Osteopathic Tips and AdviceIn this section I will give some tips and advice for some of the common musculo-skeletal problems we see in the clinic. This is my advice, gained from 24 yrs in practice and 4 years full time training in osteopathy prior to that. I am sure you will get advice from all and sundry, friends, family and other practitioners, but like all advice you should use your common sense, try it cautiously if it seems a good idea and stop if it does not help or if it makes symptoms worse.
Should you use hot or cold?
Cold therapy is best when an area is inflamed, particularly when visibly inflamed and swollen, commonly peripheral joints like elbows and wrists etc. An ice pack wrapped in a tea towel applied for 20 minutes (only 20 minutes as it can cause tissue damage if left on too long), 3 times a day is considered optimal.
Personally I don't believe cold therapy is best for most low back problems. The parts of the spine that become inflamed are under a thick layer of muscle, and in my experience muscles prefer heat! It helps relax them, enlarges blood vessels to take your bodies anti-inflammatory products and pain killers to the problem area. A hot water bottle or wheat pack are ideal, but be careful not to burn yourself, as many patients' eagerness for relief tends to mean they use heat that is too hot and for too long.
My own job is physical, so I have found starting the day with twenty minutes or so in a hot bath really helps to relax my muscles ready for the day ahead. I also find it useful to contemplate the day ahead and what needs to be done…but that's another matter!
Are x-rays necessary?
Whilst x-rays can be used as part of the diagnostic process, they have their limitations and the radiation involved can be harmful if the x-ray process is repeated too often. Since you will not know when you will need your next x-ray, it is best to be tentative with its use. Low back x-rays in particular require a large dose of radiation to penetrate through the torso. In the UK in the past x-rays were used almost as the first diagnostic tool, but now we realise that a thorough case history and a detailed examination can often rule out the need of an x-ray and avoid the radiation involved.
As mentioned before, x-rays have limitations as to what they reveal, they do not show soft tissue and the image in simplistic terms is only a silhouette of the bone, so the cause of the patient's problems may not even show. When I trained we were taught that you treat the patient, not the x-ray! In short, x-rays have their uses, but only after very careful consideration, it is the whole symptom picture that is important.
Another tip, if you have x-rays taken privately, make sure you keep the x-ray films – after all you have paid for them! This may save you having to have more x-rays taken at a later date reducing exposure to radiation and also saving you money!
Should you rest or exercise?
You will need to use common sense on this one, listen to what your body tells you. In the past, if you had a bad back you were usually told to have bed rest. It is now clear that gentle movement tends to speed recovery as it promotes circulation. Patients often feel stiffer and in more pain after being stationary. An exercise program can be advised by your practitioner if it is appropriate.
If your pain is too acute to move then you have to rest up. Once again let your body tell you what it requires. Ignoring it may aggravate your symptoms and slow recovery.
Do you have to give up sport or the active hobbies you enjoy?
I feel there is one simple way to look at this question…does the "pain outweigh the pleasure?" Pain is ultimately processed in the head, and it is important to keep the head happy! Rather than getting depressed about having to stop activities you enjoy you should carefully try and see what you can cope with. I would only tend to advise cessation of a sport or hobby if the patient's symptoms are not improving, in which case a short break from the activity is often all that is needed. Obviously each case is individual, and this is a rough rule of thumb.
Should you take pain killers or anti-inflammatory drugs?
I personally feel they can be useful since pain tends to create more pain. Muscles tense more when you are in pain and posture alters, putting more strain on other parts of the body. Taking pain relief or anti-inflammatory drugs can break the cycle of pain. These drugs should be used very carefully as they have side effects and your personal medical history should be taken into account so getting advice from your practitioner or pharmacist is sensible.
Are your symptoms serious?
Most causes of musculo-skeletal pain are not serious, so a positive attitude to it is very important to aid recovery. Don't despair; seek advice from a practitioner if your symptoms are not improving on their own. Remember that when someone like me is taking the case history and we ask what seem like simple questions about “where does it hurt?” or “what does the pain feel like?” etc, we are doing this not because we are mildly curious, but because we are trying to discover the tissues causing the symptoms and why, and to rule out the serious pathologies that patients tend to fear first! This followed by an examination and tests is all part of the diagnostic process, to find the cause of symptoms and to try and estimate the prognosis i.e. how the symptoms are likely to be in the future. This information should be of great use to you in helping to deal with your symptoms.
I am always amazed at how many people put up with unnecessary pain, if the pain is not getting better on its own it is a good idea to seek advice. Personally I often see people just for one consultation, often this is all that is necessary, being able to explain the problem to the patient and to tell them how to ease it or what to expect from it.
Can osteopaths treat osteo-arthritis?
There is no cure for osteo-arthritis itself, but in many cases the symptoms can be improved markedly. Each case is individual, and a consultation will allow us to tell you whether we are likely to be able to help or not.
Is Osteopathy safe?
Osteopaths take a detailed case history and do a detailed examination and we have many treatment techniques available to make the treatment as safe as possible. So if you have pre-existing conditions they can be taken into consideration before treatment. We treat all ages from babies to the elderly. Even if patients are on steroids or have osteoporosis for example, we can treat accordingly and safely if appropriate.
Will you be sore after treatment?
Whilst we do our utmost not to make patients unduly sore after treatment, some of our techniques involve causing a reaction in the body's tissues, for example, increasing the blood supply to an area. I personally believe that you cannot expect a change in the tissues we treat without there being a small risk of soreness. Often slight soreness is followed by improvement in the tissue state. If the soreness is unacceptable to the patient or not followed by the desired relief, this can give us more information to fine tune the treatment appropriately so as not to cause the soreness again. I find a clear explanation by ourselves allows the patient to know what to expect, and in the vast majority of cases most patients have no post treatment soreness at all . If you do experience an adverse reaction you should tell us and we can deal with it and adjust the treatment.
Click here to download a sheet explaining how to do five basic stretching exercises which can help the majority of low back problems.
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ADDITIONAL SERVICES .
At the clinic we can advise on additional matters such as use of back supports and braces, advice on chairs and bedding etc. We can order a wide range of products that can aid your recovery.
Some of us can write “off work certificates” or liaise with your employers, your GPs etc. The clinic is also in an advantageous position by having a podiatrist sharing the building. Podiatrists look into the mechanics of the foot as many problems arise through dysfunction of this area; even some back problems are related. We also have a satellite clinic held at Morrab Surgery in Penzance.