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Manipulative Therapy Back Chat
Backchat 1
Welcome to the Belper Back Chat.
This is a section of the site with snippets of useful information that may help both patients and their families as well as members of the public who have muscular or skeletal (joint problems). I would appreciate any contributions that you may care to make - if you have any anecdotes, stories, and aids to help your problem that you have found eases or anything that even hurts your condition. I have also included what I call Backbites; these are true things that patients have done and said. I may have changes the gender or age so only the person involved can actually know it was them that said or did it. Obviously no names will be given, so if you have do, anything you feel is silly that you would like others to know about, you can contribute your story incognito.
These articles are explained in layman terms and sometimes lose something in their translation This Newsletter is for interest and amusement only and does not seek to offer medical guidance.
Emergency Self Treatments;
If you find yourself in pain and cannot attend the Clinic please find below some emergency suggestions to help until you can get to the Clinic.
In the first instance please try applying a bag of frozen peas, (wrapped in a T-shirt or tea towel) to the Lumbar area, in the case of pain in the Lumbar or Sciatica (pain down the hamstrings and in the lower leg). In between the shoulder blades for pain in that area, or at the back of the neck for neck and whole arm pain. If you find that that is not helping try applying heat in the form of a warmed "wheat bag" or and covered hot water bottle. I have also printed below some stretches that may help in the case of lumbar (lower back and sciatica pain. Please remember to WARM up first before doing any stretches.
SACRO-ILLIAC MOBILISATION EXERCISES
Hip Twist
This is good for warming up the lower back before doing more advanced stretching exercises.
Lie on back, bend the hip and knee joints well, with the feet lifted off the floor, cross the feet over, then swing the feet side-to-side like a pendulum. This causes the pelvis to twist side-to-side and also loosens the lumbar joints.
Hip Hitching
Lie flat on your back with legs straight. While keeping legs straight, pull one hip up and push the other hip down at the same time. As you do this, when the right hip comes up so will the right foot. Then keep alternating in a rhythmic manner for about one minute.
Leg Rolling
Lie flat on your back. Then roll both legs in as far as you can and hold for 2-3 seconds, then roll them out as far as you can and hold for 2-3 seconds. Repeat about 10 times.
If you can feel and hear the back click whilst doing this exercise, this is a good sign as long as no pain is felt, which will not occur if it is done gently and the other exercises are done first to warm the back up. The clicking is a freeing up of the facet joints in the spine.
Lunge Stretch
Supporting yourself on both sides (e.g. use 2 chairs), position the feet as thought taking a very long stride. Keeping the body relatively upright, allow the knees to sink down, particularly the posterior knee, until you feel the hips stretching. Initially hold for 15 seconds, then over several days, as you get used to it, increase the time gradually to 30 seconds. Do each side about 3 times. Don't do any sudden movements when getting up out of the stretch.
Abductor Pull
Stand upright with the feet on a non-slip surface. Keeping the legs straight and the feet flat and firmly planted on the floor, tense up the hip abductor muscles as if trying to push the legs outwards, but do not allow the feet to move. This causes the force to pull on the two halves of the pelvis to take pressure off the sacro-illiac joints.
THERE SHOULD BE NO PAIN OR STRONG DISCOMFORT. IF THIS IS THE CASE DISCONTINUE THESE EXERCISES AND INFORM THE CLINIC AT YOUR NEXT APPOINTMENT.
DRIVING POSITIONS ?
If you have to travel for a long time slightly alter the back of the seat forwards and backwards every fifteen minutes (within safety limits). On long journeys every 1 ¼ to 1 ½ hrs get out of the car and walk around to loosen the legs and lumbar area. (But NOT on the Motorway).I am frequently asked “ Do you think that my car seat may be the problem with my lower back pain?” The answer it that it may be. To sit correctly in a car you should make sure that the “Squab”( the front part of the seat) is supporting the thighs. This may mean pushing the seat back slightly, although some newer models have the ability to raise and lower the squab to enable this procedure. Place the wrists on the top of the steering wheel and raise the back of the seat until you can feel it pressing onto your upper back. When you hold the steering wheel at the correct position (the left hand at ten o’clock and the right at two o’clock) you should find that you are now sitting in the correct position (sitting in the seat - not on it.)
WHAT IS SCIATICA?
The name Sciatica comes from the Sciatic Nerves which starts as five Nerves, one in the last lumbar Vertebra and four in the Sacrum and join into and branching out of one sheath travelling from the lower spine down the hamstrings to the whole of the lower leg right to the toes. There are two types of Sciatic pain one is the True Sciatica - the nerve is trapped at its root (where it comes out of the spine) generally by a misaligned vertebra or a prolapse disc (protruding out of it’s natural setting). The other is sometimes known as a Pseudo Sciatica (just as painful). This can be caused by a muscle tendon or ligament trapping the nerve somewhere along its course down the buttock and leg, or some form of inflammation in the area. The pain may show itself anywhere in the leg depending on where it is trapped or where the inflammation is. Sometimes painkillers will not relieve this pain and the safest way is to have the nerve released or the inflammation reduced.
IS IT MY MATTRESS?
A mattress has an average life of between 7 to 8 years. If yours is older than this it may be time to renew it (not necessarily the whole bed). Even if it has been turned regularly, which should be at least once per month. A mattress should not be too firm or too soft. It should follow the contours of your body. You should not be able to get your fingers under your waist when lying on your side nor should you be able to get your fingers under the small of your back when lying on your back (too hard). By the same token, you should not sink into it (too soft). The height of the pillows may also play a part in causing and prolonging neck pain. When lying on the side, your head, neck and spine should be in a straight line. It may need an extra pillow or one being removed to make you level - have someone check it for you. I believe that certain Benson Beds have a computer system that checks your back problems height weight and sleep positions and works out the best profile for you. Although it is not cheap if you think that you spend a third of your life in bed (a lot longer than you spend in your car and you can spend a lot of money on a car) it could be money well spent.
WHAT IS THE MOST COMMON REASON FOR PROBLEMS TO REOCCUR?
Doing nothing!! 90% of the patients when asked what have you been doing to cause this to happen? Say “Nothing! I haven’t done anything.” When I inquire to what they have done I get a multitude of incredible answers “Well I did do an 11 mile walk yesterday.” “I had just got these few patio slabs to move”, “ I was gardening on my knees and thought that I could push this urn out of the way when it was full with plants in it.” Although these may be nothing out of the ordinary in normal circumstances, when needing treatment these are asking the body to do too much.
WHY ICE?
When an injury occurs the body's response is to flood the area with blood taking Iron ,Oxygen and other defences to the area. As the effects of Remedial Massage and Manipulative Therapy can induce a simular response to the body's responses, it dilates the blood vessels allowing influx of blood into the area which in turn washes the toxins out of the contracted muscles. This toxin can be responsible for the pain that can be felt after treatment (the same as if you have done a hard workout when not used to it or without warming down after training). When you apply ice (wrapped in a tea-towel or tee-shirt) to the area, this has the effect of constricting the blood vessels and therefore controlling the inflammation in that area. The obvious question that I am asked is, “could I just take some anti-inflammatory tablets instead of the ice treatment?” The answer is NO! Anti-inflammatory tablets constrict the blood vessels in the whole body for a considerably longer time than the 15 minutes every two hours ice treatment does, and can not give the body a good “Contrast Bathing Therapy”treatment which is very beneficial in the healing process.
This is a section of the site with snippets of useful information that may help both patients and their families as well as members of the public who have muscular or skeletal (joint problems). I would appreciate any contributions that you may care to make - if you have any anecdotes, stories, and aids to help your problem that you have found eases or anything that even hurts your condition. I have also included what I call Backbites; these are true things that patients have done and said. I may have changes the gender or age so only the person involved can actually know it was them that said or did it. Obviously no names will be given, so if you have do, anything you feel is silly that you would like others to know about, you can contribute your story incognito.
These articles are explained in layman terms and sometimes lose something in their translation This Newsletter is for interest and amusement only and does not seek to offer medical guidance.
Emergency Self Treatments;
If you find yourself in pain and cannot attend the Clinic please find below some emergency suggestions to help until you can get to the Clinic.
In the first instance please try applying a bag of frozen peas, (wrapped in a T-shirt or tea towel) to the Lumbar area, in the case of pain in the Lumbar or Sciatica (pain down the hamstrings and in the lower leg). In between the shoulder blades for pain in that area, or at the back of the neck for neck and whole arm pain. If you find that that is not helping try applying heat in the form of a warmed "wheat bag" or and covered hot water bottle. I have also printed below some stretches that may help in the case of lumbar (lower back and sciatica pain. Please remember to WARM up first before doing any stretches.
SACRO-ILLIAC MOBILISATION EXERCISES
Hip Twist
This is good for warming up the lower back before doing more advanced stretching exercises.
Lie on back, bend the hip and knee joints well, with the feet lifted off the floor, cross the feet over, then swing the feet side-to-side like a pendulum. This causes the pelvis to twist side-to-side and also loosens the lumbar joints.
Hip Hitching
Lie flat on your back with legs straight. While keeping legs straight, pull one hip up and push the other hip down at the same time. As you do this, when the right hip comes up so will the right foot. Then keep alternating in a rhythmic manner for about one minute.
Leg Rolling
Lie flat on your back. Then roll both legs in as far as you can and hold for 2-3 seconds, then roll them out as far as you can and hold for 2-3 seconds. Repeat about 10 times.
If you can feel and hear the back click whilst doing this exercise, this is a good sign as long as no pain is felt, which will not occur if it is done gently and the other exercises are done first to warm the back up. The clicking is a freeing up of the facet joints in the spine.
Lunge Stretch
Supporting yourself on both sides (e.g. use 2 chairs), position the feet as thought taking a very long stride. Keeping the body relatively upright, allow the knees to sink down, particularly the posterior knee, until you feel the hips stretching. Initially hold for 15 seconds, then over several days, as you get used to it, increase the time gradually to 30 seconds. Do each side about 3 times. Don't do any sudden movements when getting up out of the stretch.
Abductor Pull
Stand upright with the feet on a non-slip surface. Keeping the legs straight and the feet flat and firmly planted on the floor, tense up the hip abductor muscles as if trying to push the legs outwards, but do not allow the feet to move. This causes the force to pull on the two halves of the pelvis to take pressure off the sacro-illiac joints.
THERE SHOULD BE NO PAIN OR STRONG DISCOMFORT. IF THIS IS THE CASE DISCONTINUE THESE EXERCISES AND INFORM THE CLINIC AT YOUR NEXT APPOINTMENT.
DRIVING POSITIONS ?
If you have to travel for a long time slightly alter the back of the seat forwards and backwards every fifteen minutes (within safety limits). On long journeys every 1 ¼ to 1 ½ hrs get out of the car and walk around to loosen the legs and lumbar area. (But NOT on the Motorway).I am frequently asked “ Do you think that my car seat may be the problem with my lower back pain?” The answer it that it may be. To sit correctly in a car you should make sure that the “Squab”( the front part of the seat) is supporting the thighs. This may mean pushing the seat back slightly, although some newer models have the ability to raise and lower the squab to enable this procedure. Place the wrists on the top of the steering wheel and raise the back of the seat until you can feel it pressing onto your upper back. When you hold the steering wheel at the correct position (the left hand at ten o’clock and the right at two o’clock) you should find that you are now sitting in the correct position (sitting in the seat - not on it.)
WHAT IS SCIATICA?
The name Sciatica comes from the Sciatic Nerves which starts as five Nerves, one in the last lumbar Vertebra and four in the Sacrum and join into and branching out of one sheath travelling from the lower spine down the hamstrings to the whole of the lower leg right to the toes. There are two types of Sciatic pain one is the True Sciatica - the nerve is trapped at its root (where it comes out of the spine) generally by a misaligned vertebra or a prolapse disc (protruding out of it’s natural setting). The other is sometimes known as a Pseudo Sciatica (just as painful). This can be caused by a muscle tendon or ligament trapping the nerve somewhere along its course down the buttock and leg, or some form of inflammation in the area. The pain may show itself anywhere in the leg depending on where it is trapped or where the inflammation is. Sometimes painkillers will not relieve this pain and the safest way is to have the nerve released or the inflammation reduced.
IS IT MY MATTRESS?
A mattress has an average life of between 7 to 8 years. If yours is older than this it may be time to renew it (not necessarily the whole bed). Even if it has been turned regularly, which should be at least once per month. A mattress should not be too firm or too soft. It should follow the contours of your body. You should not be able to get your fingers under your waist when lying on your side nor should you be able to get your fingers under the small of your back when lying on your back (too hard). By the same token, you should not sink into it (too soft). The height of the pillows may also play a part in causing and prolonging neck pain. When lying on the side, your head, neck and spine should be in a straight line. It may need an extra pillow or one being removed to make you level - have someone check it for you. I believe that certain Benson Beds have a computer system that checks your back problems height weight and sleep positions and works out the best profile for you. Although it is not cheap if you think that you spend a third of your life in bed (a lot longer than you spend in your car and you can spend a lot of money on a car) it could be money well spent.
WHAT IS THE MOST COMMON REASON FOR PROBLEMS TO REOCCUR?
Doing nothing!! 90% of the patients when asked what have you been doing to cause this to happen? Say “Nothing! I haven’t done anything.” When I inquire to what they have done I get a multitude of incredible answers “Well I did do an 11 mile walk yesterday.” “I had just got these few patio slabs to move”, “ I was gardening on my knees and thought that I could push this urn out of the way when it was full with plants in it.” Although these may be nothing out of the ordinary in normal circumstances, when needing treatment these are asking the body to do too much.
WHY ICE?
When an injury occurs the body's response is to flood the area with blood taking Iron ,Oxygen and other defences to the area. As the effects of Remedial Massage and Manipulative Therapy can induce a simular response to the body's responses, it dilates the blood vessels allowing influx of blood into the area which in turn washes the toxins out of the contracted muscles. This toxin can be responsible for the pain that can be felt after treatment (the same as if you have done a hard workout when not used to it or without warming down after training). When you apply ice (wrapped in a tea-towel or tee-shirt) to the area, this has the effect of constricting the blood vessels and therefore controlling the inflammation in that area. The obvious question that I am asked is, “could I just take some anti-inflammatory tablets instead of the ice treatment?” The answer is NO! Anti-inflammatory tablets constrict the blood vessels in the whole body for a considerably longer time than the 15 minutes every two hours ice treatment does, and can not give the body a good “Contrast Bathing Therapy”treatment which is very beneficial in the healing process.