Osteopathy and Healthy Ageing

Everybody gets grey hair and wrinkles as we get older. In the same way, it is normal for our muscles, bones, joints and associated tissues to change as we age. Ageing does not necessarily mean that we will experience increased pain or stiffness. However, if this does become a problem, people often find that treatment and advice from an osteopath can complement GP care and pharmaceutical products. If you do notice problems, your osteopath can work with you to keep you healthier, allowing you to enjoy the pleasures of life into your older years.

Advice as you get older

Although aches and pains may be a common element of ageing, they don’t have to get in the way of your lifestyle. Here are some healthy tips to keep you active:

  • 150 minutes of exercise per week, in blocks of ten minutes or more (enough to make you warmer and breathe harder, whilst still being able to have a conversation) can help reduce the risk of circulation problems and falls. It can also help to improve your mood and levels of confidence. This might include activities such as dancing or brisk walking.
  • Make sure you eat a healthy, varied diet.
  • Doing some form of balance exercises twice a week (for example, Tai Chi) is also recommend as you get older to help reduce the risk of falling, particularly if you are over the age of 65. Try to also include exercises that strengthen your arms, legs and body.
  • The use of trainers or similar footwear can help absorb shocks and take the pressure off your knees, hips and spine when walking for longer periods.
  • A short rest can help recover energy for the remainder of the day’s activities.

How can your osteopath help?

You don’t have to put up with aches and pains simply because you are getting older. In fact, many people find it helpful to talk to an osteopath about ways of keeping active, preventing common problems such as falls and managing conditions such as osteoarthritis, rheumatic pain and osteoporosis. Osteopathic care is based on the individual needs of the patient and so varies depending on your age, fitness levels and diagnosis. Osteopaths use a wide range of gentle hands on techniques that focus on releasing tension, stretching muscles and mobilising joints.

Please call us on 07423 433930 or book online via the home page.

Are You Fit For Work?

Your health at work

Do you feel fit for work?
Musculoskeletal conditions (problems with the muscles, bones, joints and associated tissues) are a major contributing factor to work place absenteeism. The Office for National Statistics reports that 30.8 million working days are lost each year due to musculoskeletal issues, such as back, neck and upper limb pain, in the UK alone.

Habitual poor posture can contribute to daily aches and discomfort in the workplace and beyond. Whether you work at a desk or have a more manual occupation, your job may expose you to stresses and strains that can cause you pain.

Common causes of strain in the workplace can include:

  • Prolonged sitting at a desk
  • Driving long distances
  • Awkward lifting and carrying
  • Overstretching
  • Bending
  • Extended periods of repetitive motion
  • Using a computer without taking breaks

These can lead to various aches and pains, and other common musculoskeletal conditions such as sciatica, carpal tunnel syndrome and tennis elbow. Furthermore, workplace stress can increase the amount of pain you feel by causing muscle tension and spasms.

Keeping healthy at work

These simple tips can keep you healthy at work and avoid unnecessary strain on your muscles and joints:

  • Frequent short breaks away from the computer may help avoid back, neck and eye strain.
  • Ensuring that your chair and computer display are appropriately adjusted so that the top of the screen is at eye level, may be more comfortable for your upper body and neck.
  • When lifting, judge whether you can do this safely alone or need help (don’t be afraid to ask for assistance). Always keep the item you are lifting close to your body. Bend your knees and make your legs do the work. Try not to twist your back – turn with your feet
  • When driving make sure you are positioned comfortably, and take regular breaks on long journeys, at least once every two hours.

How can your osteopath help?

Osteopaths are highly trained, healthcare professionals, experts in the musculoskeletal system (joints, muscles and associated tissues) and its relationship to other systems of the body. Osteopathic care is based on the individual needs of the patient and so varies depending on your age, fitness levels and diagnosis. Your osteopath can provide you with a fit note if you do need to take time off from work. You can discuss with your osteopath the impact work may have on your body and agree on an appropriate course of action that may help. Along with hands-on osteopathic treatment, your osteopath may also offer advice on posture, lifting and workplace ergonomics.

Advice for working at your desk

If your work is office or computer based, you can spend a significant portion of your day seated at a desk which can lead to host of problems for your health.  But with a few changes and addition of good habits, you can keep productive at work and keep healthy.

Sit-well

  • It is really important when working at your desk that you are mindful of your posture and your equipment is correctly set-up.  Things to look out for include;
  • Is your screen at eye level? If your monitor does not have height adjustment try elevating it with a riser, or even some old books!
  • Keep your mouse close.  It’s easy for your mouse to drift away from you when working, make sure you are not over-stretching to reach it
  • Keep your keyboard close.  You should be able to sit up in your chair, have your elbows in an L-shape and still be able to reach your keyboard. If you are overstretching to reach it, you will need to adjust accordingly.
  • Adjust your chair. You should be able to sit right back into your chair, so your lower back is supported while still comfortably accessing your equipment
  • Feet to the floor. The height of your chair should allow your feel to easily reach flat to the floor. Use some form of riser if needed
  • Avoid crossing your legs. It can cause circulation problems and puts unnecessary strain through your lower back.

If you are unsure about your desk or workstation set-up, ask your employers to provide a workstation assessment.

Regularly re-set your posture

While you may start off in the correct position it can be very easy to drift into slouched position as your desk.  Try putting a sticker on your monitor as a reminder to re-set your posture every time you see it.

Take regular breaks

  • It is recommended that you should take a break from your desk every 30 minutes for at least one or two minutes. Try building in some of these good habits into your working day.
  • Stand-up and move around for a few moments around your desk
  • Use a break to get a drink of water, which also helps you keep hydrated.
  • Rather than phoning an office colleague, can you walk over to talk to them?
  • When taking a call, can you take the opportunity to stand-up rather than sit?

On the phone

If your work involves making lots of calls, avoid tucking handsets between your neck and shoulder. Consider getting a headset so you are not battling with the handset, keeping your hands free and able to maintain a healthy posture.

Laptop working

Increasingly we are working directly off laptops, particularly if you are a mobile or remote worker or hot-desking across offices.  However the same rules apply, and even more so if you don’t have the luxury of an adjustable chair or monitor.

If you are mainly working off a laptop you may want to consider getting wireless keyboards and/or risers, so you can optimise your work posture.

Also consider where you work – your dining room table may be convenient but if of an incorrect height, extended working may cause shoulder, neck or back pain.

 

Advice for physical work

If your work involves lifting or more physical activities, you need to be careful that you are not putting yourself at risk of injury or long-term health problems.

One of the biggest causes of back injury at work is due to lifting incorrectly.  Additionally, continuous repetitive activities, or staying in the same position for extended periods of time, can also lead to pain and discomfort. Being aware of how to move correctly when at work can keep you healthy for longer and keep you safe from injury.

Lifting safely

  • Before you lift any object, try to establish its weight and if you can indeed lift it safely. If in any doubt, don’t attempt it.
  • Check your destination. Make sure you know where you are going to deposit your load and you have no obstructions in the way.
  • Lift in stages.  See if you can phase your lift. For example, from floor to table and then to destination. Once at the destination can you lift it in stages to its desired location?

The golden rule of lifting – Bend at the knees and not your back! 

  • Remember do not bend forward from your back to lift an item.
  • Before you start to lift make sure your footing is stable, keeping a wide stance.
  • Get a good hold of the item and keep the item close to your body as you move up, using your legs to straighten up.
  • Avoid twisting your back/body when lifting or positioning a load.

Awkward places and repetitive movements

If your work involves getting into awkward places or repetitive movements for extended periods of time, this can also put additional stress and strain on your muscles, joints and associated tissues. Overhead movements when decorating, working under cars, on knees fixing carpets or leaning over to fix pipes, are all examples. The demands of your job will often dictate what can you do, but you may want to consider:

  • Rotating jobs. If you’ve got several things to do, try and rotate from one activity to another after a shorter period of time, so you don’t get stuck in one position or activity.
  • Take regular breaks. Short regular breaks that allow you to move into different positions can be helpful
  • Keep a healthy lifestyle. With a physically demanding job it’s important to make sure you are eating healthily, and maintaining your body fit for work. Depending on your job, you may want to consider doing other physical activities for fun that will either build strength or your cardiovascular stamina.

Off work and suffering back pain?

  • Keep in regular contact with your employer to make them aware of your situation, and to discuss what adjustments might be needed once you are ready to return.
  • Discuss your needs with your employer and occupational health provider
  • If there is no occupational health provider available, your GP or safety representative may be able to discuss possible work restrictions or adjustments.
  • Suggest any practical workplace adaptations or alterations which might help you to cope while you return to full time working.
  • And of course, see your Osteopath!

We offer appointments in Devizes, Pewsey and Amesbury – please call 01380 728453 for further information or book online.

Lower Back Pain

Lower back pain is very common – according to a survey published in 2000 almost half the adult population of the UK (49%) report low back pain lasting for at least 24 hours at some time in the year. It is estimated that four out of every five adults (80%) will experience back pain at some stage in their life. (1)

In most cases it is very difficult to identify a single cause for back pain. In about 85% of back pain sufferers no clear pathology can be identified. (2)

 

The following factors could contribute to back pain:

  • Having had back pain in the past, smoking and obesity. (3)
  • Physical factors such as heavy physical work, frequent bending, twisting, lifting, pulling and pushing, repetitive work, static postures and vibrations. (4)
  • Psycho-social factors such as stress, anxiety, depression, job satisfaction, mental stress. (3, 5)

Nearly 40% of back pain sufferers consulted a GP for help. 10% visited a practitioner of complementary medicine (osteopaths, chiropractors and acupuncturists). (6)

Common causes of low back pain include:

  • Muscular strain – sometimes you can ‘pull a muscle’ in your back, resulting in a small tear or sprain in your muscle.
  • Disc problems – sometimes the discs between the vertebrae may become weaker and bulge out. In extreme cases, this may lead to a prolapsed disc.
  • Spinal stenosis – the spinal column runs through a narrow opening in your vertebrae.  If this opening becomes too narrow, the nerves may become trapped, which causes pain.
  • Collapsed vertebra – the vertebrae give much of the structural support to the spine but these may become damaged as a result of disease or injury. Severe osteoporosis may result in a vertebra collapsing and by doing so, disturb the surrounding structures.
  • Inflammation of sacro-iliac joints, or lumbar spine facet joints
  • ‘Wear and tear’ ie arthritis/spondylitis of the lumbar spine

If you have a physical job, sit or stand for long periods, or are in poor physical condition, you are at greater risk of developing lower back pain.

Most people associate back pain with physical risk factors such as heavy lifting, twisting and bending and awkward postures.  These can contribute to back pain or exacerbate any existing pain. Therefore you should pay attention to controlling these factors by, for example, using manual handling aids (lift, hoists etc) and ergonomically assessed workstations.

Other risk factors of a physical nature include vibration (for example the vibrations that a driver experiences when driving a car or truck), repetitive work and static postures.

Emotional stress and long periods of inactivity can also make symptoms appear worse.

Structure of the spine:

Understanding a little basic anatomy can help you understand the nature of your pain and where it’s arising from.

Your back consists of many different structures that all have to work together.

Your spinal column is comprised of 33 vertebrae, with discs (like shock absorbers) in-between them.  You have 7 in your neck (Cervical vertebrae), 12 in your middle back (Thoracic vertebrae), and 5 in your lower back (Lumbar vertebrae). You have 5 vertebrae which are fused together to form your Sacrum, attached to which are 4 vertebrae, which are also fused, that form your Coccyx (tailbone).

The shape and size of these vertebrae changes from the top to the bottom of the spine. Cervical vertebra are small, and are designed for movement and flexibility, whilst lumbar vertebrae are much bigger, being responsible for the weight bearing of almost all of the upper body.

As the vertebrae stack up one on top of the other, a small gap called a foramen is formed. Pairs of spinal nerves branch away from the central spinal cord and travel through these foramen to supply organs, limbs etc.

The spinal cord is encased in a ring of bone formed by the front and the back of the vertebra, and this runs from the base of the brain to the bottom of the spinal column.

The discs between the vertebrae are more formally known as intervertebral discs. They are made up of a soft jelly like substance called the nucleus, which is held inside a tough, elastic and fibrous outer casing known as the annulus.  The vertebrae and the discs together are known as the spinal column. This is supported by many muscles, tendons and ligaments. Their function is to provide strength and stability to the spinal column.

The muscles are connected to your bones with tendons – when a muscle contracts, the forces are passed on to the skeletal system via the tendons. This ensures that a muscle contraction results in a movement of a certain body part. The role of a ligament is to provide stability to a joint – however, ligaments are also flexible to a certain degree, so they can stretch or contract when the joint moves.

It could be thought that any abnormalities in the structure or functioning of your back will result in pain, but this is not necessarily true.  People have very different backs and it is difficult to define a ‘normal’ structure. Some people with severe deformities may not experience any back pain while others who appear to have ‘normal’ backs experience severe pain.

Osteopathic Treatment for Lower Back Problems:

Although lower back pain is often very painful, the good news is that few people have a major problem with the bones or joints of their backs.

A good proportion of lower back problems can be resolved using non-surgical methods.Manipulation by a specialist practitioner followed by mobilisation and exercises has been proven to be the most effective treatment for acute low back pain (UK BEAM BMJ 2004; 329; 1377)

Prevention is better than cure, and it is often easier for an osteopath to treat underlying stresses and strains when there is no current back pain. You do not have to have the pain on the day of the treatment.

Likewise, you do not have to wait for a particularly painful episode to settle before visiting an osteopath.  Most back pain is easier to treat in its early stages. It is also important for the longer term to minimise the potential for structural damage or arthritis, which can be caused by wear and tear through strain on weak areas of the spine, by getting treatment when it is needed.

During your consultation, the osteopath will take a full history of your condition, and also ask questions relating your current and past state of health. It is helpful if you could bring a list of any medications you may be currently taking.  Once a diagnosis had been made, the osteopath will discuss it with you and outline what the best course of treatment would be.  Occasionally, further diagnostic tests may be required, such as x-rays, MRI scans or blood tests –  for these you be referred back to your GP/Specialist.

Osteopathic treatment of lower back pain may include one or more of the following techniques:

  • High velocity low amplitude thrusts (HVT) – the osteopath applies a high-velocity low amplitude thrust to the joint to reduce any restricted movement. This is painless and makes a small ‘clicking’ or ‘popping’ sound.
  • Myofascial Release – The osteopath may use this soft tissue therapy to release muscular shortness and tightness.
  • Muscle Energy (MET) – The osteopath applies a counterforce to the muscles while they are being used in a specific position and direction, such as when flexing.
  • Soft Tissue Mobilization / Massage – The osteopath uses rhythmic stretching, deep pressure or traction techniques to engage the muscle area around the spine.

The average patient usually responds positively within three to six treatments, but more, or indeed fewer treatments may be required depending on the nature of what is being treated and the individual’s circumstances and past history of the condition. A chronic lower back problem may well take considerably longer to resolve.

After your treatment, you may well be given a series of exercises to do, and/or postural advice if your osteopath feels this would be of benefit to you. 

To book an appointment, please telephone 07423 433930, or book online.

References:

(1) Palmer KT, Walsh K, et al. Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years BMJ 2000;320:1577-1578.

(2) Nachemson AL, Waddell G, Norlund AI. Epidemiology of neck and low back pain. In: Nachemson AL & Jonsson E (eds). Neck and back pain: The scientific evidence of causes, diagnosis and treatment. Philadelphia: Lippencott Williams & Wilkins, 2000.

(3) Burton AK, Balague F, et al. European guidelines for prevention in low back pain. Eur Spine J 2006:15(suppl 2):S136- S168

(4) Andersson GBJ. The epidemiology of spinal disorders. In: Frymoyer JW (eds) The adult spine: Principles and practice.  Philadelphia: Liipincott-Raven, 1997.

(5) Hoogendoorn WE, van Poppel MNM, et al. Systematic review of psychosocial factors at work and in private life as risk factors for back pain. Spine 2000;25:2114-2125.

(6) Department of Health Statistics Division. The prevalence of back pain in Great Britain in 1998. London: Government Statistical Service, 1999