Achilles tendon pain? Which type do you have?

Massage on runners calf and Achilles tendonIf you have suffered from Achilles pain in the back of the heel or calf you know how long it can last and how bad it can be. Understanding why you’re getting Achilles pain plays a big role on the road to recovery and prevention.  The pain is often due to Achilles tendinopathy and used to be called Achilles tendinitis; “itis” means inflammation and we now no longer believe that it involves inflammation so we don’t use that term anymore.  Either way, Achilles tendinopathy is one of the most common runners’ injuries that I see at Sundial Clinics here in Brighton. In this series of articles you will learn some of the ways in which you can avoid, treat and manage this common and troubling tendon pain. 

Types of Achilles tendinopathy?

First off, it is important to establish exactly what is causing the problem and exactly what type of Achilles pain you have.  There can be several other reasons why you may be getting Achilles symptoms, but for the purpose of this article, we will concentrate on the most common.

Recent studies have shown that injury rates are as much as 29-58% in new runners. It’s also estimated that 60-70% of running injuries are due to overuse or training error.

In other words, don’t just concentrate on the painful point!  Rehabilitation from an injury can be complicated and unless you’re addressing the root cause of the problem, it’s likely to come back!  This is why seeing a physio can be useful: we can help you to understand the reasons for your symptoms and help you address the imbalance and weakness which may lead to injury.  

 

Diagram of Achilles tendinopathy, tendinitis

Mid Portion Achilles Tendinopathy

The most common cause of Achilles pain is mid-portion Achilles tendinopathy. This commonly affects the Achilles 2-7cm above the bony point at the back of the heel.  Typically, this is likely to appear swollen, be tender to touch and will often cause pain and stiffness first thing in the morning and when weight-bearing.

Insertional Achilles Tendinopathy

This condition is less common but still a prevalent problem that I see in the clinic.  The key difference between the two is that mid-portion tendinopathies are commonly caused by tensile loading and insertional tendinopathies are caused by compression.  

The main presentation for the insertional kind is a pain at the heel bone where the Achilles attaches and pain with the ankle flexed to stretch the tendon i.e. the position of the foot when walking up a steep hill.  This position of the foot is what causes the compression and aggravates the symptoms – and why exercises that exacerbate this should be avoided!

Below I will outline the best way to manage these conditions, along with links to some self-help videos for exercise and pain management.  However, it’s probably worth mentioning at this stage that these are only to be used as a rough guide and if you are unsure about your condition please book yourself in for a physio consultation.  The first appointment is free! And it may help you avoid getting it wrong and potentially delaying your healing time.

Tendinopathy Phases

Now that you have a rough idea of why you have tendinopathy, you now need to figure out what stage of tendinopathy you are dealing with.  To avoid going full physio geek on you, we’ll keep this simple and concentrate on two phases of tendinopathy, the first being the reactive type and the second being the degenerative tendinopathy. 

Phase One – Reactive Tendinopathy

Commonly caused by an increase in loading exercise, for example trying to run faster or further than you’ve ever done before…we’ve all done it!  This will typically cause pain during or after the activity and may be exacerbated first thing in the morning or during weight-bearing activity.  

The key to your management at this stage is to reduce the load that you’re putting through your Achilles and try and calm the symptoms down.  It’s pretty simple: if you carry on doing the same thing at the same pace and effort then you are likely to make it worse!

Phase Two – Degenerative Tendinopathy

At the tender age of 41 and having played sports for most of my life, sadly I would fit into this category.  In fact, I would say it is almost normal to have a degenerative tendon somewhere in your body if you’ve been active for most of your life, especially with high impact sports such as running, football, netball and basketball. So do not fear – this is common!  

Basically, if you’re older and have a previous history of Achilles pain and a grumbly tendon that is prone to flare-ups, it’s likely that you will also fit into this category.  The typical presentation is a thickened tendon, which is painful to touch and is often sore first thing in the morning and during weight-bearing activity. Again, load management is important. If you keep aggravating it, there is potential to make the situation chronic and potentially lead to a partial or full Achilles rupture.

It is also possible to have a reactive, degenerative tendon.  An example of this would be a 60-year-old man who has a history of Achilles pain with symptoms which have been under control for several years, but a recent increase in tennis has caused his degenerative tendon to become reactive.  If this is the case with you, then start your management at the reactive phase i.e. reduce the load, pain management, rehab exercises then graded return to activity.  Tendons are complicated and there is no one recipe for treatment. Finding the right treatment is an important part of your recovery.

Now that we have the geeky part out of the way, let’s look at treatment. Part Two to follow soon covers the treatment for both the mid-portion and insertional Achilles tendinopathy.

James Masterson
Physiotherapist

 

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Recent Posts on Sports Injuries …

  • Achilles tendon pain? Which type do you have? 4th December 2019 Achilles tendon pain? Which type do you have?
  • Brighton half marathon recovery tips: how to manage an acute injury 18th November 2019 Brighton half marathon recovery tips: how to manage an acute injury
  • Brighton Half Marathon runners’ offer 27th February 2019 After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong ...
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  • Runners MOT – Brighton Half Marathon 30th November 2015 Running injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because ...
  • Do I need orthotics for running? 4th December 2014 Why would I need orthotics? Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is ...
  • Running shoes – top tips for the marathon season from Brighton physio 27th November 2014 If like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton. Which running shoe shall I buy? Inappropriate footwear is the root ...
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  • The 7 R’s – Brighton Marathon Training Tips 5th February 2014 The Brighton Marathon is the highlight of our sporting calendar. We have supported Brighton runners and their charities for many years but we have noticed that many people are not getting the support and advice they need to complete the marathon injury free. One in five people who enter the marathon will not complete it ...

Brighton half marathon recovery tips: how to manage an acute injury

knee-examination-brighton-physioAs a physiotherapist, I get asked how to manage an acute running injury a lot and having just completed training session or race itself you may be asking yourself the same question.  So in order to help you with your post-run recovery here are a few useful tips to ease you back to fitness and training for your next race.

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often referred to in the industry as POLICE.  With each letter relating to a useful management strategy, this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

Protection:  Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

Optimal Loading:  The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention.runners-start-vitality-brighton-half-marathon-sm

Ice:  Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

Compression:  Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation:  Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the affected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

At this point, it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight-bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

James
Sundial’s Physiotherapist

Sundial is a partner for the Brighton Half Marathon on 23rd February 2020 providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you. Call for a free Runners MOT

Recent Posts on Sports Injuries …

  • Achilles tendon pain? Which type do you have? 4th December 2019 Achilles tendon pain? Which type do you have?
  • Brighton half marathon recovery tips: how to manage an acute injury 18th November 2019 Brighton half marathon recovery tips: how to manage an acute injury
  • Brighton Half Marathon runners’ offer 27th February 2019 After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong ...
  • How to manage an acute injury yourself 29th February 2016 “As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back ...
  • Great stretches for running 10th February 2016 Stretching may help reduce injury and improve flexibility in runners. Most runners include stretches in their routine. It is important to prepare your muscles for a run by gently warming up and keep flexible by doing these stretches. These exercises put together by our physio can help stretch the main running muscles. These stretches should be ...
  • Runners MOT – Brighton Half Marathon 30th November 2015 Running injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because ...
  • Do I need orthotics for running? 4th December 2014 Why would I need orthotics? Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is ...
  • Running shoes – top tips for the marathon season from Brighton physio 27th November 2014 If like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton. Which running shoe shall I buy? Inappropriate footwear is the root ...
  • Is your spine slowing down your running? 26th February 2014 If back or hip pain is hindering your running performance and fitness goals then here are some facts to help put a spring back in your step writes Brighton chiropractor Amy Pease. Staying fit helps to prevent aches and pains, however various factors come in to play when pounding the pavements that could put you ...
  • The 7 R’s – Brighton Marathon Training Tips 5th February 2014 The Brighton Marathon is the highlight of our sporting calendar. We have supported Brighton runners and their charities for many years but we have noticed that many people are not getting the support and advice they need to complete the marathon injury free. One in five people who enter the marathon will not complete it ...

Brighton Half Marathon runners’ offer

After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong and what to do about it.

We understand how annoying aches and pains can affect your running and can even stop you doing what you love. You don’t have to put up with it.

We’ll give you 50% off your next physio or massage session here at Sundial for all Brighton Half Marathon runners.

  1. Book an appointment for a massage or physio session
  2. Get a customised treatment plan based on our review
  3. Take the first step towards pain free running

50% off your next physio or massage session – Book now

Download Top Tips to Beat Running injuries pdf

We have treated thousands of runners over many years and have been the clinic partner for the Brighton Half Marathon for the last four years.
Achilles tendon massageOur patients say:
A sequence of physiotherapy and home exercises continued over the next few weeks and gradually the condition improved until it completely cleared.
Lee Ashton

He tried various techniques with me to find exactly what worked for me. We tried different physio exercises to build up the strength in my knees and the pain has reduced massively. I am really grateful for his help, and the lovely team at Sundial who are always welcoming and kind.
Charlotte S

50% off your next physio or massage session – Book now

Simple exercises to do at home for heel pain and plantar fasciitis

Here is a video of some simple exercises to do at home to help with heel pain and plantar fasciitis. Do them gently and don’t exceed 4/10 on pain when doing them. If the symptoms are not getting any better then make an appointment with for a check up or with your local physio.

 

To learn more about heel pain and plantar fasciitis go here.

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. 

How to beat running injuries with strength training

single-leg-squat-strength-exerciseTo avoid common running injuries you should follow the lyrics of Daft Punk – Harder, Better, Faster, Stronger!

As a physiotherapist I get to meet lots of runners with common overuse injuries and I believe most of these problems can be overcome with some simple strength and conditioning principles.

If you’re planning on competing in a running event this year such as the Vitality Brighton Half Marathon it’s likely that at some point during your training you will pick up an injury.  Like most people you’ll probably turn to the internet or a running magazine where you’ll find lots of information on the benefits of warming up and stretching but less likely to find any guidance on strength exercises for running.

In a recent study with 26,610 participants by Lauersen et al (2013), looking at the effectiveness of exercise interventions to prevent sports injuries, found that overuse injuries could be almost halved with strength training alone.

With this research in mind I have put together three basic strength and conditioning programmes for you to work on as part of your running training.  Begin with stage one giving yourself roughly four to six weeks or until you feel confident before moving onto the next programme.

3 strengthening moves for runners from Vitality Brighton Half Marathon on Vimeo.

Remember this is just a rough guide to strength training and your ability to perform these exercises will depend on many factors, so if you have an injury or you don’t feel confident then get it checked out!

Sundial offers a free 20 minute physiotherapy consultation to anyone who is unsure about an injury so please get in touch if you need any further advice.

James
Sundial’s Physiotherapist

VBHM logoSundial is a partner for the Vitality Brighton Half Marathon on 26th Feb 2017  providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Running the Vitality Brighton Half Marathon? Call for a free Runners MOT

How to manage an acute injury yourself

Runners knee pain“As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back to fitness and potentially your next race.”

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often  referred to in the industry as POLICE.  With each letter relating to a useful management strategy this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

 Protection

Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

 Optimal Loading

The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention

 Ice

Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

 Compression

Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation

Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the effected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

 At this point it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you.  Why not call the clinic today to arrange a free informal consultation and stop that niggle turning into a pain!

Great stretches for running

Stretching may help reduce injury and improve flexibility in runners. Most runners include stretches in their routine. It is important to prepare your muscles for a run by gently warming up and keep flexible by doing these stretches. These exercises put together by our physio can help stretch the main running muscles.

These stretches should be held for over 30 seconds – don’t rush. Aim to do these exercises once a day although doing them twice a day is three times as beneficial. Stay relaxed and breathe out as you develop the stretch. Develop the stretches gently to avoid overstretching and injuring yourself.

The 3 stretches we recommend for running are: hamstring, hip flexor and calf and here is how to do these.

You can download the stretches for running for free here VBHM stretches

Hamstring stretch

Dynamic hamstring stretch

Sets three each side

Hold 30 to 60 seconds

  • straighten one leg, grabbed the back of your thigh and target your leg towards your chest until you feel a gentle stretch.
  • Bend your leg at the knee slightly coming off the stretch
  • repeat by pushing your heel towards the ceiling
  • alternate your legs

Note: avoid kicking violently or arching your lower back

If it’s shaking your doing it well!

Hip flexor stretch

Hip flexor stretch

Sets three each side

Hold 30 to 60 seconds

  • hands on hips, tuck your tailbone under to flat on your back
  • lean forwards while maintaining a straight posture and keeping your head up
  • avoid arching your low back or letting your hips roll forwards

Note: do it next to a wall if you feel out of balance

Calf stretch

Sets three each sideCalf stretch

Hold 30 to 60 seconds

  • have front toes and knee touching the wall
  • move your foot back a little until you can just about keep your knee against the wall and heel on the floor
  • hold
  • Move the back foot away from the wall to feel a stretch
  • keep back heel on the ground and knee straight as possible
  • hold
  • swap legs

In partnership with the Vitality Brighton Half Marathon

VBHM logo

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.