Spinal Health Back Care UK

Degenerative Joint Problems

Alternative Names: Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis-Osteoarthritis.

Causes

Unfortunately most of the time, the cause of OA is unknown. It is mainly related to aging, but metabolic, genetic, chemical, and mechanical factors can also lead to OA.
The symptoms of osteoarthritis usually appear in middle age and almost everyone has them by age 70. Before age 55, the condition occurs equally in both sexes. However, after 55 it is more common in women.
The disease causes the cushioning (cartilage) between the bone joints to wear away, leading to pain and stiffness. As the disease gets worse, the cartilage disappears and the bone rubs on bone. Bony spurs usually form around the joint.

OA can be primary or secondary.

Primary OA occurs without any type of injury or obvious cause.
Secondary OA is osteoarthritis due to another disease or condition. The most common causes of secondary OA are metabolic conditions, such as acromegaly, problems with anatomy (for example, being bow-legged), injury, or inflammatory disorders such as septic arthritis.

Symptoms

The symptoms of osteoarthritis include:
 Deep aching joint pain that gets worse after exercise or putting weight on it and is relieved by rest
 Grating of the joint with motion
 Joint pain in rainy weather
 Joint swelling
 Limited movement
 Morning stiffness
Of course some people might not have symptoms.

Examination and Tests

A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness.
An x-ray of affected joints will show loss of the joint space, and in advanced cases, wearing down of the ends of the bone and bone spurs.

Treatment

The goals of treatment are to relieve pain, maintain or improve joint movement, increase the strength of the joints, and reduce the disabling affects of the disease. The treatment depends on which joints are involved.

MEDICATIONS

The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen, and naproxen.

Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. Manufacturers of NSAIDs include a warning label on their products that alerts users to an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Other medications used to treat OA include:
 COX-2 inhibitors (coxibs). Coxibs block a substance called COX-2 that causes swelling. This class of drugs was first thought to work as well as other NSAIDs, but with fewer stomach problems. However, reports of heart attacks and stroke have led the Drug Licensing Authorities to re-evaluate the risks and benefits of the COX-2s. Ask your doctor whether the drug is 1. Still available and if so 2. Right and safe for you.
 Steroids. These medications are injected right into the joint. They can also be used to reduce inflammation and pain.
 Supplements. Many people are helped by over-the-counter remedies such as glucosamine and chondroitin sulfate. There is some evidence that these supplements can help control pain, although they do not seem to grow new cartilage.
 Artificial joint fluid (Synvisc, Hyalgan). These medications can be injected into the knee. They may relieve pain for up to 6 months.

LIFESTYLE CHANGES
Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.
Applying heat and cold, protecting the joints, using self-help devices, and rest are all recommended.
Good nutrition and careful weight control are also important. If you're overweight, losing weight will reduce the strain on the knee and ankle joints.

PHYSICAL THERAPY

Physical therapy can help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it likely will not work at all.

BRACES
Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

SURGERY
Severe cases of osteoarthritis might need surgery to replace or repair damaged joints. Surgical options include:
 Total or partial replacement of the damaged joint with an artificial joint (knee arthroplasty, hip arthroplasty )
 Arthroscopic surgery to trim torn and damaged cartilage and wash out the joint
 Cartilage restoration to replace the damaged or missing cartilage in some younger patents with arthritis
 Change in the alignment of a bone to relieve stress on the bone or joint (osteotomy)
 Surgical fusion of bones, usually in the spine (arthodesis)

Outlook (Prognosis)

Your movement may become very limited. However Treatment generally improves function.

Possible Complications

 Decreased ability to walk
 Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking
 Adverse reactions to drugs used for treatment
 Surgical complications

When to Contact a Medical Professional
Do contact your health care provider if you have symptoms of osteoarthritis.

Prevention

*Weight loss can really help the condition and certainly reduce the risk of knee osteoarthritis in overweight women.

When our body is in the standing position it is in a state of unsteady equilibrium because the base is small and the centre of gravity is a long way above it. That is why it has to be balanced by keeping the centre of gravity over the base, otherwise the body would fall over.

Equilibrium: The steadiness of the body depends on the size of its base and the distance of the centre of gravity from that base. An object having a large base and a low centre of gravity is not easily upset.

The first thing necessary in order to accomplish good posture is to straighten the neck, keep the chin down and back. The second important thing is correct deep breathing.

The line of gravity in the fundamental standing position falls in front of the ears, and in front of the cervical and dorsal vertebrae, through the lumbar vertebrae, through the hip joint, and slightly in front of the ankle joint. But this probably varies in individuals according to their build and height.
"Biomechanics is that branch of science concerned with the understanding of the interrelationships of structure and function of living beings with respect to the kinematics and kinetics of motion"

Poor Posture associated by the following:

Genetic disorders, Familial association, Irregular/no exercise, Bad habits when sitting or standing, Carrying excess loads, (School/shopping) Underweight/Overweight (Inadequate diet)
Mental Attitude towards oneself.

Biomechanics is our way of describing how each bit of your body moves in relation to another bit.

Our bodies are fantastic at compensating when things are not quite perfect but unfortunately when we run out of compensations we usually end up with pain and stiffness.

Let’s have a look at some of the more common biomechanical problems:

Problem 1.

It’s the fashion not to tie trainers and shoes up but this prevents the shoe from supporting the inside of the foot and allows the foot to roll or ‘pronate’ too much in standing and walking.

This means the knee and the hip rolls inwards too much which makes the inside calf and inside thigh muscle shorter. The iliotibial band can then rub against the outside knee giving pain.

Further up, the bottom muscles become too long and stop working as they should do which puts added stress on the pelvis and low back joints. Before you know it you have back pain, knee pain and ankle pain! And all because of fashion!

Problem 2.

Whether you drive 5 miles or 500 miles a day your car seat is really important. In many cars the base of the seat slopes backwards. In fact some of the more expensive cars are the worst because they want you to feel ‘snug’ and safe in the seat. However, this position forces your pelvis to sit too far backwards.

Once this happens your low back and upper back flex forward too much but then your neck muscles have to work really hard to stop your head from flexing too much and allow you to see where you are going. This position then forces your shoulder blades to stretch too far forwards and a large stress is placed on both the front and the back of the shoulder.

The result is neck pain and /or upper or low back pain. This position can exacerbate sciatica as it is a big stretch for the nerves.
The solution is to raise the back of the seat so it becomes more horizontal. Some cars allow you to alter this angle but if yours does not then sit on a small cushion or buy a special wedge shape cushion that fits into the seat.

Our lumbar spine (lower back) provides a foundation to carry the weight of the upper body. It also houses the nerves that control the lower body. With aging, degenerative changes in the spine can occur. The disks between the vertebrae (bones) may become dehydrated, and the joints may become overgrown due to arthritis. Over time, these changes can also lead to narrowing, or stenosis, of the spinal canal.

Narrowing of the lumbar spinal canal pinches the nerves that go to the skin and muscles of the legs. Sometimes, the pinched nerves become inflamed, causing pain in the buttocks and/or legs.

Degenerative changes in the lower back also can diminish the ability of the spine to carry the load of the upper body. This can lead to forward slippage of one vertebra on another, a painful condition called spondylolisthesis.

Lumbar spinal stenosis usually affects middle-aged and older adults. People who are born with narrower spinal canals are more likely to develop this problem.

Symptoms
Typically, patients with lumbar spinal stenosis have a long history of pain in the back, buttocks, and/or legs that gradually worsens over time. Standing or walking upright usually increases the symptoms, resulting in an achy pain, tightness, heaviness, and a sense of weakness in the buttocks and/or legs. These symptoms are generally relieved by sitting down or leaning forward.

Although patients with lumbar spinal stenosis are unable to walk for long periods of time, they may be able to ride an exercise bicycle for much longer. Some patients also find that it is easier to walk while leaning forward on a shopping cart. This position tends to create more space in the spinal canal and can relieve some of the pressure on the nerves. Leaning on the handlebars of a bicycle creates the same effect.

Diagnosis
An orthopaedic surgeon can diagnose lumbar spinal stenosis using a combination of:

Symptoms
Physical examination
Plain radiographs (X-rays)
Magnetic resonance imaging (MRI)
Radiographs can show the presence of arthritis and slippage of vertebrae. An MRI scan can show whether nerves are being pinched.

For people who cannot get an MRI (for example, people with pacemakers), a special test called a computed tomography myelogram may be necessary. In this test, dye is injected into the spine to make the nerves visible. The doctor can then determine whether the nerves are being pinched.

Treatment

Nonsurgical Treatment

Most patients with lumbar spinal stenosis do not require surgery. However, if a patient is experiencing severe pain that limits the activities of daily living, surgery may be recommended.

Generally, nonsurgical treatment for lumbar spinal stenosis consists of:

Physical therapy A program of physical therapy usually includes aerobic conditioning and exercises for strength and flexibility. The exercise bike is a good way for patients to exercise without pain. Pool exercises can be useful for people who cannot do aerobic exercises on land.

Anti-inflammatory medications Medications such as ibuprofen and naproxen may be prescribed to decrease pain and inflammation; however, they can have serious side effects. Prolonged use can lead to gastrointestinal ulcers, bleeding, and kidney problems. Some anti-inflammatory medications may also increase the risk of heart attack and stroke.

Epidural steroid injections These injections deliver anti-inflammatory steroid medication directly into the spinal canal—straight to the pinched nerve roots. The injections can provide relief for weeks to months, and may allow the patient to participate in more aggressive rehabilitation. In some cases, they may enable the patient to postpone or avoid surgical treatment altogether. Epidural steroid injections are more effective than anti-inflammatory medications taken by mouth, and they may also have fewer side effects.

Bracing A lumbar brace or corset can provide some support and help the patient gain some mobility, but bracing is generally not recommended for long-term use. If used for too long, bracing can lead to deconditioning of the muscles that support the back. Acupuncture or chiropractic manipulation can also be attempted.

All of these nonsurgical treatments are aimed at decreasing inflammation and providing relief of symptoms. However, nonsurgical treatment will not improve the narrowing of the spinal canal.

Surgical Treatment
In general, surgery is only considered as a last resort if all attempts at nonsurgical therapies are unsuccessful, and if the overall potential benefits of surgery are greater than the potential risks. Surgery may be recommended on an urgent basis if a patient has severe weakness or loss of bowel and bladder control.

Decompression
The surgical procedure for lumbar spinal stenosis involves removing the bone and soft tissues of the spine that are pinching the nerves. This procedure is called a "decompression" or a "laminectomy."

Spinal Fusion
Some patients with lumbar spinal stenosis require only a decompression. However, if there is also forward slippage of a vertebra or curvature of the spine, a "spinal fusion" may be needed. In this procedure, two or more vertebrae are permanently fused together, using a bone graft harvested from the hip. Fusion eliminates motion between vertebrae and prevents the slippage or curvature of the spine from worsening after surgery, which would cause more back and/or leg pain. The surgeon may use screws and rods to hold the spine in place while the bones fuse together.

The use of rods and screws makes the fusion of the bones happen faster and speeds postoperative rehabilitation. Overall, the results of spinal fusion are good to excellent in approximately 80% of patients. Patients tend to see more improvement of leg pain than back pain. Most patients are able to resume a normal lifestyle after a period of recovery from surgery.

Complications of Surgery
There are some risks to surgery for lumbar spinal stenosis, including:
 Bleeding
 Infection
 Blood clots
 Reaction to anaesthesia
 Tear of the sac covering the nerves (dural tear)
 Failure to relieve symptoms
 Return of symptoms after some time
 Failure of the bone fusion to heal
 Failure of screws or rods
 Need for further surgery
 Injury to the nerves

The risks of surgery depend on the patient and the exact procedure being performed. Elderly patients have higher rates of complications from surgery. So do overweight patients, diabetics, smokers, and patients with multiple medical problems.

Rehabilitation
After surgery, patients may be hospitalised for several days, depending on the patient and the procedure performed.

Relatively healthy patients who undergo only decompression may be discharged from the hospital the same day, and may return to normal activities after only a few weeks.

Patients who undergo spinal fusion are hospitalised for several days. They usually receive an outpatient physical therapy program.

A lumbar corset or brace may also be prescribed after surgery. Patients generally return to normal activities after 2 to 3 months.

Older patients who need more physical therapy may be transferred from the hospital to a rehabilitation facility.

Prevention
The best way to avoid lumbar spinal stenosis is to stay as physically fit as possible. Regular exercise can improve endurance and keep the muscles that support the spine strong.
Avoiding weight gain can decrease the load that the lumbar spine has to carry.

Patients should also avoid cigarette smoking. Both the smoke and the nicotine cause the spine to degenerate faster than normal.

The Silent Disease is the name that is often given to Osteoporosis, as most people don't know they have osteoporosis until it has progressed often to the point of fracture, usually in the hip, wrist or spine. Even when undiagnosed osteoporosis results in a vertebral fracture, the pain is frequently dismissed as general back pain. This lack of awareness can lead to serious illness, deformity, even death.

Osteoporosis alone does not cause back pain. It can, however, weaken the spine to where it is no longer able to withstand normal stress or minor trauma, resulting in vertebral fracture. It is the ensuing fracture that causes pain.

Osteopenia is a condition where bone mineral density is lower than normal, but not low enough to be classified as osteoporosis. While often a precursor to osteoporosis, not everyone with osteopenia will develop osteoporosis. Since a diagnosis of osteopenia puts one at greater risk for osteoporosis, patients are encouraged to seek the advice of their GP’s about implementing preventive measures.

Osteoporosis Causes and Risk Factors

Bones are made of complex, constantly changing, living tissue. They are able to grow and heal, and are also susceptible to changes in diet, body chemistry, and exercise levels.
Early in life, more bone is laid down than is removed by the body. People typically achieve peak bone mass by around age 30, after which more bone is lost than is replaced. Too much bone loss leads to osteoporosis.

Both of the two primary types of osteoporosis are far more common in women than men:

Type I osteoporosis (postmenopausal osteoporosis) —generally develops after menopause, when estrogen levels drop precipitously, leading to bone loss — usually in the trabecular (spongy) bone inside the hard cortical bone.

Type II osteoporosis (senile osteoporosis) — typically happens after age 70 and involves a thinning of both the trabecular (spongy) and cortical (hard) bone.

In addition, certain medications and medical conditions can damage bone and lead to what is known as “secondary osteoporosis”. Patients being treated for any of the following conditions should discuss the risk of osteoporosis with their physicians:

Endocrine disorders

Marrow disorders

Collagen disorders

Gastrointestinal disorders

Seizure disorders

Eating disorders (such as anorexia or bulimia)

It is important to distinguish between primary and secondary causes of osteoporosis because treatment is often different. To determine the cause, a thorough medical history, physical examination, and appropriate diagnostic tests need to be conducted (see Diagnosing Osteoporosis).

Key risk factors for developing osteoporosis include:

Advanced = age over age 65.

Gender = Women are four times more likely to develop osteoporosis than men.

Heredity = Family history of osteoporosis or fracture on the mother’s side.

Personal history = any type of fracture after age 45.

Race = Caucasian and Asian women are at greater risk.

Body type= small-boned women weighing less than 127 pounds.

Menstrual history = Normal menopause increases the risk of osteoporosis and early menopause can exacerbate this risk.

Lifestyle = calcium and/or vitamin D deficiency; little or no exercise (especially weight-bearing exercise); alcohol abuse; smoking; too much cola/soda.

Testosterone deficiency (hypgonadism) = in men.

Why women are at greater risk for developing osteoporosis

Estrogen plays an important part in maintaining bone strength. Starting at about age 30 through onset of menopause, women lose a small amount of bone every year as a natural part of the aging process. When women reach menopause and estrogen levels decrease, the rate of bone loss increases for approximately 8 to 10 years before returning to premenopausal rates.

Osteoporosis Symptoms
Osteoporosis can go undetected for years and fracture is typically the first outward sign. Advanced osteoporosis is potentially disabling, often leading to one or more of the following:
fractures of the spine, wrist or hip

spinal deformity (e.g., lost height, hunched back)

chronic or severe pain

limited function and reduced mobility

loss of independence

decreased lung capacity

difficulty sleeping

Osteoporosis is the leading cause of spine fractures, especially in women over age 50, but only about one third of all spine fractures are diagnosed.

Most osteoporotic spine fractures (vertebral compression fractures) start with sudden back pain, usually after routine activity (lifting or bending) that slightly strains or jars the back. After a month or two, this acute pain is usually replaced by an achy pain (see Diagnosing vertebral compression fractures).

Osteoporosis Prevention

Postmenopausal (Type I) osteoporosis can be significantly influenced by preventive measures. Most of these behaviors are up to the individual and should be started as early in life as possible. For those genetically predisposed to osteoporosis, the following practices are even more important:

Exercise regularly weight-bearing exercises (activities that work one’s bones and muscles against gravity) are essential to maintaining bone health.

Ensure adequate calcium intake, Calcium plays a key role in keeping bones strong. Vitamin D is also essential, as it helps ensure absorption and retention of calcium in bones. Calcium and vitamin D requirements vary depending on age and gender.

Eat a balanced, healthy diet Certain foods provide excellent sources of calcium, while diets high in protein and/or sodium increase calcium loss.

Quit smoking - Smoking has a detrimental effect on bone density, leading to greater risk of injury and longer recovery times.

Limit alcohol consumption - While the exact way alcohol affects bone isn’t entirely understood, excessive alcohol use has been proven to accelerate bone loss.

Limit intake of colas/sodas - recent research indicates that too much cola or soda can increase the risk of osteoporosis.

Undergo bone density testing - every 1-2 years if you are postmenopausal, over age 65, or have other risk factors. Bone mineral density (BMD) tests indicate normal, low or osteoporotic bone density levels, as well as any increased risk of fracture.

For more information, see How to prevent osteoporosis.

Osteoporosis Treatment

Once osteoporosis has been diagnosed, patient and physician should work together to develop a treatment plan where the goal is to slow bone loss and prevent fractures. Treatment may include:
Education on diet/nutrition - see Food for Thought: Diet and Nutrition for a Healthy Back.

Exercise (if no fracture) - to help maintain bone density and reduce the risk of falls.

Medication - to slow bone loss and prevent fractures. Osteoporosis medications fall into two categories:

medications that slow or stop bone resorption (loss);

medications that increase bone formation.

Treatment for vertebral fractures, which may include:

rest, though long-term rest accelerates bone loss;

rigid back braces to support the spine;

ice/heat and pain medications;

surgery (kyphoplasty or vertebroplasty), which may be necessary in certain situations where the fracture is causing severe pain and/or deformity, or has failed to respond to three months of non-surgical treatment.

Do be positive because even once osteoporosis has been diagnosed, it is possible to slow bone loss, build bone density and prevent fractures. Continually advancing osteoporosis and related fractures are not an inevitable outcome of being diagnosed with osteoporosis.

Osteopathy originated from the common sense principle that a patients history of illnesses and physical traumas are written into the body’s structure. Practitioners have a highly developed sense of touch which allows them to palpate (feel) the patients living anatomy (i.e. flow of fluids, motion of tissues, and structural make-up).

Their job is to set the body up to heal itself. To restore its normal function, Practitioners gently apply a precise amount of force to promote movement in areas of congestion to restore normal motion of the body, release the compression of bones and joints, thus allowing restoration of normal tissue function.

When the body is balanced and efficient, just like a well tuned engine, it will function with the minimum of wear and tear, leaving more energy for living.
As Osteopaths, they quite rightly consider each person as an individual. On your first visit, they will spend time taking a detailed medical history including important information about your lifestyle. You will normally be asked to remove some of your clothing and perform a series of simple movements. This will allow a full diagnosis and a treatment plan to be devised, tailored to your individual needs.

Through a variety of stretching, mobilising and manipulative techniques they aim, through working with you, to restore the body’s harmony. This, coupled with exercises and health advice, enable them to reduce the symptoms and restore your health and quality of life.

Osteopaths treat a variety of common conditions including changes to posture in pregnancy; repetitive strain injury (RSI), postural problems caused by driving or work strain, the pain of arthritis and sports injuries.

Remedial Massage – This therapy consists of therapeutic massage and soft tissue manipulation for the treatment of muscular-skeletal conditions, sports injuries etc. When most people think of massage they think of relaxation massage, where the primary aim is to relieve stress and soothe muscular aches and pains. Remedial massage, however, takes this a little further focusing on the root cause of persistent chronic muscular or skeletal pain and then seeks to alleviate it permanently. Often such pain is the result of injury, caused by specific trauma or imbalances in the joints, muscles and ligaments.

Therapists are trained to assess these imbalances and establish an effective programme of therapeutic treatment. The remedial massage treatment process involves the application of scientifically based treatments, often in conjunction with a rehabilitation programme.

The application of remedial massage and manipulation is based upon a thorough understanding of anatomy and physiology. It aims to re-balance the musculo-skeletal system, by working specifically on muscles, tendons, joints, fascia and ligaments, thus making the treatment a powerful yet non-traumatic therapy. This re-balancing of soft tissue, allows freedom of movement within the joints so facilitating the normal function of the vascular and neural systems.

Many studies have demonstrated the wide-ranging benefits of massage. It is useful for specific ailments such as asthma, depression, back and neck pain, insomnia, immune deficiency disorders and diabetes. It can be helpful during pregnancy and labour and is also used to help premature babies thrive. It can also be taught to their mothers to help them bond with their infants while they are still in incubators. Massage is often a part of therapy for people with cancer since it promotes relaxation and a sense of wellbeing.

Electrotherapy – Therapists apply electrotherapy where appropriate to be of benefit to the condition being treated. Modalities used in the Practice include interferential, pulsed electromagnetic energy fields and medium frequency modulated current (Likon).

Some of the equipment available is designed for continuation of therapeutic treatment at home.

Interferential – This is based on the crossing of two separate applied electronic currents of two different frequencies which “interfere” at their cross points, creating the required therapy frequency. This is done by applying four electrodes to the body (in direct contact). The reason for this form of therapy is to create this interferential field deep within the localized tissue.

Pulsed Electromagnetic Treatment - Electromagnetic Therapy does not need any electrical contact with the body and creates a much larger area of therapy field within the body and penetrates easily through the body. It works by applying a low frequency pulsing magnetic field to the injured area. This pulsating field influences the ions within the body cells to enhance ion exchange which, in turn, improves oxygenation to the cells which accelerates healing and cell regeneration.

Osteopathy offers a wide range of modalities that can be extremely beneficial in both the treatment and management of various medical conditions. However please ensure that you liaise with your GP and if it is your first visit to an Osteopath always check that they are registered with the appropriate governing body. Here in the UK that is the GOC.-osteopathy.org.uk.

Surveys recently carried out both here in the UK and France, have indicated that Middle back pain is an increasingly common ailment. Luckily, for most people middle back pain is relatively easy to fix. Symptoms associated with middle back pain can vary and there could also be a wide range of causes. However, most cases turn out to be relatively simple, common problems that are usually treated quickly.

The middle back is composed of 12 vertebrae which are part of the thoracic section of the spine. These bones protect the spinal cord. Between each of these bones are discs of cartilage which act as shock absorbers due to their elasticity and help with movement. There are also muscles and tendons that are responsible for providing stability to the back.

There are many different problems that could arise creating middle back pain. Most often muscle strains are the most common cause of pain. These can occur as the result of lifting heavy objects, exercising too much, or even suddenly twisting or bending can often cause muscles in the middle back to be come overworked and strained. In addition, bad posture, not sleeping right, and obesity are also common causes of middle back pain.

Herniated discs also account for middle back pain. When this occurs, a bulged develops in between the vertebrae, causing it to spill out into the spinal column. This can create severe pain, and it can also cause a nerve in the spinal column to become pinched. When this occurs, pain is not only present in the middle back, but it can also radiate throughout the lower extremities.

Aging also has negative effects which can cause middle back pain. Arthritis is a common disease that develops among people as they age. This condition causes inflammation of the joints. Sometimes, this inflammation can become so great that not only can there be difficultly moving, but inflammation and swelling might also be so great that it could even cause nerves in the spinal column to become pinched. Years of wear and tear on the spine can also cause the cartilage to become worn and thin. When the cartilage between the vertebrae thins, moving can become very painful and difficult. Osteoporosis is also a disease that causes bone density to decrease. This increases the likeliness of bone fracture, even when lifting everyday objects.

As already mentioned, most cases of middle back pain can be attributed to strained muscles. Luckily, this condition can be relieved by simple means. Usually, rest is the first thing recommended by doctors. It’s important to avoid activities that could make the condition worse, so it’s important to stop lifting and stop exercising. Applying ice packs followed by applying heating pads can also help the tension with a sore muscle. Sometimes physical therapy may be recommended. This is a great way to learn the necessary exercises and stretches that can significantly reduce back pain while also strengthening the back, preventing addition instances of middle back pain.

Surgery may sometimes be required for middle back pain. If conservative treatments do not improve middle back pain after several weeks, or if the pain and symptoms worsen during that time, surgery may need to be considered. If a nerve is pinched for example surgery is sometimes necessary to remove the pressure that is being placed on it. Luckily, surgery is not usually required for the majority of middle back pain cases.

Prevention of middle back pain is also very important. Stay clear of smoking and make sure to exercise regularly. This will help maintain your proper body weight and also strengthen the muscles throughout the body, helping to prevent injury. Also, before exercise it is important to stretch the muscles out. In addition, ease into an exercise routine so that you don’t overdue it. Also, having good posture is a way to keep the middle back from getting sore. If most of these methods are maintained, your chances or preventing further middle back pain will be greatly improved.

Osteopathy is an established recognised system of diagnosis and treatment, which lays its main emphasis on the structural and functional integrity of the body. It is distinctive by the fact that it recognises that much of the pain and disability we suffer stems from abnormalities in the function of the body structure as well as damage caused to it by disease.

What kinds of problems can Osteopathy help with?
Whilst back pain and neck pain are the most common problems seen, Osteopathy can help with a wide variety of problems including changes to posture in pregnancy, babies with colic or sleeplessness. Repetitive strain injury, postural problems caused by driving or work strain, headaches and migraines, the pain of arthritis, soft tissue sprains and strains and sports injuries among many others.

What can I expect when I visit an Osteopath?

When you visit an Osteopath for the first time a full case history will be taken and you will be given an examination. You will normally be asked to remove some of your clothing and to perform a simple series of movements. The Osteopath will then use a highly developed sense of touch, called palpation, to identify any points of weakness or excessive strain throughout the body. The Osteopath may need additional investigations such as x-ray, scans or blood tests. This will allow a full diagnosis and suitable treatment plan to be developed for you.

How many treatments will I need?

Osteopathy is patient centred, which means treatment is geared to you as an individual. Your Osteopath will give you an indication of your treatment plan and options during the initial consultation. For some acute conditions one or two treatments may be all that is necessary. Chronic conditions may need more initial treatment and ongoing maintenance sessions at 2-6 month intervals.

Do I need a referral from my GP?
A formal referral from your GP is not necessary. Whilst patients may be referred to Osteopaths by Doctors, many patients self-refer.

How does Osteopathy work?

Osteopaths work with their hands using a wide variety of treatment techniques. These may include soft tissue techniques; rhythmic passive joint mobilisation or the high velocity thrust techniques designed to improve mobility and the range of movement of a joint. Gentle release techniques are widely used, particularly when treating children or elderly patients. This allows the body to return to efficient normal function by maximising blood, neural (nerve) and lymphatic flow.

Can I claim Osteopathy on my private health insurance?

Many private health insurance schemes give benefits for osteopathic treatment. Reimbursement will depend on the insurer and the plan you have chosen. Contact the help-line of your insurance company who will explain the actual benefits and methods of claim for your individual policy.

Preventive care:

Osteopaths are concerned not only with trying to alleviate patients’ pain and other symptoms, but also with trying to help prevent problems recurring. We regard treatment as a co-operative process between practitioner and patient and encourage patients to participate in preventive health programs. Preventive osteopathic care may include the prescription of exercise programs, provision of ergonomic and postural advice, and dietary and general lifestyle advice. In addition, where appropriate, osteopaths may refer patients to other practitioners to assist with preventive work.