Back Pain

Back pain is a common condition in Western culture that often results from sedentary lifestyles; poor ergonomic conditions in the workplace and general stress.  Back pain is the largest cause of work related absence in the UK.

The Hale Approach

Osteopathy

After taking a medical history and carrying out a detailed physical examination, an osteopath will plan a course of treatment. Each session, which usually lasts about thirty minutes, may involve soft-tissue massage, gentle, repetitive movement of joints, and rapid guiding of the joints through their normal range of movements (producing the characteristic clicking that most people associate with osteopathy). There may also be advice on posture, exercise, and relaxation techniques.

Chiropractic

Spinal manipulation (chiropractic) is one of the most well-documented complementary therapies in terms of effectiveness and cost effectiveness. Studies suggest that with manipulation the stimulation of nerves (reflexes) can cause the muscles to relax and possibly also have an effect on the vascular system via these nervous reflexes. The majority of cases need an average of five to eight treatments, but chronic back pain will often need more than 10, spread over several weeks or months, in conjunction with exercises, ergonomic advice, stress management, and so on.

Physiotherapy

Consultants and GPs regularly refer people experiencing back pain to work with physiotherapists, as physiotherapy is effective in treating back pain and reducing the time you may need to take off work and leisure activities as a result of it. You can also refer yourself for treatment directly. The physiotherapist will fully assess your condition and symptoms and give you an explanation of findings - usually the first step in understanding and treating your back pain. Immediate advice is given and treatment commenced as soon as appropriate. Some people may only need one treatment and a review to check all's well, while a course of four to eight treatments is usual, depending on your overall health and any underlying conditions. Longer periods of treatment can be offered, as needed. Your course of treatment may include a combination of postural advice, spinal mobilisation, soft tissue manipulation, electrotherapy for pain relief or improving healing times and an exercise programme designed to re-mobilise, stretch or re-strengthen your back. Specific advice on areas such as ergonomics and manual handling techniques may be offered, if these are thought to be implicated in your symptoms or helpful in preventing further episodes.

Ergonomic Assessment

Optimal working postures can prevent or help to eliminate work-related neck, back, arm, hand and leg pain. Incorrect working postures, positions or using equipment that doesn't fit you well can cause these conditions, which may also be associated with stress. If you associate your work with musculoskeletal pain, you may well benefit from an Ergonomic Assessment at work. Please see the Physiotherapy section of the website for details.

Acupuncture/Chinese Herbs

Depending on a patient’s condition, a combination of acupuncture and Chinese herbs may be used to regulate the energy balance and get through any blockage in the body’s meridians, particularly the bladder and kidney meridians. Most patients will experience some improvement and some will achieve a complete cure after a course of this treatment. Acupuncture has been particularly successful in the treatment of back pain caused by muscular spasm of sciatica.

Homeopathy

Although each case has to be judged individually, there a number of homeopathic remedies that is commonly associated with the treatment of back pain. The first step is to find the origin of the back pain. Rhus tox is a very common remedy when there is stiffness in the back and particularly if there is a stiffness after the first movement of the day which then disappears. Arnica is also useful, especially when there is a sensation of bruising in the back, and after mental or physical trauma. Sometimes the problem is weakness in the back rather than pain, and then phosphoric acid is used. Ruta grav and Hypericum are often indicated when nerve damage is involved.

Marma Massage

Marma is a form of deep-tissue which is used together with yoga and Ayurveda to eradicate muscle spasm and inflammation, and to correct mechanical and pathological conditions of the back. This integrated physical therapy has been very effective with back pain. The duration of treatment varies with the severity of the case, but as a rule of thumb two or three sessions should be enough to eradicate acute pain; between 6 and 20 sessions may be needed to relieve chronic pain completely. According to one Ayurvedic physician and Marma therapist, “The back maintains a unique pressure. If there is an imbalance of pressure for mechanical or pathological reasons, muscle spasms and inflammation will be created and this results in back pain. Marma therapy can help the back to maintain pressure. In terms of lifestyle changes, diet and exercise are very important for the prevention of back pain. I also recommend no acidic food.

Alexander Technique

The Alexander Technique improves posture, allowing the body to work in a more natural, relaxed, and efficient manner. To treat back pain, the therapist begins by watching how you use your body. He or she will then guide you to correct any harmful postures you may have acquired over the years and help you regain the habit of using your muscles with minimum effort and maximum efficiency. Good posture and correct use of the body will release tension, alleviate symptoms and prevent further pain.

Shiatsu

Shiatsu and its associated maintenance advice (such as corrective chi yoga/exercise) focus on the underlying causes of the back pain. Therapy aims to support and energize the weak areas and relax the tense areas of the back (and indeed the whole body). Following a series of treatments the individual may not only expect relief from pain, but will also be equipped actively to prevent further attacks.

Reflexology

Whatever the complaint, reflexologists will give a full reflexology treatment, based on treating the whole body, before moving on to specific areas relating to the particular problems. With back pain, a full treatment would be followed by extra treatment specific to the area where the pain was being experienced, such as the lower back, and to the neck, adrenal glands, and solar plexus. The duration of treatment depends on how long the problem has been present. Some people who are sensitive and react very quickly may need only three treatments. Others need a longer time, particularly if the problem is deep seated. You can treat yourself by working along the inner side of both feet, but only after you have been instructed by your practitioner and have a clear understanding of what you are doing. Inexpert treatment can overwork a reflex area, possibly upsetting the balance in the body, with unpleasant results.

Tuina

Tuina (meaning “push” and “squeeze”) is traditional Chinese massage working over acupoints and meridians, using deep pressure, tapping, clapping or friction to alleviate pain (caused by the stagnation of chi energy in the body). This stimulates the flow of blood and is helpful in the treatment of chronic and acute back pain, and sports injuries. The treatment is normally very deep tissue massage, leaving the patient alert and balanced. Chi Kung exercises are also normally prescribed.

Nutrition

In general terms, nutrition cannot be used to treat back pain which his caused by muscular pain or injury. However, some people are sensitive to the tannin and caffeine group of products, e.g. tea, coffee, chocolate, cocoa, cola, red wine, etc, and for them these foods appear to dry out the synovial fluids which lubricate joints. If synovial fluid becomes low, general wear and tear on the joints (and, of course, the back is basically a series of joints), is greater and you are much more likely to experience “lesser grade” back pain. A good way to identify whether this food sensitivity is present is to eliminate these products from your diet. If you then have a pressure headache for several days and are generally slow and mentally unfocussed, you probably do have a sensitivity – you are experiencing withdrawal symptoms, which would be instantly relieved if you were to take half a cup of coffee or tea.

Aromatherapy

A massage using specifically chosen essential oils can relax and stretch the muscles, calm nervous activity, stimulate the flow of blood and chi (intrinsic) energy and mobilize joints, thereby reducing pain and increasing flexibility. Two to three treatments involving massage, exercises, and stretches should be enough to relieve back pain, although this is obviously dependent on the severity of the condition, how long it has been present, and your emotional state. In the case of arthritic or stress-related muscle spasm and in sufferers who do not exercise sufficiently or are overweight, improvement is normally immediate; in other cases total cure is often achieved. As well as the treatments, it is important for exercise to be incorporated into a patient’s lifestyle if success is to be long-lived; good posture must also be maintained. Advice on these subjects would be given during the treatment sessions. The essential oils recommended for your condition can also be used in moderation and under direction at home to relieve early symptoms of back pain through muscle relaxation. Rosemary is good for muscular pain, while eucalyptus, citriodora, juniper, ginger, and orange are deeply relaxing.

Herbalism

This is a useful complementary therapy in cases of acute back pain such as lumbar strain, when a patient is consulting an osteopath or a similar therapist. Anti-inflammatories such as devil’s claw or turmeric extracts taken internally can be helpful. Arnica tincture applied to unbroken skin, and various arnica creams are useful for any external strain. Very dilute concentrations of various essential oils which have anti-spasmodic and analgesic qualities and which increase blood flow might be recommended as the base for a vegetable oil. Suitable oils include rosemary, peppermint, lemon grass, geranium and nutmeg. If the back pain is related to a bone problem such as osteoarthritis of the spine, an external treatment with an anti-inflammatory such as devil’s claw and willow bark is still useful. Certain herbs, including capsicum and prickly ash, improve blood flow, which helps osteoarthritis. In additionReferer: http://www.haleclinic.cca, can help to reconstruct the joints. In some cases, back pain may be a symptom of depression and this can be treated quite effectively by herbal medicine. The main herb for this situation is hypericum (St john’s wort).

Supportive Treatments

Maya Abdominal Massage

A non-invasive massage technique that specialises in treating gynaecological and digestive conditions. It improves organ function by relieving congestion, enhancing blood supply; increasing lymphatic drainage and aiding nerve supply to the pelvic and reproductive organs. Further Details

Colonic Hydrotherapy

According to colonics therapists, back pain may be caused by toxicity of the muscles, kidneys, or a congested colon or spasms. Where this is the case, colonic hydrotherapy (gently flushing out the colon to remove any unbeneficial material) can alleviate and even remove the condition. In these situations, colonics combine very well with massage to remove back pain. However, if the pain is due to poor posture, spinal misalignment, or serious spasms, colonics is not really appropriate and massage alone or in conjunction with another therapy may be more beneficial.

Remedial Yoga

Before attempting to alleviate back pain through yoga it is important to determine if the condition is due to an acute injury- misplacement or whiplash, for example. Once this is established, yoga can be highly beneficial. Retained tension and overworked muscles bring a lot of pain to the upper spine. You can overwork muscles by the way you use them. In Hatha yoga therapy, you can learn through the asanas (postures) to relax the spine, which makes it supple and avoids further problems in the spine itself. In cases of whiplash or after surgery, yoga can help renew the tone and suppleness in the spine once you are on the way to recovery. Yoga also brings strength back to the muscles and helps to build confidence in the affected area (confidence can be lost after experiencing pain), so that the back and the body can once again be used fully. Shock needs to be worked through. One of the ways to break through these blockages is to ensure that breathing is complete and not limited. Breath awareness helps to release the body of blockages.

Chi Kung

The seven basic exercises of Chi Kung and the eight fundamental T’ai Chi exercises form the basic reference point from which treatment begins. Both philosophies treat the person as a whole by using and balancing the chi (intrinsic) energy in the body. The underlying purpose is to bring the patient back to his or her “tantien” centre, thereby strengthening lower back muscles. Gentle exercises, stretching and affirmations are used to release tension in the back and bring relief from pain. Once mastered, Chi Kung can be used as a preventative therapy for back pain.