Lower Back Pain

Lower back pain affects 80% of us at some point during our lives. There is no specific category of people who suffer back pain more frequently than others; men are affected as often as women and physical workers as much as sedentary workers. However, there are several factors that could be working against you, which do increase your chances of developing back pain. Below is a brief description of the spine and some of the more common causes of back pain that you may be able to avoid. 

The spine is a fascinating and complex structure containing muscles, ligaments, nerves, discs, blood vessels, bones and of course the spinal cord. All these structures are basically stacked on top of each other in a way that protects the spinal cord, yet allows it to connect the brain to the body. The vertebrae are placed above one another and separated by the discs, while the joints between them allow for movement. The spinal cord sits in the spinal canal and sends out branches which connect to every muscle, every organ and every blood vessel. This connection allows constant two-way communication to and from the brain.This intricate system is not without its flaws and a multitude of problems can occur. Some of these problems are beyond our control, but some are well within it.

Muscle strain: By far the most common back complaint is a muscle strain. Muscle strains can be mild, or they can be extremely painful and literally bring people to their knees. They can occur from the simplest of movements, such as bending forward when cleaning your teeth, or from the more obvious causes like lifting a heavy object. Weakness of the lower back muscles also increases their susceptibility to a strain and often leads to poor posture over extended periods of time.

It is important to keep the back muscles strong and flexible, and the best way to achieve this is with regular exercise. A variety of exercises would be the ideal, but at the very least, regular walking will have a significant benefit. Strong core muscles around the trunk, will also help protect the spinal joints and discs, as well as creating a stronger and more appealing posture. This in turn will help prevent that hunched shoulder stance and reduce the chances of spraining other structures in the spine, such as the ligaments.

Slipped disc: Another very common source of back pain is a ‘slipped’ or ‘prolapsed’ disc. Your discs are the shock absorbers between each vertebra within the spine; they have a tough outer layer with a fluid centre. A prolapsed disc is common between the ages of 20-40, although it can happen far beyond that age group. A prolapsed disc occurs when the thick viscous fluid (nucleus pulposus) deep inside the disc, bulges through the outer layers of the disc (annulus fibrosus). This fluid then pushes onto the closest nerve resulting in back pain and often ‘Sciatica’ (pain radiating into the gluteal, hamstring and lower leg).

Prolapsed discs often resolve over time and the vast majority won’t need an operation. However, be cautious as disc problems can be made worse by constant bending forward, lifting heavy objects or slouching for hours at a time at work or on the sofa. Exercises such as walking, swimming, Pilates and core stability training can aid healing, though recovery speed is often dependent on how bad the disc has ruptured.

Osteoarthritis: Firstly, let me start by stating that osteoarthritis (OA) is very different to rheumatoid arthritis (RA). Rheumatoid arthritis is an ‘auto-immune’ disease, which means the body’s immune system is attacking a variety of joints, causing damage and pain. Whereas osteoarthritis is a condition often referred to as ‘wear and tear’ of the joints, and as so, tends to commonly affect the weight bearing joints such as the lower neck, lower back, hips, knees, ankles and fingers.

Osteoarthritis produces small cracks within the cartilage at the end of the bones. These cracks tend to worsen over time resulting in the underlying bone being exposed and damaged. The joint will then often swell, thicken, stiffen and become painful, especially during weight bearing activity. As time goes by the joints can become less painful but remain stiff.

Certain types of exercise can often help as joint movement produces synovial fluid, which lubricates the joints. Exercise also helps to keep the muscles strong, which in turn helps to support the joints. However, be cautious as exercises which involve leaning backwards could potentially aggravate the lower back joints. It’s often a case of trial and error to see what your back is comfortable with, and for how long you can continue. Painkillers will also have their place in treating back pain, but other options such as heat packs and gels give relief too.

Helpful foods: Another option available to improve osteoarthritis is through your diet. Foods such as tomatoes, white potatoes, peppers and eggplant are members of the ‘Nightshade’ family and are thought to promote inflammation in the body, leading to joint pain. Sugary foods are also thought to promote an inflammatory response in the body. This doesn’t mean people with OA should completely cut these foods from their diet, but perhaps reduce them to see if it does make a difference. There are also plenty of anti-inflammatory foods out there such as omega-3 oils, salmon, avocados, broccoli, green tea and many more.

There are of course plenty of other causes of back pain including infection, ligament sprain, fractures, ankylosing spondylitis, rheumatoid arthritis and cancer. Fortunately, most back problems are mechanical and improve over time; sometimes with treatment, sometimes without. But, if you are in pain and concerned, you should consult your GP or a qualified therapist.


How an Osteopath can help: your osteopath will have studied the spine in detail and Lower back pain will be aware of the many factors that can cause pain. Osteopaths should be able to test and diagnose the likely cause of pain, followed by treatment and advice to help improve the situation. Should further investigation be required, your osteopath can liaise with your GP to discuss the best way forward for you. Osteopathy is primarily a ‘hands-on’ treatment although often includes acupuncture, ultrasound or TENS therapy.

“Happiness is nothing more than good health and a bad memory” – Albert Schweitzer

For more information, visit www.jhoughtonosteopath.co.uk or contact Jason at: info@jhoughtonosteopath.co.uk or T: 01603 291925. M: 07736 449603. Thanks for reading.

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Knee Problems

Knee Problems

The knee is the most frequently injured joint in athletes. Most injuries occur due to the extreme stress during twisting activities such as football, skiing, squash and any other sport that requires a large amount of body movement. Fortunately, the muscles surrounding the knee generally do a very good job of protecting the joint and most injuries are not too serious. However, as there are a multitude of things that can go wrong with the knee joint, any prolonged or acute pain,along with restricted movement should be checked out. 

The Knee Joint:
The Knee Joint is made up of four bones: the thigh bone or femur, the two long bones of the lower leg: tibia and fibula, and patella, or knee-cap. The knee joint is a hinge joint, and although it may look like quite simple, it is one of the most complex joints in the body. It is also the largest joint in the body and more likely to be injured than any other. 

As well as flexing and extending, the knee also has a small degree of rotation. This is perhaps one of the reasons why there are so many injuries to the knee. It is also one of the main joints to be affected by arthritis as we age. Taking care of our knees in the younger years may possibly help prevent future complications in our more mature years.

Common Problems:
The Menisci (meniscus) are you shock absorbers. They sit between the femur and tibia to provide cushioning, lubrication, stability and load transmission. A meniscal tear can often occur whilst twisting the knee, leading to pain, swelling, locking or giving way. Operations are often performed to remove, or partially remove the damaged area of these structures. Surgeons often try to removal as little as possible as removing a complete meniscus can significantly reduce the shock absorbing ability of the knee.

The Cruciate Ligaments are found in the centre of the knee and are the major stabilising ligaments of the joint. You may have heard of these ligaments: the Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). These ligaments prevent the femur and tibia sliding in opposite directions against each other. ACL tears are usually dramatic with immediate symptoms, whilst PCL tears are often less dramatic, but still result in problems.

A rupture of one of these ligaments often leads to significant swelling and instability, along with pain, discomfort and other complications. Surgery is often be performed to repair theses ligaments, but is not needed in every case. Suitable and persistent rehabilitation can have very beneficial effects in regaining stability and mobility over time.

There are four main ligaments that stabilise the knee joint; the cruciate ligaments, which we have spoken about, and the two collateral ligaments, which sit either side of the knee joint. The collateral ligaments stabilise the knee in a sideways direction, and you can probably guess, a sideways force is often the mechanism of injury. Most injuries occur to the inside (medial) ligament through direct trauma and include pain to the touch and stiffness. Fortunately, the majority of injuries to this ligament are not serious and heal quickly.

Osteoarthritis (OA) is a disease that causes the hyaline cartilage within a joint to break down; and the surrounding bone to thicken and restrict movement. OA commonly affects the hips, lower back, neck and knee joints. OA in the knee affects over 70,000 people each year in the UK; and most physicians believe a combination of factors including muscle weakness, obesity, injury and aging are responsible. Symptoms of OA include pain, stiffness and thickening around the joint, as well as reduced range of motion. Pain is commonly worse in the morning and during weight bearing activity.

Other problems which cause knee pain include: OA under the kneecap (patella), rheumatoid arthritis, muscle strains, bursitis, tendonitis, Osgood Schlatter’s disease, thrombosis, fracture and dislocation. Other areas that can refer pain to the knee include: OA of the hip joint and lower back, along with problems around the foot or ankle, such as overpronation (flat footed).

Stay Injury Free:
As the knee joint sits between two long levers, the upper and lower leg, it is extremely reliant upon the surrounding muscles and ligaments. The muscles at the front of the knee are the quadriceps and the muscles behind are the hamstrings. As well as aiding smooth movement, these muscles also help to support and protect the knee from damage. Therefore, exercise will help maintain the strength and condition of these muscles, whilst movement will lubricate the joint and the structures within it. Overall, regular exercise which will help maintain the integrity and longevity of the joint and hopefully minimise problems later on. Be kind to your knees.

How an Osteopath can help:
Osteopaths can often identify the cause of knee pain or discomfort and can help to reduce this discomfort. Your osteopath should also provide information on exercises to help with your condition, or possibly activities to avoid. Osteopathy is predominantly a ‘hands on’ treatment, although it may also involve ultrasound, acupuncture or TENS therapy. Should your condition require further investigation, an osteopath can write to your GP asking for further investigation.

“The weight of the world may be on your shoulders; but think what that’s doing to your knees!” JH.

For more information please contact Jason at: info@jhoughtonosteopath.co.uk or visit: www.jhoughtonosteopath.co.uk Tel: 01603 291925. M: 07736 449603. Thank you for reading. 

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Slipped Disc – The do’s and dont’s of Rehabilitation

A slipped disc in the lower back (lumbar spine) is a common problem and can often be overlooked, mis-diagnosed and treated with exercises that may worsen the problem rather than help it. It is extremely important to have a correct and specific diagnosis for your low back pain in order to treat and advise any rehabilitation. 

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