eds) The adult spine: Principles and practice.  Philadelphia: Liipincott-Raven, 1997.

(5)    Hoogendoorn WE, van Poppel MNM, et al. Systematic review of psychosocial factors at work and in private life as risk factors for back pain. Spine 2000;25:2114-2125.

(6)    Department of Health Statistics Division. The prevalence of back pain in Great Britain in 1998. London: Government Statistical Service, 1999

The Great British Pain in the Neck

  • Britons are more likely to suffer from neck pain
  • Massaging the spine is more effective than medicine in short and long term

People living in Britain are among those most likely to suffer neck pain according to an article published this month.  It states that those living in high-income countries are more susceptible to the problem than those living in low or middle-income countries.

 

The study of neck pain treatment, published in Annals of Internal Medicine earlier this month, also reveals that women are more likely than men to experience neck pain and that the problem is particularly prolific among office and computer workers.

Britons are exceptionally hardworking and driven,  with the UK ranked as the 13th most prosperous country out of the 130 countries measured in the 2011 Legatum Prosperity Index.  Much of the work in high-income countries, including the UK, is conducted at a desk where ergonomics and stress are common factors that can result in neck pain and exacerbate existing conditions.

According to the article, spinal manipulation, which is practiced by osteopaths and some other health practitioners, was more effective at relieving symptoms than medication.  Medication, whether over-the-counter or prescribed by GPs, is often a popular choice among time-poor workers who are reluctant to take time off for expert treatment.  However patients who were taught self-massage techniques rather than solely having to rely on treatment provided by professionals also benefitted more than those taking medication.

Kelston Chorley, Head of Professional Development at the British Osteopathic Association (BOA) says: “These research findings are positive for individuals, employers and employees.  Pain relief medication can be expensive and learning self-massage techniques mean individuals can be empowered to help manage their pain.  Further, where medication is ineffective, this can result in on-going problems that could have been resolved earlier and may even worsen as a result.  This can mean people have to take time off work for extended periods.

“An osteopath will usually provide some initial treatment to help correct any underlying cause for the condition and will always provide self-help strategies for neck pain so patients can manage their condition in the future.”

The article also says that mobilisation, described by the BOA as repetitive movements of joints to free up restrictions and increase the movement of joints and surrounding tissues, may be a better first treatment for non-specific neck pain than manipulation, described as unlocking restricted joint and surrounding tissues with a single highly specific movement, which can be an uncomfortable experience for some patients.

Kelston concludes: “In many cases of acute or chronic neck problems manipulation is not always the first line of treatment by an osteopath. Using a combination of soft tissue massage, mobilisations and self-help exercises often proves to be a more appropriate solution than the “neck clicking” commonly associated with manipulation.”

To read the article in full, please visit:

http://www.annals.org/content/156/1_Part_1/1.abstract?aimhp