Why does back pain come back? And how to prevent it

Man with poor posture at table at risk of back painBack pain recurs when the stresses and strains on your back overcome your body’s ability to deal with them. Daily activities like bending, lifting and long periods of sitting with poor posture can put a strain on the spine which it can normally cope with very well. Unfortunately, if there is an underlying issue which reduces your ability to manage these forces then the back muscles, joints or discs can get irritated and start to hurt.

Back pain often comes and goes. If you have a mild episode of back pain it will often get better by itself over a few days or week or two. Even though the pain may be gone, however, the underlying dysfunction which caused the problem in the first place may still be lurking. When this happens a simple movement may strain something in the back and the pain flares up again.

As each episode of back pain strikes the more likely it is that you will have another back attack. These episodes often get worse the longer the problem is unresolved and get more and more frequent and last for longer each time. So what can you do about it?

There are three things that help reduce recurrent back pain:

  1. Take regular exercise

Staying active is the single most important thing to prevent back pain from returning. Whilst back muscle or core exercises are very useful in the treatment of low back pain, no one particular exercise regime has been shown to be better than any other when it comes to prevention. This means that any sort of regular moderate exercise can help prevent back pain. It’s probably more important to do something that you enjoy and is easy to get to so that you keep doing it.

  1. Watch your posture and movement

Well known simple things make a big difference like bending your knees when you bend and lift; not sitting at your desk or on a sofa for too long and making sure your normal back curve is maintained by putting a cushion in the small of your back. Sometimes you will need to avoid deep soft sofas too. Being aware of these things is often enough to improve your posture sufficiently to take the strain off your back.

  1. Get stiff spinal joints sorted out

Even though the low back pain may have gone, silent spinal joint dysfunction can persist. Improving the mobility of these joints has been shown to prevent future bouts of pain. That’s why we recommend a periodic check-up by one of our chiropractors every few months if you are prone to recurring back pain. It can make a big difference and can save time and money in the long run.

 

Stress affects back pain

Other things can also increase the likelihood of another bout of back pain. Stress, anxiety and depression have been associated with persistent or recurrent low back pain. A post on this is coming soon.

Little-known cause of back pain starts in childhood and is entirely preventable

Back pain often comes on apparently without reason. In fact, one possible cause might stretch all the way back to childhood. Hove dentist, Pieter Grobbelaar, tell us how teeth and jaw problems can be behind chronic pain.

The jaw joint (TMJ) and pelvic joints (sacro-iliac joints) both work in conjunction with one another, compensating for one another when either joint becomes misaligned writes Pieter Grobbelaar. With an abnormal bite the TMJ becomes dysfunctional and this creates instability at the weight bearing sacro-iliac joint in the pelvis. This leads to poor body posture which can cause low back pain, neck pain, headaches and other health problems.

The majority of children (75%) now have crooked teeth, incorrect jaw development and other orthodontic problems, which is evident from 3-5years of age, are not caused by big teeth in small jaws or hereditary factors. However, rather than blame genetics for crooked teeth and poor jaw development, modern research has produced evidence that points to other causes.

Concordia dental healthcare has recognised that Soft Tissue Dysfunction or poor myofunctional habits such as mouth breathing, incorrect tongue position, reverse swallowing and thumb sucking are the real causes of malocclusion and poor cranio-facial development.

The restricted development limits the space available for erupting teeth and prevents them from emerging into their natural position.

75% of growing children are affected and most commonly will presents with crooked teeth, undeveloped facial and jaw bones, TMJ (Temporomandibular joint) dysfunction and poor body posture.

Mouth breathing is abnormal and is one of the causes of Sleep Disorder Breathing (SDB) problems.

SDB in children has been recognised as causing widespread health, developmental and behavioural problems, including snoring, gasping, cessation of breathing such as Obstructive Sleep Apnoea (OSA) and interrupted sleep, which can result in drowsiness during the day as well as behavioural problems in children. Additionally, as well as being detrimental to the development of the face, jaws and teeth, if left untreated paediatric SDB can lead to significant and serious health problems causing poor quality of life later in adulthood.

If a child breathes through their mouth during the day or while sleeping at night, the tongue drops to the bottom of the mouth, which results in upper and lower jaw development problems. Allergies, asthma and open mouth posture also cause the jaws to develop incorrectly.

Incorrect dental and facial development can be detected at an early age, but so often no treatment is recommended. It is well known that the majority of our children do not develop their jaws and face correctly. This results in crowded teeth and underdeveloped faces.

Braces and extracting teeth in teenage years does not solve the underlying problems behind the causes of crooked teeth and incorrect facial development.

The balanced cranium provides the anchor points for the tension membranes which support the brain. The rhythmic pulsing of the brain as it expands and contracts, when breathing, provides the basis for the sacro-occipital pump which circulates cerebo-spinal fluid.

One of the most important aspects of normal cranial function is the position of the jaw. When the lower jaw (Mandible) comes in contact with the upper jaw (Maxilla) the movement should be symmetrical, simultaneous and even. This constitutes normal cranio-dental function. When the jaw becomes distorted the entire balance of the cranium is put in jeopardy.

A misaligned jaw will change the bite plane and ultimately the bite, affecting the cranium, TMJ, muscle balance, normal spinal mechanics and pelvic stability.

Good cranial development is needed for optimum neurological development.

The cranium consists of 28 bones, any distortion will affect transmission within the brain, cranial nerves and ultimately the nervous system.

Cranial development is 65% completed at age 8 years and 95% completed at 12 years of age, therefore it’s essential that intervention occurs as early as possible assisting cranial development to its optimum genetic potential.

Pieter-Grobbellar

 

 

Dr Pieter Grobbelaar BChD

Founder and Principal Dentist of Concordia Dental,

51-53 Church Road Hove

 

 

Exercise mistakes that make your back worse

Most back exercises are great for the back and it doesn’t seem to matter much what exercises you do as long as you stay active. But some exercises can be harmful and actually damage your back. So whether you like the gym, Pilates, yoga or a sport it is important to know the good and the bad. Matthew was recently interviewed about just this topic by Stu Girling from Love Yoga Anatomy. Stu trains yoga teachers and practitioners on safe ways to do yoga.

One of the exercises that does more harm than good is forward bending despite the fact that lots of people do it to stretch their back. As we bend forward huge pressure builds on the lower discs. As you bend from the waist, if the lumbar spine is held in neutral, with its natural forward curve, the pressure on the disc is reduced. If you round your lower back as you bend forwards then the discs are vulnerable. The jelly inside the disc gets forced backwards and can cause cracking in the outer disc wall. If this carries on it can cause a disc bulge or a “slipped disc”.

 

Forward-bending
Lumbar-loads

 

If you bend, as in a yoga forward fold, over and over again then it can cause injury. It is like repeatedly bending a credit card, a white line appears and ultimately it breaks.

Many people with back pain feel that their back is too stiff and want to stretch it. A better goal for exercises is the right mix of flexibility and stability. If your back is too stiff and this causing pain then the solution is to unlock the spinal joints with chiropractic manipulation or mobilisation. If, however, your problem is too much flexibility then we work to stabilise your spine.

Why an accurate back pain diagnosis is essential

Back pain is not one condition but several conditions causing similar symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back problems that can refer pain down to the buttock and leg and a skilled chiropractor or physio can tell which problem it is likely to be. Whilst several conditions can co-exist an accurate diagnosis is important because the treatment is different for all three.

The diagnostic confusion is made worse by the different experts who treat back pain because they often use different terminology to describe the same thing, recommend different treatment based on their area of expertise and frequently ignore the evidence that their approach has been shown to be ineffective and so leave you, the patient, in pain and more confused about what is wrong.

Most back pain is caused by irritation to:

  1. joints,
  2. discs,
  3. muscles or
  4. nerves of the spine.

This irritation happens with repetitive minor trauma such as bending and lifting or, more rarely, by a single traumatic injury such as a fall or accident. It can also be caused by inactivity which causes the joints of the spine to stiffen up and the back support muscles to become weak such as sitting at a desk for long periods.

If the joints of the lower back get stiff they are less able to carry out normal movements and this can lead to further joint irritation, stiffness and pain. This is often called Facet Joint Syndrome. The nerves around the stiff joints get irritated too and fire off alarm signals into the nervous system which can cause further symptoms such as tingling and pain referred down to the hips and legs. This can mimic sciatica.

Occasionally, the nerve irritation can cause muscles in the legs to weaken and this can lead to problems in the hips and knees. How this occurs isn’t clear but anyone with hip or knee problems seeing us here at Sundial will get a thorough muscle and spine check-up.

We treat back pain with an effective step by step programme to rebuild strong and healthy backs so you can lead an active and fulfilling life.

 

Get started today with a free consultation…

Book now

 

 

Back pain in pregnancy and chiropractic

freestocks-org-71789-unsplash

During pregnancy your body changes to adapt to your growing baby. These changes happen fast and you can experience pain and discomfort in your pelvic and lower back area.

Hannah’s story

Hannah came to me here at Sundial during her 4th month of pregnancy because she was experiencing pelvic pain for few weeks and the intensity of pain was increasing with time. She was also suffering with pubic pain for the last few days.

She would feel more pain turning in bed, walking and going up or down stairs. Being a nurse Hannah needed to be on her feet most of the day and she desperately needed relief.

After an examination I explained to Hannah that she was experiencing pain because of a sacroiliac dysfunction, a lack of movement in the joint of the pelvis.

These types of pain are very common during pregnancy. In fact 20% of pregnant women suffer with pelvic pain and 50 to 85% with low back pain. This is mainly due to the hormonal changes during pregnancy as your body starts to produce relaxin, the hormone that relaxes your ligaments in order to increase the space for your baby and birth. Also mechanical changes occur as the pregnancy goes along. As your tummy gets bigger the curve of your lower back increases and creates pressure on your back joints and muscles too.

We started working on this sacroiliac dysfunction using very gentle techniques to free up the joints and also working on the ligaments and muscles of the pelvis with gentle pressure. I also gave Hannah stretches and exercises to stabilise her core muscles and pelvis at home.

I saw Hannah regularly throughout her pregnancy in order to maintain the right sort of movement in her pelvis and, fortunately, she didn’t experience pelvic pain anymore!

Can arthritis of the spine cause back pain?

Does arthritis, specifically osteoarthritis, cause low back pain? In this video Brighton chiropractor and back pain expert, Matthew Bennett, reveals the answer and explains what osteoarthritis of the spine actually looks like.

Headaches – the hidden cause

Neck exercise to relieve headacheAnyone who has suffered from regular headaches knows how unpleasant and disrupting they can be. Many headache sufferers find it difficult to concentrate, to work or even carry out simple activities without feeling grumpy.

Jamie’s story

Jamie came to me here at Sundial because of six years of headaches that were affecting his work and his life with his partner. And things were getting worse. A recent increase of the frequency of the episodes made him realise he had to do something.

Headaches can be bad enough but Jamie’s symptoms started a journey all of their own. His pain was travelling from his neck to the top of his head on one side and travelling down to the shoulders and to between his  shoulder blades. He would always have the headaches during the week and only found respite at the weekends. A stressful day at work or being on a computer for long period of time was increasing the pain to unbearable levels so even painkillers were ineffective

Jamie has a job with a lot of responsibilities in a big company and needs to manage a team. He spends a lot of time sitting in meetings and even more staring at  a computer screen. Stress is a constant feature in his work.

When Jamie came to see he was keen to end this agony. After an examination I found that some of the joints in his neck were stiff and not moving correctly. The surrounding muscles were in spasm and were very sore to the touch. It was clear that Jamie was suffering from headaches caused by referred pain from the neck – so called cervicogenic headaches.

In Jamie’s case the dysfunction has been triggered by his repetitive poor posture, especially sitting at the computer for long periods of time.

Successful treatment begins

I started to treat Jamie for cervicogenic headaches, by addressing the cause. As a chiropractor I worked on the muscles of Jamie’s neck and shoulders applying gentle pressure to relax the muscle tension. I also used my hands to increase the mobility of his neck joints using gentle pressure.

But Jamie had to bring some change in his life as well. Here are the tips I gave him and it could help you too to deal with your cervicogenic headaches.

Jamie has now far fewer  episodes of pain and during a really stressful day at work, if the pain starts, he can decrease the intensity and the duration of the episode by himself using these tips

If you would like a free check up to see if chiropractic can help you then call to make an appointment or use our online booking above.

New study slams medical treatment for back pain

backsA new study on back pain in the prestigious medical journal, the Lancet, roundly criticises medical treat of low back pain. Researchers from all over the world took part and looked at how back pain is treated and they concluded that there is “inappropriately high use of imaging, rest, opioids, spinal injections, and surgery.”  They go on to say that “Doing more of the same will not reduce back-related disability or its long-term consequences.”

Back pain is now the number one cause of disability globally and rates have continued to rise in spite of increased spending on treatment. The authors make a plea for more sense and evidence based treatment. They call for a new direction which encompasses emerging treatments alongside effective solutions that exist already.

Effective treatment for back pain

Guidelines exist for doctors to follow on the most effective sorts of treatment but often these are ignored or not implemented properly. Here in the UK, NICE has issued guidelines and these are mentioned in this study as being helpful and they echo the findings in this paper.  The evidence points to a biopsychosocial model of care which looks at the behavioural, psychological, and social factors as well as the anatomical structures which play a role in the persistence of pain and disability. What does this mean for you if you have back pain?

It means that there is greater emphasis on self-management, physical and psychological therapies, and some forms of complementary medicine, and less emphasis on pharmacological and surgical treatments. So staying active, doing gentle exercises, getting some manual therapy as well dealing with stress, anxiety and depression, especially negative feelings around pain and disability, are very helpful. Some guidelines also recommend massage and acupuncture. One thing the guidelines in the US Denmark and UK agree on is that spinal manipulation is helpful. Which is good news because that’s what we do here at Sundial.

The report goes on to highlight the differences in standards of care throughout the world and it is clear that there is huge variance in practise and approach. For instance in the USA only half of back sufferers are prescribed exercises and in Sweden, USA and Australia electrical modalities like ultrasound are routinely used in spite of being ineffective.

Back pain is not one condition

This review is an excellent summary of the worldwide management of low back pain but has its limitations. Back pain is not one condition but several conditions causing a similar group of symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back that can refer pain down to the buttock and leg and a skilled clinician can tell which problem it is likely to be. Whilst several conditions can co-exist it is clear that an accurate diagnosis is important because the treatment is different for all three. Here at Sundial we make sure we make an accurate diagnosis and agree a treatment plan that is the most likely to get the best results.

If you would like a free check up to see if we can help your back pain please give us a call or book online above

 

Reference:

Prevention and treatment of low back pain: evidence, challenges, and promising directions

Foster, Nadine EBuchbinder, Rachelle et al.
The Lancet , Volume 0 , Issue 0 ,

21 March 2018

Free physio exercise routine (worth £42) with free spinal check-up

Low back stretchMost people think that having a healthy back is matter of luck, a matter of avoiding accidental injury and bending a lifting properly. Whilst these things certainly help there are three things that research has shown to be the most effective way of treating and preventing back pain.

Firstly, and most importantly, keeping fit and active has the biggest impact on preventing back problems. Initially, a few days rest may help a bad back but getting active early on is key to a full recovery. Once your back is better it is important to maintain levels of activity and there are certain simple exercises that you can do at home. These exercises can also prevent back pain coming on in the first place.

The second thing that will help keep your back in tip top condition is getting treatment sooner rather than later. If back problems are not clearing up or keep coming and going it may be a sign that that the condition is slowly worsening and this can lead to chronic, ongoing pain.

The third solution to keep your back healthy is regular preventative check-ups. Back problems come on because the spinal joints gradually stiffen over time, causing reduced movement, inflammation and pain. We can check for the early signs of spinal stiffness and our treatment can unlock the stiff joints and prevent the pain from coming on in the first place.

For January, we are offering a free spinal check-up with a chiropractor combined with free 30-minute physio assessment and personalised exercise routine (worth £42) for everyone seeing a Sundial chiropractor. To book in online – www.sundialclinics.co.uk or call Sundial Queens Road, 01273 774114

 

Terms and conditions: One free spinal check up and one free physiotherapy exercise session is available on request. To be eligible to claim you must receive a session with a Sundial chiropractor between 2nd – 3rd February 2018. Only one free chiropractic check-up and one free physiotherapy session is allowed per person and it must be taken by 31st March 2018. The free sessions are not transferable and cannot be exchanged for the cash equivalent. 

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.