Alternative medicines

Posts Tagged ‘back pain relief’

Our ligaments, tendons, discs and skin are made up of forms of collagen, one of the most important structural proteins in our bodies. This gives our tissues the ability to heal, its elasticity, its integrity and its strength, allowing us to have strong and healthy joints and skin which will put up with the stresses life puts upon them. Collagen is also responsible for the strength and integrity of our arteries and many other bodily structures. Human populations show great variation in collagen function from those who are very stiff jointed to those who are very mobile jointed or “double jointed”.

Ehlers-Danloss syndrome is caused by an abnormality in the way collagen is produced and acted upon in the body, causing an inheritable deficiency in the strength of the substance. 10 forms of EDS are known to exist, with much overlap, and EDS Three is considered the same as benign joint hypermobility syndrome, called benign because the serious changes such as in the arteries are not present in this form. Very hypermobile joints are the most obvious sign of this syndrome, with a smooth, flexible skin which tends to heal slowly and scar poorly in terms of wide and thin scars.

Patients with joint hypermobility syndrome show various symptoms and signs: joint hyper-mobility; less skin strength; reduced healing of wounds; easy bruising; skin flexibility and likelihood to dislocate easily. Sufferers from this syndrome may develop a chronic pain syndrome with constant and persistent joint pain, with incorrect muscle balances leading to joint stability problems and poor muscle balance. Functionally hypermobile patients can be very limited in normal activities or suffer pain when undertaking them and are unable to join in with vigorous activities or contact sports.

Self management in hypermobility syndrome is the main aim of intervention, with patient education taking a strong role to equip the patient to manage their lifelong condition. Due to the abnormally large ranges of joint movement they are vulnerable to ligament or joint strain if they are held posturally at end range or moved with momentum. Hypermobile patients should practice joint protection like arthritic patients, avoiding party pieces like showing off with extreme movements or joint dislocations. Yoga or high momentum activities such as contact sports are particularly unsuitable for these patients.

The stresses and strains of daily life and recreational activities tend to result in more acute injuries and pain complaints in hypermobile patients which are managed by physiotherapy to the joints and muscles. Even in normal circumstances the shoulder is very mobile yet unstable but in hypermobile patients the lax connective tissue makes the joint very unstable and difficult to control. The shoulder and surrounding muscle must keep the large ball of the arm bone aligned with the small socket during large movements and this is difficult with hypermobility, leading to abnormal muscle patterns and pain. It is common to have pain due to this and to repeated dislocations.

Spinal pain, in the neck, low back or thoracic regions, is a common symptom which hypermobile patients complain of, and physiotherapists interpret this as a lack of stabilising muscle control and muscle balance. Physios do not manipulate these patients but mobilizations, core stability work, strengthening weak muscle groups and general exercise are typical approaches. Increasing the usually low muscle tone by gentle weight training or using resistive bands can help joint control in the mid positions and avoid stresses at end ranges. Hyperextension of the knee is a typical problem, leading to joint pain on weight bearing and later to osteoarthritis. Hamstring work to strengthen the muscle opposing the abnormal movement is useful, with patients typically working on the muscle balance of several body areas.

All postures and activities are a challenge to a patient with hypermobility as unsuitable stresses are very easy to apply, causing pain. The patterns of muscle activity are abnormal when the joints are under load, pushing them into end range positions where the ligaments and capsules suffer from strains. Physiotherapy retraining of poor muscle balance can be helpful but patients need to be constantly vigilant and work at their weaknesses persistently. The most important factor overall is patient education as the condition is a long term one and all physical activities challenge the joints.

Have you been suffering from piercing pains in your lower back lately? Do you have trouble turning around, bending down, or rolling over in your sleep? If this is the case, you might have a sacroiliac joint inflammation – not exactly when you are waiting for right before the holiday season.

Now, you might be wondering what the sacroiliac joints even are. They are two ‘L-shaped’ joints are situated at the lower back, between the pelvic ilium and the sacrum (the small wedge-shaped bone at the bottom of your spine), and are held in place by various muscles and ligaments. Their function is to enable you to move your pelvis – sacroiliac joints get pulled and twisted along the pelvic girdle whenever you move your lower back.

When either of these joints gets inflamed, it can create a sharp pain in the lower back, upper thighs, and sometimes the buttocks. This is either caused by the fact that the joints get stuck, or that one half the pelvis continually glides backwards and forwards, irritating and inflaming the iliolumbar ligament.

Mild inflammations of the sacroiliac joints and the surrounding regions are not uncommon, but the more severe forms of sacroiliitis tend to crop up with old age. The most significant causes of sacroiliitis include pregnancy (because the pelvis is forced to expand during labour); trauma or sudden impact injury to the spine or pelvis; and degenerative arthritis, or osteoarthritis of the spine (which deteriorates the sacroiliac joints). But do not fret: it is possible to treat sacroiliitis, just as long as you visit your osteopath and keep an eye out for any early symptoms of the disease.

The most noticeable symptoms of sacroiliac joint inflammation include: – Restricted hip movement (having difficulty turning around or rolling over in bed) – Stiffness in the lower back after long periods of immobility (such after long car journeys) or when waking up in the morning – Difficulty bending down – Pain during sexual intercourse – Sharp pain the thighs when swinging your legs out of bed or out of the car

If you recognize any of these symptoms in your own situation, be sure to visit someone with an in-depth knowledge about the sacroiliac joint, such as an osteopath. To minimize your discomfort temporarily, you are advised to: – Wrap a damp tea towel around an icepack and place it on the painful area for 10-minute intervals, over the course of a half hour, for up to three times a day. – Sleep on your side at night (not your back or stomach) – Place a pillow between your knees while you are in a sedentary position or when lying down. This should take some of the pressure off your pelvis.

Sacroiliac joint inflammation can be extremely uncomfortable, but osteopaths can help you deal with the pain quite effectively through a combination of physical therapy and anti-inflammatory treatments. So as long as you visit your osteopath regularly and take good care of yourself, this upcoming holiday season should be as enjoyable as your last.

The gleno-humeral joint, known in lay terms as the shoulder, is a vital part of the links in the upper limb and responsible for our ability to place our hands where we can see them to perform activities. Because flexibility is a prime requirement the shoulder is a less stable joint with moderate muscle power and a large range of motion. It is described as a “soft tissue joint”, implying that the joint’s functional ability is dependent on its soft and not its hard components. Physiotherapists are closely involved in treating and rehabilitating the shoulder, dealing with the muscles, ligaments and tendons.

The gleno-humeral joint is made up of the ball of the humerus and the socket of the shoulder blade which is called the glenoid surface. The top of the arm bone, the humeral head, is large and carries many of the tendon insertions for the stability and movement of the shoulder. The socket or glenoid is a relatively small and shallow socket for the large ball but is deepened slightly by a fibrocartilage rim called the glenoid labrum. Above the shoulder is the acromio-clavicular joint, a joint between the outer end of the collar bone and part of the shoulder blade, a stabilizing strut for arm movement.

A great many muscles act on the shoulder joint and on the other joints in the shoulder girdle, the acromioclavicular, sternoclavicular and scapulothoracic joints. The glenohumeral and scapulothoracic joints are acted upon by the major stabilisers and movers in the area, varying from power muscles which allow forceful work to stability muscles such as serratus anterior and the rotator cuff to smaller movement muscles such as deltoid. The muscles must keep the relationship between the shoulder blade and the thorax and ribcage steady and under control for the glenohumeral joint to also enjoy stability and precise movement.

The shoulder muscle tendons become flatter and thinner as they approach and then insert themselves onto the head of the humerus. By this way the rotator cuff, a group of four muscles including the supraspinatus, infraspinatus, teres minor and subscapularis, is able to exert its forces on the humeral head. The tendons coalesce as they surround and insert onto the ball of the humerus, forming a cuff around the ball, centering the ball on the socket to counter the tendency to slide upwards under muscle activity. Keeping the ball centred on the socket means the larger and more powerful muscles can perform functional shoulder and arm movements.

As a person ages, the rotator cuff develops degenerative changes in its tendinous structures, causing small tears in the tendons which can enlarge until there is no continuity between the muscles and their attachments. This leads to loss of normal shoulder movement and can be very painful but is not always so and “Grey hair equals cuff tear” is a common saying. Physios work at rotator cuff strengthening, whilst in massive tears the main shoulder muscles can be progressively strengthened to improve function. Surgery is possible for massive, moderate and small rotator cuff tears and physiotherapists manage the post-operative protocols.

The shoulder joint is not typically affected by OA (osteoarthritis) but when it is physiotherapists treat arthritic shoulders by joint mobilisations, muscle strengthening and ranges of motion. Once physio has nothing else to offer, total shoulder replacement is one of the further options, with various surgical techniques involving replacing the humeral ball and the scapular socket either anatomically or in reverse. The shoulder is often called a “soft-tissue joint” as the soft tissues, their strength and balance, are vital to the function of the joint. Post-operative physio management is essential as the correct protocol must be closely followed to ensure success.

Many other shoulder conditions are managed by physiotherapists, such as hyper-mobility, dislocations and fractures, impingement and tendinitis. Physios manage shoulder hyper-mobility by patient education and stability training and abnormal muscle activity by teaching correct patterns by repetition and biofeedback. Physiotherapy for impingement involves rotator cuff strengthening, sub-acromial injection or surgical management by acromioplasty and tendinitis by local treatment and strengthening. Dislocations and fractures are managed according to the type and severity of injury and according to the trauma surgical and physiotherapy protocols.

The largest and the strongest tendon in the body is the Achilles tendon in the distal posterior calf. Typical patients with Achilles tendon rupture are men in good health from 30-50 years old and who have not suffered major injuries or any kind of difficulty with the leg before. Rupture occurs typically in people who have not been recently active and who may indulge in infrequent physical activity such as playing weekend sport, players known as “weekend warriors”.

The two large calf muscles, the gastrocnemius and the soleus, each have a tendon and these converge and form the Achilles tendon about 15 centimetres above the calcaneum. Tendons transmit forces from muscles to bones and to do this they have high resilience and sufficient stiffness, good tensile strength and allow 4 percent stretch before damage. Damage and rupture to the fibres can occur when the stretch reaches 8 percent. Most of the tendon rupture and degeneration occurs where the blood supply is poorest, about 2-6 centimetres up from the heel bone.

Achilles tendon tears occur mostly in the left leg where the poor blood supply is, perhaps because most people are right handed and push off more with their left leg. Common injuries are on sudden foot push off, an unexpected forcing up of the ankle and an upward force on the ankle when pushed down. Direct trauma and general degeneration of the tendon without trauma can also occur. People at risk include those exerting themselves when they are unfit, relatively older people, steroid users and those who exert themselves in extreme ways.

Achilles tendon forces in running can be very high and have been measured at six to eight times bodyweight. The patient typically reports a sudden snap or blow to the rear of the lower calf, a sudden strong pain, an ability to walk but not to run or climb stairs. On examination there may be a swollen or bruised calf, a palpable gap in the tendon and an inability to stand on tiptoe. A history of treatment with steroids, previous tendon rupture or an unusually high activity level (e.g. weekend warrior) can also be important findings.

Doctors choose conservative or surgical management, operation having a higher risk of complications and conservative treatment a higher risk of re-rupture. Non-operative treatment is suitable for sedentary people, diabetics, older people and those with medical problems or poor skin integrity. Impaired blood supply, diabetes and other illnesses make wound breakdown, tendon separation and infections more likely. A calf or thigh length plaster may be used with the ankle flexed down, moving it up regularly over six to ten weeks. The patient is allowed to weight bear and given an orthotic as the tendon heals.

Open or percutaneous surgery can be used and after the operation the leg is plastered with the ankle in plantar flexion or put into a brace. The ankle angle is adjusted upwards regularly week by week as healing goes forward until after 4 to 6 weeks the brace can be removed. Surgical repair is more successful due to lower rates of repeated rupture, quicker return to activity, greater strength and better endurance when compared to non-operative treatment. Research indicates that immobilizing the tendon for shorter periods is more successful.

The physiotherapy rehabilitation starts with ankle range of movement exercises without body weight loading, encouraging a good walking pattern and a heel raise to reduce the upward force on the tendon in gait. Static cycling and swimming are good starting activities, moving onto weight bearing exercises, muscle strengthening and onto more vigorous activities such as jogging, jumping and balance practice. Normal activity may be resumed by four months from surgery but this varies.

Achilles tendon rupture usually turns out with good or excellent results with most athletes getting back to their chosen sports. Surgical management has a re-rupture rate of 0-5 percent and conservative treatment up to 40 percent, so patient education by the physio in training and stretching performance and the best choice of footwear is important for the long term.

We have all been there: we go to the doctor with an aching back, she gives us a diagnosis, and writes out a prescription for some pain killers, along with some medical advice of what we can and cannot do. We take the pills, follow the advice, and the problem goes away. Or does it? Two months later, we pick up a heavy suitcase and injure our back once again – and start the vicious cycle of doctor-pills-advice all over again.

Treating a physical problem is always an uphill struggle – that is, unless you eradicate the problem completely. This is where osteopaths come in: they don’t just treat the symptoms of an ailment, they cure the cause of the problem. That is the fundamental difference between your local GP and an osteopath – while a doctor just examines individual symptoms, an osteopath will look at the ‘total person,’ or the body in its entirety. There are various other factors that distinguish osteopathic doctors from medical doctors:

1. Osteopaths are specialists in how the body works. Where medical doctors have a general overview of a large number of diseases, osteopaths are specifically trained in the musculoskeletal system. They therefore have a greater understand of how one system within the body influences the other, giving them a diagnostic as well as therapeutic advantage over GPs.

2. Osteopaths are uniquely capable of using Osteopathic Manipulative Training (OMT) to diagnose an illness within the body. In involves the manipulation of certain muscles with the hands to encourage the blood to flow to necessary regions of the body, which gives the body a much more natural opportunity of healing itself.

3. An Osteopath not only uses their hands to diagnose a problem, but also to treat to the predicament. While a medical doctor would prescribe an anti-inflammatory drug to treat the symptoms at face value, an osteopath would work to free the muscle tensions, which not only stimulates circulation, but encourages the body’s own forces to eradicate the problem, preventing it from re-emerging in the future.

4. While medical doctors work to treat the immediate symptoms of an illness, osteopaths look at the history of the disease. If a patient were to have a knee injury, for example, a GP would most commonly acquire a patient’s medical history through means of laboratory procedures, such as blood tests, or other psychical examinations. Osteopaths work differently: they obtain a patient’s history by questioning whether the patient experienced excessive stiffness in the joints in the past, whether increased activity further aggravates the knee, and whether the pain varies based on the position in which the knee is placed. By obtaining the history in this manner, osteopathic doctors aim to find the source of the problem, and ensue to eradicate its cause.

The benefits of osteopathy are therefore numerous, but do they override the advantages of visiting your local GP? That is for you to decide. Depending on the nature of your ailment, you might even want to see both. The primary question you have to ask yourself whether your physical problem is a reoccurring one, and whether you want to treat the symptoms, or cure the disease.

Golfer’s elbow (medial epicondylitis) is not confined to golfers, but occurs in many sportsmen and women, with racquet sports the most common causes. Other sports where golfer’s elbow occurs are in bowlers in cricket, archers and weightlifters. This and the more common tennis elbow are tendinopathies, overuse syndromes where there is no significant inflammation but a pathological alteration in the body of the tendon at the painful site.

The muscles which flex and rotate the forearm originate over the medial epicondyle, the bony prominence on the inside of the elbow, with the tendon anchored into the bone by the tendinous insertion. The pain occurs close to this and may be due to a degenerative process occurring in the tendon, as little inflammation has been noted in these cases.

High stresses occur in the cocking phase of a throw and during the subsequent acceleration, and in the golf swing from high backswing down to near the ball strike. Golfers are more likely to have their dominant hand affected and tennis players who use heavy topspin in their forehands are also more at risk.

Golfer’s elbow is the most common cause of pain over the inside of the elbow and less common than tennis elbow. Twice as many men are affected as women, with people being affected initially mostly in their twenties to their forties. Golfer’s elbow presents in the dominant hand in 60% of occurrences, with 30% of sufferers reporting a sudden and painful onset, the remainder having a slow onset.

Patients complain of aching pain over the front of the inner epicondyle, worse with repeated wrist flexion and better with rest. Pain can occur in the shoulder, elbow, forearm or hand, with weakness in the lower arm and hand also. The physiotherapist will examine the bony areas and joints of the elbow, check the muscles and their tendinous insertions. The physio palpates the ulnar nerve in the groove behind the elbow, called the “funny bone” when it’s hit. The nerve can give pins and needles or weakness in the forearm and a neurological examination excludes other causes of pain or weakness.

Conservative, non-surgical, treatment is the mainstay of management. This includes physiotherapy, anti-inflammatory drugs, wrist splints and steroid injections. Patient education is important and activity modification is the first line of treatment, reducing the frequency of aggravating episodes. Altering the mechanics of the golf swing or other activity is vital if the area is to be allowed to settle. The patient avoids certain activities with the affected muscles and avoids leaning on the elbow.

In the acute phase of golfer’s elbow the physiotherapist’s aim is to reduce any pain and inflammation using ice treatment, stretching gently, deep frictions, ultrasound and anti-inflammatory medication. Progression into the sub acute phase changes treatment to increasing flexibility, strength and returning to normal activities in a paced manner. Counterforce forearm bracing can help realign the tendon stresses, or a wrist brace can give the muscles a rest. For a chronic syndrome the treatment is similar with reducing splint use and returning to sporting activities.

Doctors inject corticosteroid medication into the sites of chronic golfer’s elbow but this treatment appears to be more useful in the earlier, acute cases. Other therapies, such as shockwave or laser, have been used but do not seem to be effective. Once physio has been attempted for some time without improvement then a surgical approach may be considered, cutting out the abnormal tissue from the tendon. The ulnar nerve can be transposed around to the front of the joint from its position in the groove posteriorly.

Advice from a professional instructor is well worthwhile as they can instruct on technique of the golf swing, aerobic fitness, muscle strength work and flexibility. Warming up prior to activity and stretching afterwards, with good sporting technique and sound choice of equipment are the basic requirements. Monitoring of patients by the physiotherapist, especially if they are sports people, may be essential to avoid overdoing and training or performing through pain.

When a bitter wind bites at our toes, when exhaustion threatens to overwhelm us, and when eight out of ten faces we see are obscured by hankies, we all know what time it is: winter is on the way.

Winter has a way of getting to us with all the nasty that it brings with it: exhaustion, cold, illness, depression not exactly something to look forward to. In order to counter that, we have scavenged the globe for the most useful tips on how to prevent those coughs and sniffles this winter, ranging from dietary tips to advice on how to spend your free time. Here are some words of wisdom from some of our most valued experts:

Your Nutritionist says: Consume carbs, carbs, carbs! Forget Atkins, forget low-carb diets, your body needs carbohydrates in order to keep itself warm throughout the winter. Don’t overdo it, of course – keep in mind that everything is best consumed in moderation. What is essential to a healthy diet is to eat quality foods (whole foods, starch, protein, veggies) in the right quantities.

Your GP says: Build up your defences in as many ways as you can. One of the ways you can do this is by getting the flu jab. Modern medicine is a wonderful way of tacking long-existing illnesses. Other ways to boost your immune system are to take vitamin tablets and to get plenty of rest. A few extra hours of sleep a night will also increase your chances of staying healthy, doing miracles for your mind as well as your body. Also get some extra nutrients in addition to your daily meals, such as Zinc, Iron, and Vitamin C, will help strengthen your defences against the inevitable flues and sniffles that come knocking at your door at this time of year.

Your Osteopath says: Acupressure and acupuncture are well-used ancient practices which will enhance your sense of well being. They help spread and balance the energy within your body so you feel more centred and revitalised. A good deep-tissue massage can also achieve this sense of balance. By loosening up your stiff joints and sore muscles, a massage stimulates blood flow which enables you to feel fresh and more energetic. In order to treat external illness, we have to start by tackling the disease from within – only then can we treat the problem, not just the symptoms.

Your Psychologist says: Relax. Take a break from your daily stresses and go on holiday to Spain or the French Alps this winter – anywhere that is tranquil, sunny, and offers the opportunity to get some exercise. Many people suffer from seasonal depression at this time of year, which is largely due to the absence of sunlight. You won’t believe how much sunlight influences your physical and emotional wellbeing, so make sure you get plenty this winter.

Our experts have done their bit, now do yours. Now that you are armed with some of these useful health tips, go and face this winter head-on and emerge from the cold with a smile.

Osteopathic medicine is a kind of medicinal practice in which the entire body is taken into consideration instead of looking at symptoms separately. This type of medicine is very “in” right now, especially for those who suffer from pain in their muscles and joints. A lot of people believe that an osteopath is your best option when you suffer from neck pain. Obviously, if this is your first visit to an osteopath, you are probably nervous, but you can relax. Here is what you can expect to experience when you treat neck pain with an osteopath:

The first part of your visit will be an exam that feels more like a visit to a “traditional” doctor. You’ll most likely give your complete medical history and also receive a physical examination. In many cases, your osteopath might order extra tests to help narrow down exactly why your neck is in pain. You might have an X-Ray taken to see if there is any physical damage to the vertebrae in your neck, but don’t be surprised if your osteopath pays attention to other parts of your body as well!

It is important to know that your appointment will involve a lot of physical contact between you and your osteopath. Osteopathic treatment is very “hands on.”

The osteopath you visit can use any or all of the following methods to treat your neck pain:

Counterstrain technique: this technique involves moving you into a position that will help your body restore motion to any of your muscles that might have been strained or restrained.

Muscle Energy technique: Your osteopath gives you exercises that will start with your muscles in precise positions and follow with you moving those muscles in precise movements.

Soft Tissue technique: this is where your osteopath will apply pressure to the muscle areas around the spine. It can also involve deep pressure, rhythmic stretching and, in some cases, traction.

Thrust technique: In the thrust technique your osteopath will reintroduce movement to your joints with high velocity force. This should help rid you of any asymmetry in your muscles, any movement that has been restricted and any tissue changes or muscle tenderness.

In some cases, osteopaths will also use low level lasers or acupuncture to treat their patients.

An osteopathic visit might sound scary, but there is no reason to be frightened. Most people who visit an osteopath don’t experience any pain. Most of the time osteopathic visits have been reported to be pleasant and relaxing!

There are some people who might confuse osteopathic medicine with chiropractic medicine. The two night sound alike, but they are actually very different. Chiropractic medicine focuses on your spine and joints. Osteopathic medicine focus on your whole body!