BACK PAIN – What is it all about?
To understand back pain first it is necessary to recognise that most back pain is natural and normal. Even the strongest and fittest among us are not immune to back pain, in fact athletes can sometimes be more predisposed to back pain because of the intensity of their sport and training. Essentially the spine has many joints each of which can be problematic or dysfunctional due to a wide variety of factors.
The spinal joints form passageways that allow nerves to pass from the spinal cord to the muscles, tendons and ligaments they are related to. Due to this neurological anatomy muscle, tendon or ligament problems can often be tracked back to dysfunctional (strained, compressed, subluxed, mal positioned, inflamed) spinal joints.
What Factors Cause Your Back to Suffer Stress?
Sustained postures especially those in awkward positions
Repetitive movements
Lack of exercise and lack of body awareness
Overdoing it in a multitude of ways at work or play
Common Orthopaedic Conditions of the Back
The following list is not exhaustive but does give an overview of what commonly presents in a clinical setting;
Facet Joint Dysfunction
Sacroiliac Dysfunction
Maigne’s Syndrome
Meralgia Paraesthetica
Femoral, Sciatic, Genito-femoral, Obturator, Pudendal nerve entrapments
Piriformis Syndrome
These types of conditions are by far the most common to see. All can be present without the patient having suffered any significant damage and all are rapidly resolved through treatment, basic exercise and activity moderation.
Chronic Muscular Pattern Conditions
Seen in common recognisable postures; chronic muscular tension often alters posture and leads to strain on the joints, reduced blood supply to muscles and irritation of nerves e.g.
Upper / Lower crossed Syndrome
Anterior pelvis
Osteopathy can rebalance muscles and realign joints resolving these postural problems. Exercises to strengthen and stretch particular muscle groups are helpful in these cases.
Developmental conditions:
Scheuermann’s Disease – fixed, fused forward curve (kyphosis) in the thoracic spine developed in teenage years.
Adolescent Idiopathic Scoliosis
Hip Dysplasia / FAI: Lack of movement in the hips can mean compensatory transference of increased forces to the low back during activity. Irritation / damage to hip joint is predisposed in this condition inevitably involving hip muscles that are concurrently back muscles.
All can be helped and managed through Osteopathic treatment, simple exercises and advice.
Degenerative Conditions:
Spondylosis – varying degrees of osteoarthritis in the spine. A natural condition that in most cases the body manages exceptionally well. However, the effects of spondylosis can alter the alignment of the spine, reduce its shock absorption, reduce range of motion and irritate surrounding structures.
Osteoarthritic joints often respond very well to joint mobilisation, gentle stretching and massage.
Conditions involving damage:
The major difference with these conditions is they involve a significant level of damage and inflammation often though trauma. Thus, healing is necessary, and therapy is done very carefuly at the appropriate time to support healing.
Disk Herniation
Whiplash
Fracture
Joint sprain
Muscle / tendon strain
Osteopathic therapy timed correctly and delivered appropriately can help with healing and any compensatory problems.
Autoimmune Conditions
These types of conditions involve an overreaction of the autoimmune system leading to inflammation of the joints, muscles, tendons or ligaments.
Ankylosing Spondylitis (AS)
Enteropathic Arthritis associated with inflammatory bowel disease (IBD)
Reiters
PMR (Polymyalgia Rheumatica)
These kinds of conditions can gradually cause inflammatory damage and degenerative change in the spinal joints. The correct medication is needed to control this along with physical exercise and therapies such as Osteopathy.