All posts by Alex Newton

In the UK, back pain is one of the most common reasons people miss work, and is the leading cause of disability worldwide. With something so common, it has easy for people to get confused about back pain and misconceptions to arise!

We know that the easiest way to tackle back pain is to keep moving, but sometimes these myths and misconceptions can stop people from doing exercise or seeking proper treatment.

One of the most common myths about back pain is that people think it’s not going to happen to them. In fact 4 out of 5 of us will be affected by back pain at some point in our lives!

Here are the top myths about back pain debunked:

• MYTH: Exercise will cause or worsen back pain

• Staying bed bound with back pain can be one of the worst things you can do! Without exercise muscles become weakened, deconditioned and stiff. To reduce back pain you should rest, calm the pain, followed by gentle exercise.

• MYTH: If you see a spine specialist you will end up getting surgery

• Spinal surgery is only recommended in about 1% of cases. In most cases the treatments recommended will be non-surgical, such as exercise, physical therapy and anti-inflammatory medication.

• MYTH: Back pain is a normal part of aging

• Some people believe that back pain is a typical part of getting older but it shouldn’t be a normal part of your day. We all get aches and pains as we age, however with all the options to ease back pain available today you shouldn’t suffer in silence.

When you are suffering with back pain, whether it is in the neck, between the shoulder blades or in the lower back, it can sometimes be difficult to know what to do. Do you sit, rest, keep active, use heat or cold?

The most common cause of back pain is when the joints of the back become restricted due to abnormal stress such as, incorrect posture, degeneration and emotional stress. This causes tightening and inflammation around the joints resulting in muscles tightening in order to protect that area of the spine from further trauma. Muscle tightness causes the joint to be even more restricted in movement and therefore causes more joint inflammation and the cycle continues. People suffer from different types of back pain, some with tightening but others without, and therefore they will require a different treatment plan.

Chiropractors have the skill of removing joint restriction by using spinal adjusting to address the underlying problems of back pain.However, secondary problems of muscle tightness and joint inflammation require ongoing treatment so there are certain things a patient can do to relieve the pain.

Cold Treatment

• The recommended treatment for back pain without muscle tightness is a cold treatment. This is simply a cold pack applied to the injury, which acts like a painkiller reducing the inflammation.
• A Cold treatment can be used in any area of inflammation. i.e. spine or joint inflammation and restriction, knee swelling, sprained ankle etc.

Hot Treatment

For back pain with muscle tightness a hot pack is more suitable. Tight muscles are usually tender to touch, you can sometimes feel pea-sized knots and crystals in the muscle, heat relaxes the muscle and improves flexibility. Hot treatment can be used alone over tight muscles when they have contracted due to overuse, or ache following being used in a different way.

Hot & Cold Treatment

Leaving a hot pack on the spine for a long time can increase the inflammation and cause the pain to increase. In this case once relaxation has occurred a cold pack is placed over the area to help decrease the joint inflammation.

It is always best to consult a Chiropractor first but the advice is not to rest, but to try and keep active, manoeuvring the joint at least every 20 – 30 minutes. Combine this with the hot or cold method of treatment and you will help relieve the pain resulting in a quicker recovery.

Coming up this month is the awareness week for the charity ‘BackCare’.

Back pain is one of the major disabling health conditions among older adults aged 60 years and older. Many causes of lower back pain are age-related with physical and psychosocial changes. There is a distinct lack of awareness, especially in older adults to the causes and effects of back pain and pain management.

Existing evidence suggests that prevalence rates of severe and chronic low back pain increase with older age. As compared to working-age adults, older adults are more likely to develop lower back pain like osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis

                                                                                               – NCBI (www.ncbi.nlm.nih.gov)

In the clinic your chiropractors are constantly aware of the risks our older patients are prone to and are keen to encourage exercise and advice to support as best they can -why not ask for some tips when you see your chiropractor next.

Also in October (Taking place on October 16 each year), is World Spine Day.

It has become a focus in raising awareness of back pain and other spinal issues. With health professionals, exercise and rehabilitation experts, public health advocates, school children and patients all taking part, #LoveYourSpine will be celebrated on every continent.

Look out for the hashtag: #LoveYourSpine it will be used to highlight the importance of spinal health and wellbeing. Promotion of physical activity, good posture, responsible lifting and healthy working conditions will all feature as people are encouraged to look after their spines and stay active.

With an estimated one billion people worldwide suffering from back pain, it affects all age groups, from children to the elderly. It is the biggest single cause of disability on the planet, with one in four adults estimated to suffer from back pain during their lives. Prevention is therefore key and this year’s World Spine Day will be encouraging people to take steps to be kind to their spines.

Populations in under-serviced parts of the world often have no access to conventional healthcare resources to care for spinal pain and disability. Often relying on traditional healers, even those who are seen in hospital are often only given anti-inflammatory medication. Dedicated spinal health professionals do not exist in many parts of the world, so education and self-help is key. Even in high-income countries, back pain affects many millions of people, resulting in an enormous impact on industry and the economy.

Organized by the World Federation of Chiropractic on behalf of the Global Alliance for Musculoskeletal Health, World Spine Day has over 500 official organizational supporters worldwide. More information is available at www.worldspineday.org

With long distance running marathons and triathlons becoming increasingly popular as well as a increasing array of high intensity exercise classes like Zumba, Barry’s Bootcamp, HulaFIt, calf muscle injures are seen more commonly.

How does it happen?

Calf strain occurs when the muscle at the back of the lower leg becomes damaged or inflamed due to excessive strain or force being placed on the calf muscle. These injuries often arise from sports that involve repeated jumping or change of direction as well as explosive sprinting or long distance running.

Calf muscle tears get more common as we get older due to the loss of elasticity in our muscles and tendons. Soft tissue injuries get more common if you over train a certain structure and eventually it breaks. Often injuries can start with micro-tears in the calf muscle and achilles tendon and this in turn can result in a to a complete tear.

What are the symptoms?

Patients are likely to feel aching and stiffness which becomes more apparent first thing in the morning and often the calf will feel weak, making the patient unable to resume activity and sometimes bear weight resulting in a limp.

How can I prevent it?

If you’ve been inactive for an extended period of time, to prevent injuries you need to start off very slowly and gently. Start with non-ballistic exercises such as calf raises and progress the program to eventually include ballistic exercises, maybe 3 months later.

Top Tip

Warming up and stretching after exercise is always recommended but be careful not to overstretch or put excess force on calf muscles. Stretch until there’s light tension in the muscles, taking a deep breath and slowly exhaling. Hold that position for 15-to-30 seconds, relax and repeat up to four times. Stay still and don’t bounce during stretching. Don’t push yourself to the point of pain; ease the stretch until it is comfortable.

Researchers reveal that sudden, acute episodes of low back pain are not linked to weather conditions such as temperature, humidity, air pressure, wind direction and precipitation.

Findings published in Arthritis Care & Research indicate that the risk of low back pain slightly increases with higher wind speed or wind gusts, but was not clinically significant.

According to the World Health Organization (WHO) nearly everyone experiences low back pain at some point in their life, making it the most prevalent musculoskeletal condition; affecting up to 33% of the world population at any given time.

“Many patients believe that weather impacts their pain symptoms,” explains Dr. Daniel Steffens with the George Institute for Global Health at the University of Sydney, Australia. “However, there are few robust studies investigating weather and pain, specifically research that does not rely on patient recall of the weather.”

For the present case-crossover study 993 patients seen at primary care clinics in Sydney were recruited between October 2011 and November 2012. Weather data from the Australian Bureau of Meteorology were sourced for the duration of the study period. Researchers compared the weather at the time patients first noticed back pain with weather conditions one week and one month before the onset of pain.

Results showed no association between back pain and temperature, humidity, air pressure, wind direction or precipitation. However, higher wind speed and wind gusts did slightly increase the chances of lower back pain, but the amount of increase was not clinically important.

One of the most common side effects of pregnancy for women across the country is back pain, especially lower back pain.

Your body goes through lots of changes when you’re pregnant, including gaining extra weight, your centre of gravity becoming lower and the ligaments around your pelvis are relaxing to prepare you for labour.

Did you know.. Although exercise may not seem appealing, it can be very effective at helping to ease the pain.

Gentle exercise that helps strengthen the core abdominal muscles can help to spread the weight around your body and prevent localised pain in your lower back.

Keeping your muscles active can help prevent them becoming stiff and painful as your pregnancy develops.

Remember.. Posture is also key to relieving back pain during pregnancy.

Always remember these principles of good posture to help relieve any stress on your spine:

• Stand up straight rather than slouching
• Hold your chest high
• Keep your shoulders and back relaxed
• Stand with your feet hip width apart to keep your upper body fully supported 

It is also good to support yourself, whether you’re exercising or simply lying down, to help your body cope with the extra weight it is carrying.

Did you know… Water based exercises, such as aqua natal classes, are a particularly effective way to exercise the muscles during pregnancy without over exerting yourself as the buoyancy of the water can also act as an extra support for your body.

Gentle yoga or going for a walk are other good ways to keep the muscles active and help ease the symptoms of backache during pregnancy.

One of the most likely times men and women get back pain is when there is an infant in the house needing to be picked up and carried. Both these times are paradoxically when you would like your back to be functioning at it’s best.

Caring for an infant puts stress on your back. Initially, you may be lifting the 7 to 10 pound baby up to 20-30 times a day. By the time the child is a year old, you are lifting and carrying around 17 pounds. Two years later, you will be lifting a 25 to 30 pound child.

Here are some ways that new mothers, fathers and grandparents can help reduce their risk of injury and back pain.

Safe lifting, the basics: Stand with your feet at least a foot apart, this will give you a stable base of support. Keep your back as straight as possible and bend your knees. Do not stretch your arms out straight to pick up the baby. Bring the baby close to your chest before lifting.

Lift using both arms and your thigh muscles, which are amongst the largest and strongest muscles in the body. To pick up a child from the floor, bend at your knees-not at your waist. Squat down, tighten your stomach muscles and lift with your legs. When carrying and moving a child, pivot with your feet until you are facing your destination then lower the child into the crib or onto the floor by bending at the knees, with a straight back.

Carrying: Hold your child in an upright position, directly against your chest. Carrying a child on one hip creates postural imbalances that can lead to low back pain over time. Consider using a ‘front pack’ to carry the baby when you are walking.

Exercise for women:   Begin exercising again soon after delivery to restore muscle tone to the abdominal and back muscles. While the baby is napping, take 10 minutes to do stretching exercises on the floor or bed each day. This will help restore hip and back flexibility. Try to return to your normal weight within six weeks after giving birth. If you had a Caesarean-section (C-section) delivery, wait six weeks or until you get the permission of your obstetrician or GP before you begin exercising.

Breast feeding: To avoid upper back pain from breastfeeding, bring the baby to your breast, rather than bending over the baby. While you are nursing, sit in an upright chair rather than a soft couch or ask your chiropractor about biological feeding – this is a better and more effective posture for you and your baby.

Birth is one of the most traumatic experiences a baby can go through. It is not often known, for example, that the baby’s cranial bones move and overlap affording the flexibility required during delivery. Even after a successful delivery, a baby’s spine is still at risk.

However, there are some precautions you can take as a parent to minimize this risk both to your baby and to yourselves. Here are the healthiest positions for you to care for your baby.

Holding baby: your baby should be held close to you with the back of your baby’s head supported with your index finger behind the ear.

Bathing baby: your baby’s head should be supported using your thumb and forefinger while your free hand is used for bathing and supporting your baby in the tub.

Parent/child interaction: throwing your child up and down can actually cause spinal problems due to a lack of support as your child is being bent forward and backwards.

Picking children up: when lifting your child, you should be on your haunches, lift your child while holding them under both arms, and avoid carrying them on one hip. Preferably, your child should be carried in front of you with one leg either side of you.

Papoose type slings and carriers: unfortunately contraptions that allow your child to sit before it is naturally able to can cause major spinal problems. Most of the holding devices keep your baby’s spine in the ‘c’ shape curve it’s born with and do not allow the normal curves in the neck and low back to develop.

Dressing the child: clothing that has a tight collar can put a strain on your child’s spine in the neck and the area between the shoulder blades. Buttons and zips should be used as much as possible.

Feeding: if breast feeding, you should hold the baby at the level of the breast whilst supporting your arm on a pillow, to reduce spinal problems in yourself. You should place the baby so that it faces your breast so that rotation of your baby’s neck is minimized or aim for the biological nurturing position.

Crawling: crawling should be actively encouraged, as a lack of sufficient crawling is responsible for weak spinal architecture. If your baby resists lying on their tummy during this time it may be an indication of a spinal problem that should be assessed by your chiropractor.

Emotional stress can also affect your baby. Domestic disharmony and maternal distress is very quickly picked up by the infant and translated into irritability, crying and unsettled behaviour. The negative effect on muscle tone, sleeping and feeding patterns is a major contributor to spinal subluxations.

As parents, bonding should be encouraged immediately for you both. Holding the infant close to your body, maintaining sustained eye contact, smiling and making soothing sounds are all important.

The new school year has just started. Children are back in the classrooms, will be running around playgrounds and playing sports. However, children, like adults, can be prone to back pain, and there can be several causes.

The most common causes of joint and back pain in school children are:

• Lack of exercise or excessive exercise
• Weight of school bags
• Bad posture
• Poorly set up desks
• Use of a computer or computer games
• Sports injuries
• Ill-fitting shoes/improper shoes

Lack of exercise and excessive exercise

The general finding from various studies is that children involved in competitive sports and those who are sedentary are more prone to getting low back pain while those that participated in moderate activity were protected. The children involved in competitive sports run the risk of getting repetitive strain injuries. Those children who are sedentary are often those who sit and watch a lot of television or play on computer games. The implication of this will be discussed below.

Weight of school bags

School bags are exceptionally heavy for those attending secondary school due to the number of different subjects covered and therefore the number of textbooks required and the fact the children often have to move between classes. Not all children have access to lockers, which mean that books have to be carried with them. Bags carried on one shoulder causes an asymmetry of the body and therefore certain muscles will have to tighten and others lengthen in order to carry the bag. These kinds of imbalances can cause long-term problems.

Bad posture

All aspects of life can induce bad posture; lack of exercise, weight of school bags, spending too much time playing computer games or on the computer, incorrect shoes, and growth. Those children who grow faster and become taller than their peers may slouch in order to not tower above their friends and this can ultimately lead to bad posture.

Poorly set up desks

Whether at school or home, ill-fitting desks can lead to bad posture. School desks and chairs cannot cater for individual heights of children and, as mentioned earlier, the children often have to move between classes. The desks and chairs are uniform and unable to be altered to the child’s individual needs. Guidance on correct desk set up should be implemented at home; not just for the kids but also for everyone in the family who uses the desk. At school this can’t be done, but by advising the child to sit upright and not to slouch and not to cross the legs will help.

Use of a computer or computer games

Anybody position requires certain muscles to shorten and others to lengthen. This occurs every time we move. If we were to stay in one position for too long those muscles will eventually stay that particular length. When children play on computer games it quite often requires time. This leads to the above situation with muscles. Children should be encouraged to not spend longer than 30-40 minutes at any one time playing games, using a computer, or even doing homework before having a break. The child should spend a few minutes walking around and then returning to the game/homework by reviewing their posture and sitting correctly.

Sports injuries

Those children who play a lot of sport and those who play contact sports such as rugby may be injured either by direct contact or by overuse of certain muscles. If a child is injured it is advisable that they are seen by a chiropractor as problems unresolved can lead to compensations, i.e. walking differently due to sprained ankle leading to low back pain, a rugby tackle causing neck pain and headaches.

Ill-fitting shoes/improper shoes

Children are conscious of fashion, which can affect their shoe wear. Girls particularly may wear shoes with a high heel. This causes the calf muscles to shorten and pushes the body forward. To prevent falling over the girl would have to lean back and causing an increase in the low back curvature which can not only cause low back pain but also pain between the shoulder blades.

Wearing improperly fitting shoes can cause many problems from blisters, pressure sores and ingrowing toenails in the short-term, to feet deformities like hammer toe, and knee and posture problems in the long-term. It can take up to 18 years for feet to fully develop, so teenager’s feet need to be looked after just as much as younger children’s.

Shoes should be the correct size and offer the right amount of support. When purchasing new shoes, get the child’s feet correctly sized by the shop assistant and ensure that the shoes are the correct length as well as width.

Here’s some advice to help your child:

• Rucksacks should be worn across both shoulders and the straps adjusted so the bag is held close to the body.
• If a locker is available, encourage your child to use it and ensure they only take the books and equipment needed for that day.
• Check their shoes are correctly fitted, supported, relatively flat, and are not too worn.
• Encourage your child to enjoy regular exercise, such as swimming and cycling.
• Use of the computer, playing computer games and homework should be in blocks of no more than 30-40 minutes. Advise them to have a little walk before returning and again that they sit with their shoulders down and back (not slumped) and their legs are uncrossed.
• See a chiropractor if your child is experiencing pain or discomfort, or even just to get a check-up.