Preventing low back pain

low back treatment, chiropractor BrightonRecent research shows that low back pain can be prevented with regular chiropractic care. Researchers from the Karolinska Institute in Sweden reported that early results from their randomised control trial showed significant improvements in the recurrence of back pain. These results, as yet unpublished, were reported at the latest European Chiropractic Union Conference in Cyprus, May 2017.

In the trial, people with recurrent low back pain were divided into two groups. Both groups were treated with an initial course of usual chiropractic care which consisted of spinal manipulation, mobilisation, exercises and advice. One group was then told to come back every few months and the other group was told to come back only if and when the pain recurred.

The group that were told to come back every few months experienced nearly 20 fewer pain days over the year.  On average they had two more treatment visits than the other group.

This result confirms for the first time that regular chiropractic care can have a significant influence on the course of low back pain. People with recurrent episodes of back pain should consider regular preventative check ups to reduce the impact of their back pain.

Here at Sundial we recommend periodic check ups every few months based on your history and the severity of the problem. We monitor progress through regular reassessments and online questionnaires to help us improve our care.

Latest research show what works for sciatica

Back manipulation - Brighton chiropractorEffective treatment for sciatica has been hard to prove. There may be many reasons for this but recent research has attempted to analyse all the best studies and combine the results in a so-called meta-analysis. The research team from Bangor University looked at more than 120 studies comparing 21 different treatment strategies. What they found will surprise many doctors and patients alike.

Previous studies have often found little or no significant improvements between various treatment strategies. This understanding combined with the fact that most sciatica gets better over a few months all by itself has meant that usual medical treatment has been to reassure the patient, prescribe pain-killers, and send them on their way. This new study should change that approach.

The researchers from the North Wales Centre for Primary Care Research concluded that for the best overall outcome significant improvements followed disc surgery, epidural injections, nonopioid analgesia, manipulation and acupuncture although disc surgery and epidural injections were associated with some adverse effects. If the only consideration was pain relief then epidural injections helped as did certain anti-inflammatory drugs. The interventions that were shown not be effective were bed rest, certain strong pain killers (opioids like codeine), traction and some surgical procedures like discectomy. Lead researcher Ruth Lewis said  ‘The most interesting finding was that opioids are not effective. The lack of effect is probably due to the type of pain you’re dealing with.’

What sciatica treatment should you try first?

Back examination - Brighton chiropractorThe NHS Pathfinder helps identify what treatment is best and when to seek it out. First of all you need a thorough assessment and examination by a competent health care professional such as a GP, of course, but also a chiropractor, physiotherapist or osteopath. This first assessment is important to rule out serious diseases and nasty nerve problems that need more invasive treatment like surgery. Fortunately most sciatica problems respond well without surgery. Manual therapy, like manipulation, as well as acupuncture feature have been shown to be effective.

How you choose to be treated for sciatica will often depend on your personal preferences. Some people hate the idea of acupuncture needles. For others manipulation or drug treatments are not appealing. Fortunately there are many treatment options and usually a combination of the most effective ones should be tried first. This means consulting a practitioner who is happy to work as part of a team to get the best outcome. Here at Sundial we have chiropractors, physiotherapists and acupuncturists who work with the recommendations from your GP. For more information on back and leg pain go here.

Surgery for sciatica is usually only contemplated for patients with severe nerve compression, if symptoms don’t respond to conservative care or carry on getting worse in spite of treatment.

Reference

Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses.
Lewis RA et al. Spine J. 2015 Jun 1;15(6):1461-77.

New research reveals working causes neck and back pain in South East

Image:  slworking2
Image: slworking2

Hard at work? So is your back. New research reveals working causes neck and back pain for people in the South East of England.

As part of the British Chiropractic Association Chiropractic Awareness Week (13 – 19 April) Matthew Bennett from Sundial is urging people to take regular breaks at work to help combat neck and back pain.

The advice comes as new research from the back and spinal care experts finds of those who have suffered from back and neck pain, working is a cause of the pain for almost a third (30%) of people in the South East.

More than half (52%) think that sitting in the same position for long periods at a time has the most negative impact on their back health. Despite recognising the source of pain, almost one in ten (8%) of those who spend the day mainly in one position don’t take regular breaks.

Matthew Bennett from Sundial Clinic in Brighton says “If you work in an office or drive a vehicle for long periods of time, it’s easy to stay seated, rarely taking breaks. Many people are unaware that staying in the same position can place unnecessary strain on their neck and back which can lead to long term pain.”

“Sitting causes up to twice as much pressure on the spine as standing. If your job involves sitting for long periods of time, it’s important that you take regular breaks to relieve the built-up tension in your lower back. Your back is always hard at work – even when you think you’re relaxing – so ensuring you move and stretch regularly will help relieve the extra load through the discs which will prevent long term problems, keeping your back on track.”

In the South East, 41% currently live with neck or back pain – and more than one in five (22%) suffer on a daily basis. So what can we do to combat neck or back pain at work?

Sundial offers the following top tips to help people get through the working day back pain free:

  • Sit up straight: Relax when sitting into your seat, making sure you have your bottom against the seat back with your shoulder blades touching the back rest of the chair. Keep arms relaxed and close to the body and place on the desk when typing. For drivers; the back of the seat should be set slightly backwards, so that it feels natural and your elbows should be at a comfortable and relaxed angle for driving.
  • Be computer compatible: Make sure the top of the screen is level with the eyebrows and the chair is titled slightly forward, allowing for the knees to be lower than the hips and the feet to be flat on the floor. Using a laptop or tablet away from a desk will encourage poor posture, so limit time spent in this way.
  • Take regular breaks: Don’t sit for more than 20-30 minutes at a time – stand up to stretch, change position and walk around a little. If you struggle to get away then take time to gently massage the back of your head and neck as you relax your stomach region with slow easy breathing. This will help to improve posture and reduce back pain by promoting balance, strength and flexibility in the spine.
  • Drink Up! Try drinking water instead of tea or coffee; it will be healthier and keep your body hydrated.

For more information on how to maintain a healthy posture and help keep neck and back pain at bay, call Sundial Clinics, Brighton, Queens Road 01273 774114 or St James’s Street 01273 696414 for a Free Posture Check.

 

Sleeping and sitting named as top triggers for back pain

Choosing a mattressWhat are the commonest causes of back and neck pain? Surprisingly most people don’t mention strenuous exercise but sleeping and sitting as their commonest causes of neck and back pain.

A new survey asked people throughout the South East about their neck and back pain. 76% said they were currently experiencing pain in the neck or back or had done so in the past. 43% said that sleeping caused their problem whereas 44% said sitting was also a trigger.

With 4 out 5 people spending 6 hours or more in front of a computer screen and 19% spending 4 or more hours in front the the television it could be that modern lifestyle is to blame for these high figures for neck and back pain.

As part of Back Pain Awareness Week (6-12th Oct) we are raising awareness about this issue and encouraging everyone not to take it sitting down. By being more active you can drastically reduce neck and back pain. Understanding how to sit properly and keeping active will help improve posture, strengthen muscles and therefore reduce neck and back pain

TOP TIPS for maintaining a healthy back and neck:

  • Sit up straight – keep arms relaxed and close to the body and place arms on the desk when typing. Make sure the top of the screen is level with the eyebrows and the chair is titled slightly forward, allowing for the knees to be lower than the hips and the feet to be flat on the floor. Workstation help.
  • Keep moving – if sitting in the same position all day take regular breaks – ideally every 30 minutes. It’s good to stretch your arms, shrug your shoulders and move your fingers around – this helps to keep the muscles more relaxed. RSI treatment and prevention.
  • Switch off – try to limit the time you spend leaning over you mobile devices or with your laptop on your knees especially after a day spent in front of a screen, to help improve your posture and relieve neck strain.
  • Sleep easy – test out your mattress before you buy it to find the perfect one and lie on your side rather than lying on your front with your neck twisted to one side. Mattress help.

For more information on how to maintain a healthy posture, here is a simple, three minute exercise programme for all ages, designed to help strengthen the spine and improve posture and help joints. To watch a video of the exercises you can do, please visit: http://www.chiropractic-uk.co.uk/straightenup.

If you have a neck or back problem you might like to see one of our Brighton chiropractors or physio’s then call 01273 774114.

Research was commissioned in January 2014 on a sample of 2006 UK adults.

*Sample of 408 adults from the South East responded to the question ‘have you ever suffered from neck or back pain’ and 312 adults from the South East responded to the question ‘how often do you suffer from neck or back pain’.

Free Spine Check for Kids on Friday 21st February 2014

Kids get back pain tooSundial Clinics, Brighton are supporting Rockinghorse with a new free spine check for children. On Friday 21st February 2014 Sundial will be carrying out free spinal check ups to check for poor posture and other causes of back pain as well as joint and muscle problems. Parents will be invited to make a donation to support the Rockinghorse Children’s Charity, which aims to improve the lives of sick children throughout Sussex.

Kids spine check includes:-

-Posture check
-Spine check
-Exercises to improve posture

Sundial chiropractor Matthew Bennett says

”Sundial Clinics have been a long term supporter of Rockinghorse and we look forward to raising money to support their excellent work for children in Sussex. Many children suffer from back pain and other aches and pains sometimes put down to growing pains. We can identify and help these problems.”

Kids posture smBack pain in children is more widespread than first thought. Researchers at Swansea University report a large increase in the number of children receiving treatment for back and neck pain. Research done by the British Chiropractic Association has found similar trends. Indeed as far back as 2005, 45% of children had suffered some kind of back pain by the time they were aged 11.

Richard Hollis, of Sundial Kemp Town is all too aware of this problem.

“As a chiropractor, I talk to a lot of parents who are concerned about their children’s posture and the health of their backs. Kids seem to need to carry so much more to school, do less physical exercise during the school week and then sit at home in the evening.” says Richard

As well as a posture check and spinal examination the Sundial chiropractors and physiotherapists will be giving exercises and helpful tips to keep children’s spines fit and healthy. Getting more active and tackling poor posture can help prevent back, neck and shoulder problems.
Straighten Up UK for kids is a simple, three minute posture care programme from the British Chiropractic Association, designed to help children feel and look their best. Straighten Up consists of just three simple exercises which are intended to be completed on a daily basis to become a part of a daily routine, just like brushing our teeth. Easy to learn and do, the sequence of exercises consists of precise, slow stretches, each with a specific purpose.

Analiese Doctrove at Rockinghorse Children’s Charity, added:

“This is an opportunity for parents to get their child’s spine and posture checked and to support Rockinghorse at the same time. The experts at Sundial can give plenty of tips and advice to help prevent aches and pains starting in the first place. By promoting an active lifestyle as well as balance, strength and flexibility in the spine, the risk of back problems in children can be reduced.”

To book an appointment call Sundial Queens Road or Sundial Kemp Town.

Here are some photos of the day.

Rockinghorse Kids Check 1

Rockinghorse Kids Check003 Rockinghorse Kids Check 2

Three gym exercises to avoid with a bad back – Johns’ story

Deadlift can cause back painWhen John came to see me with a recurrence of his back problem he was really fed up. He had been going to the gym and doing the core stability exercises that he had been shown by the instructor. He had been exercising two or three times a week since his bad back had recovered 3 years before and he felt fit and strong. His back felt great too. He didn’t do anything to upset his old problem – it just came on. Unfortunately he had been doing the wrong back exercises. The exercises he had been doing actually contributed to his back pain.

The last time John’s back was bad all he needed was a short course of chiropractic care and he was fine again. He wanted to prevent his back getting bad again so decided to get fit. Usually this is a good idea. People who exercise regularly tend to get a lot less back ache.

John asked the instructors at the gym to put together a program with his back in mind. The program they came up with included a mix of upper and lower body exercises and abdominal exercises to help with core stability. The program relied heavily on machines to provide the weights and resistance – even for the abs. Here is the first problem.

Abs machines, the sort where you sit in them with straps or a bar across your chest, can aggravate back problems. Worst of all they aren’t that good at working your core stability muscles which are important for back strength. There are safer and more effective abdominal exercises that are easy to do – when you know how.

John was doing two other exercises that could also be irritating his low back. The first one was a deadlift. Deadlifts are one of the commonest reasons gym users end up at a chiropractors. Even when done well there is a risk of damaging the low back discs. When done badly they can destroy a healthy back.

The other exercise that concerned us was a leg press. In this exercise you sit in the machine, load up the weight and push a plate away from you with your feet. Because your leg muscles are so strong you can move large weights. Lifting your own body weight is not that unusual. Again this is a disaster for the back, not because of the weight itself but rather that your low back is flexed forward when you load it up.

Normal disc standing upright
Normal disc standing upright
Disc Bulge in forward bending
Disc bulges when spine bends forward

If there is one thing the low back discs hate it is bending forward and then having a load applied as happens when you lift something. The reason has to do with the architecture of the disc itself.  The disc consists of a tough outer wall with a jelly inside. Some have likened it to a doughnut but I prefer thinking of it like a toffee eclair. As you bend forward the toffee like core is forced backwards against the back wall of the disc. If you compress the disc in this position, as you do when you lift a weight or do a leg press, then the core or nucleus, exerts huge forces against the wall. This can cause the wall to crack.

Once that tough outer coat splits or cracks then pain can come on. The pain can last for a very long time and be intense. If the crack is big enough then the toffee can ooze out and press on the nerves causing sciatica. Because the disc is slow to heal the pain can become chronic.

The good news is that other exercises can easily strengthen the low back, allowing the discs to heal and help prevent further pain. In the second part of this article we will show you how to exercise safely at the gym and protect your back from harm.

Update:

Following criticism on Twitter by several physio’s of the piece above I thought it would be useful to provide the reference for the views expressed. Most of the work comes from an excellent book by Prof Stuart McGill Low Back Disorders – Evidenced Based Prevention and Rehabilitation published in 2007.  In a 27 kg deadlift McGill found the compression and shear forces amounted to 7000N – enough to damage some weak spines.

On an anecdotal basis we regularly see people who claim to get back pain associated with certain gym exercises. Deadlifts are the commonest cause amongst these by a long way. In the case above, John was in a 1:1 training session with a gym instructor so can be assumed to be doing the exercise correctly. He still got injured and he felt the moment his back went on the deadlift.

There are other safer ways of exercising the muscles worked in a deadlift and we prefer to recommend these. There are some people who will benefit from deadlift training , especially if their work or play requires conditioning in these movements.

Matthew Bennett

Picture credit: Adrian Valenzuela

 

Mind your posture – carers, care for your backs with a free check up

Brighton chiropractor caring for carers with back painThere are currently around 140,000 thousand carers in East and West Sussex with the figure set to rise to 180,000 by 2037[1]. For many carers physical activity such as lifting is a significant part of their daily routine. However, not all carers will be aware of their back health when looking after someone.

Although paid carers may receive training on how to protect their backs during the physical aspects of their work, many unpaid carers, of which there are 5.8 million in England and Wales[2], may not receive any training or information about back care.

To coincide with Back Care Awareness Week (7 – 11 October) Sundial Clinics in Brighton is offering carers a free back check with advice on how to avoid back problems. Sundial Clinics  have developed the following simple tips for all carers to help them whilst they’re helping others.

Golden rules for carers

  • Think ahead – assess each situation and look for the best and easiest way to achieve the desired result, this may mean using any available equipment whether it be for specialist lifting or a simple sack barrow for moving boxes of supplies
  • Follow the weight – always try and face the direction in which you want to carry any weight – your body is strongest when you are square on to the weight
  • Take care when lifting – never lift while twisting from the waist.  Bend your knees, try to have a relaxed, straight back and if possible, brace your abdominal muscles. For added stability make sure that your feet are about a shoulder width or more apart before lifting
  • Ask for training – whether you are caring in a formal setting or helping someone at home, make sure you have been properly trained in how to use any equipment
  • Supportive shoes are essential – wear good, soft-soled shoes that are supportive and have a good grip on the ground
  • Take regular breaks – if doing a repetitive task, take a break every 20 minutes and do some simple stretches to relax your muscles.

Carers – Straighten Up

Matthew Bennett from Sundial comments: “Carers spend long periods of time on their feet and put a lot of strain on their bodies, from lifting and assisting the person they are caring for, to moving equipment. Even though our bodies are very well adapted to a variety of tasks, carers need to be particularly careful not to overload themselves and put their backs at risk.

“Formal care settings should have lifting and moving equipment available and staff should always make sure that they have been trained in the proper use of all equipment. Home carers should make sure they receive home assessments for the person they are caring for as equipment can be loaned out – this will require appropriate training for proper use.”

Matthew Bennett recommends a very simple three minute exercise routine entitled ‘Straighten Up UK’ from the British Chiropractic Association (BCA) has developed which is really easy to incorporate into daily life to help strengthen the spine and improve posture. The exercise routine can be accessed on the BCA website here: http://bit.ly/straightenup.

 


[1] Statistics taken from Carers UK http://www.carersuk.org/newsroom/stats-and-facts

[2] According to data from the Office of National Statistics from the 2011 census

The hidden dangers of Christmas: Top Tips to avoid back pain

Never mind the feeling of being more stuffed than the Christmas turkey there are other hidden dangers lurking around the Christmas tree. Turkey Lifters Back, Shoppers Shoulder, TV Remote Thumb may not be well known but they stalk the unwary festival reveler just the same.

Ok maybe some of those names are made up but Brighton chiropractor Matthew Bennett says “We do notice a marked increase in patients coming in with aches and pains directly related to the Christmas holidays. Probably the biggest increase is in back pain associated with spending more time doing very little. We sit around watching television, eating and drinking and sometimes even a fair bit of stress.”

Tree Mayhem for Backs

Bending and lifting awkwardly is well known to cause back pain. Lugging the Christmas in and trying to get it straight has its own hazard but also bending, stretching and twisting to put on the fairy lights and baubles start the strain.  Add in traipsing around the shops buying gifts and bending over on the floor wrapping them up pile on the pressure on your back joints and muscles.

Turkey Lifters Back

Who would have thought that a turkey could be so menacing. The benign bird becomes 25lbs of sizzling danger when bending over to get it out of a hot oven. The other option of several manageable pre-sliced fillets somehow doesn’t conjure up the same feelings of festive cheer though.

No-one wants to be a killjoy but alcohol is a factor in many of the injuries we see. There is the obvious “PFO” (Pissed and Fell Over) to the more insidious pro-inflammatory effects of booze over several days. On the plus side there is a muscle relaxation effect of moderate alcohol intake but after 2 or 3 drinks this doesn’t work anymore.

Adrenal Stress and Back Pain

Loads of sugar can affect your back too amazingly. Sugar stimulates your adrenal glands amongst other things and this combined with alcohol, caffeine and stress can over-work your adrenal glands leading to adrenal fatigue. Not only can this leave you feeling very tired but your adrenal glands produce anti-inflammatory corticosteroids. Without this chemical any injury is likely to be more painful.

You made it into the afternoon on Christmas Day uninjured. You may have been working in the kitchen on your feet for hours and your back or shoulders may be tightening up but now it is time to relax. You slump down into the sofa and watch a bit of TV. It seems like you stay there until the end of Boxing Day and by the time it is all over you feel like your back is shouting.

Top Tips to Avoid Back Pain this Christmas

  1. Take regular breaks when doing housework or cooking
  2. Use a table rather than standing up for some food preparation like peeling spuds
  3. Get help lifting awkward items
  4. Bend over by going down on one knee when pick up light stuff
  5. Bend your knees and stick your bottom out when lifting heavy stuff
  6. Use a step ladder rather than stretching when putting up decorations
  7. Get out for a regular walk over the holidays
  8. If you don’t go for a walk, do some squats
  9. If you don’t do squats or go for a walk vary the seat you seat in, possibly putting a cushion in the small of your back
  10. Take it easy on the alcohol and sugar

We hope you don’t have need of us but be assured that if you do, we are here between Christmas and New Year.

Happy Christmas from us all at Sundial.

Does back pain increase as you get older?

Brighton chiropractor, back painBack pain is one of the areas that we think gets worse as we get older but is this true? We often think that as we get older we will get more aches and pains.  To find out researchers scoured all the research on the topic to see if a trend could be found. Brighton chiropractor, Matthew Bennett, sums up the latest research.

It is reasonable to assume that back pain, or lumbago as it sometimes called, will worse as we get older because of the accumulation of wear and tear, arthritis and general use and abuse. As we get older we tend to exercise less, pick up more injuries in falls and generally recover more slowly from trauma, especially in the back. In spite of this the studies over the last 10 years don’t show an increase in back ache beyond the age of 60. In fact, in some studies, back pain actually seemed to be less frequent over the age of 60 compared to the years leading up to 60.

Why doesn’t back pain get worse as we get older?

There are several theories why back pain does not get worse as we get older. It could be that the people in the research just happened to be born at a time when they were very fit and robust naturally. Computer games, television and dishwashers were not around 60 years ago so people were growing up then were less sedentary. This may be the answer. Only a study that follows a large number of people for the whole of their lives would tell and this has not been done yet.

Another theory is that we get more tolerant to pain as we get older; our pain threshold goes up perhaps. The most likely explanation seems to be, however, that we do less physically demanding activities in old age so we don’t injure our backs so much. There are not many rugby players, mountain bike riders or kick boxers over the age of 60! Also we tend to stop work around this time. So if work posture or activity, or even work stress is the factor that brings the back ache on then stopping work might help prevent future occurrences.

Here at Sundial the average age of our patients is 38. Central Brighton has a younger demographic than other parts of the country where the average age of patients with back pain is around 45. That is not to say we don’t get people in their 60’s and 70’s coming in – we do, but the peak age to get back pain is in the younger, early middle aged groups. We also treat a few teenages with back pain which brings the average down.

If you are getting back pain and want to see if chiropractic or physio treatment can help you then pop in for a free check. We can also advise on a few simple exercises that you can do at home to keep your back healthy and pain free.

Reference

Does back and neck pain become more common as you get older? A systematic literature review. Chiropractic & Manual Therapies 2012, 20:24

Update:

Further research on the prevalence of bone and joint problems in older people show all sorts of aches and pains do continue into old age. Women tend to get more pain than men.

What is the prevalence of musculoskeletal problems in the elderly population in developed countries?A systematic critical literature review Chiropractic & Manual Therapies 2012, 20:31

Benefits of Rock Tape kinesiotaping, Brighton physio Quentin Guichard explains

Rock Tape kinesiotaping has become very popular with good reason at the Olympics. If you, like us, watched the Olympics in every spare moment whilst it was on, you will have noticed athletes wearing different coloured tape.  Usain Bolt wore some on his thigh to help him speed to his historic triple gold medals.  Novak Djokavic had some on his elbow and Serena Williams wore some too.  So what’s the difference between the coloured Rock Tape and normal taping?

How does Rock Tape kinesiology taping work?

The tape is called “kinesiotape” and the theory is that this taping raises the layer of skin and attached tissue covering a muscle, so that blood and other fluids can move more freely in and around that muscle, delaying fatigue. This keeps the athlete performing for a longer period of time. The tape is also used to promote proper form; the tape is applied so that when the muscles become fatigued, the tape helps to keep them in proper form, for longer periods.

What does Rock Tape help?

We use it to encourage proper form in running, swimming, cycling, diving in fact, just about any sports that depends on accurate and specific movement.  This also helps prevent overuse and “tracking” injuries when muscles have become imbalanced, such as Runners Knee.  Anything from back pain and posture problems to tennis elbow can also benefit from kinesiotaping.

This shows video shows Rock Tape being applied

Is there any proof that Rock Tape Works?

The research into this type if taping is in its early days, but there are some encouraging early studies showing performance improvement (1). Judging by the Olympics, the medical teams and their athletes certainly seem to think it helps them achieve their goals!  I am seeing some great results using this tape. We use Rock Tape because we find it is better than other sorts of tape. Here is how Rock Tape explain the difference. If you are getting any joint or muscle problems in your sport, then give me call to book an appointment to see if I can help.
Physiotherapist
References