Monthly Archives: November 2014

Osteopath’s thinking… Back Pain- why do we live with it?

Back Pain, why do we live with it?
The statistics are scary, 80% of adults will at some time experience debilitating back pain. As if that’s not bad enough then most of that 80% can look forward to recurring episodes. This can lead to cycles of treatment with your therapist of choice and or popping pills in order to deal with the pain.

back pain

Rather than dealing with the underlying causes many people fall into a cycle of coping with their episodes of back pain and though this may be all circumstances allow us to do in the short term in the long term it could be compounding the problem.

As an osteopath the low back pain patients I see fall into two groups:
• Patients in acute pain who have regular treatment until their symptoms subside
• Patients in acute pain who once their symptoms are under control continue with regular
maintenance treatments.

It’s easy to say that the second group are perhaps making the more sensible choice but we all have different demands on our resources, be this time or finances and for some patients the boom and bust cycle of back pain treatment is the only viable option.
For many people this coping mechanism is what gets you through the rough times but it’s not a great long term solution for many reasons.

What both groups have in common is the factors that contribute to them being in pain are usually similar an unholy trinity of poor movement patterns, leading to imbalanced muscles that act unevenly on the joints of the body resulting in wear and tear and strain.
This is not an easy fix as our movement patterns are difficult to change, especially when people become fearful of movement triggering pain. In many cases the amount of tissue damage that has occurred in order to trigger a painful episode is vastly out of proportion to the acute pain or immobility that can result.

For example the tearing of a few fibres of a ligament will cause an inflammatory response. This is the body’s natural response to any injury. One of my tutors described the area of the injury as becoming like a politician: swollen, painful and useless!
Inflammation begins to subside after 72 hours and this is where movement becomes an essential part of the healing process. As the tissue repairs collagen fibres will start to be laid down around the injured area. If the area is immobile this will happen in a random pattern and the resulting scar tissue could end up restricting movement in the future exacerbating the muscular imbalances in the area and leading to further problems with joint dysfunction.

If the injured area is passively moved through a pain free range of motion during this time then the collagen fibres will organise themselves around these movements and the resulting scar tissue will be far less restrictive with a greater chance of returning to normal movement patterns.
The fear of movement can persist long after the injury has calmed down. This can make people very wary of moving, the very thing that their body is designed to do in order to heal and setting in place the potential for further injury.

pills pills and more pills

Popping pills as a way to cope with back pain also has it’s drawbacks as a long term solution. The over the counter remedies easily available to us typically contain a class of medications known as non steroidal anti inflammatory drugs, or NSAIDS. The NHS Choices websites states that a common side effect of prolonged NSAIDs can be indigestion and stomach ulcers, further adding to your woes.

 

So far this is all pretty depressing but take heart, you are after all reading a Pilates blog and in my next piece I’m going to tell you just why I think Pilates is so fantastic for back pain.

no pills, just Pilates- thanks Pilates Nerd for the image Image by Pilates Nerd

Written by London Osteopath and Pilates instructor, Jon Hawkins
www.freerangepilates.com
Guest blogger for The Pilates Pod