Lower back pain

Low back pain can be acute – of recent onset – or chronic (or persistent) – when it has been around for longer than 5 months. An acute episode of low back pain can be very frightening and disabling and often occurs suddenly as we make a normal everyday movement. When we are experiencing this level of pain and disability it is hard not to imagine that something serious has happened to our low back – a disc is bulging, a ligament or joint is inflamed, a nerve is being pinched. These things are causes of low back pain but in the majority of cases of low back pain there is no damage and no need for an x-ray or scan. An osteopath or physiotherapist will quickly assess whether imaging is required or whether you are safe to commence manual and movement therapy. Sometimes catastrophic pain can turn around incredibly quickly but it is important to have realistic expectations as your recovery will depend on a multitude of factors – mechanical, psychological and social – that are specific to you. All of these factors will be considered in agreeing a treatment solution with you

Shoulder pain

Shoulder pain can present in many different ways from stiff and painful conditions like frozen shoulder and tendon or joint degeneration, to weak and painful shoulders.  The latter makes up the majority of shoulder presentations that we see in clinic.  The pain distribution can be variable but generally there is a nagging ache in either the upper arm, top of the shoulder, around the shoulder blade – or any combination of these.

It is important to differentiate between different shoulder conditions as the approach taken to rehabilitating the shoulder will be depend on the category of shoulder issue that you have.

In addition to working directly on the shoulder, the osteopath considers how the function of other parts of the body impact on the shoulder’s function and will work comprehensively with both hands-on manual techniques and movement and exercise therapy.

Knee pain

While in some ways a simple joint that mostly bends and straightens the knee is subject to considerable stresses – finding itself as it does at the end of two long levers the tibia (shin bone) and the femur (thigh bone).  The knee is commonly injured during sporting activities and often becomes sensitive when we increase demands on it when increasing physical exercise such as in running or squatting.  I often hear from patients that they stopped doing a particular sport because of their knees which I always think is a shame because often with the right exercises, right dosage of exercise, help from other parts of the body – hip, foot and ankle especially – and changes to shoes or insoles, we can often overcome knee pain and/or build up its tolerance to the new activity so that any residual discomfort is very manageable.

The Ankle

Tendon issues: The ankle and foot are subject to tendon issues that affect the inside and outside of the ankle and at the heel and lower calf (the Achilles tendon).   Tendons often become symptomatic when we increase training but can also start to affect us with no change in our daily or sporting regime.  Tendons become stressed when loads exceed their capacity to manage them.  In addition to ensuring that joints and muscles further up the body – hip – trunk are not limiting the tendon’s ability to load optimally, it is generally necessary to strengthen the tendon and muscle it attaches to and modify training regimes.

Ankle sprains: Ankle sprains are amenable to treatment even in the hours and days after injury.  It is always a good idea to get an ankle sprain checked out by a physical therapist, as failure to rehabilitate it satisfactorily can mean that instability or subtle residual limitation could cause problems down the line – even many years later.

Wedges and insoles can again be useful adjuncts to treatment, when necessary, for a range of foot, ankle, lower leg and knee presentations.

Arthritic conditions

Osteoarthritis is a degenerative condition in which there are changes to the joint concerned – thinning of cartilage, expansion of the bony surfaces of the joint, thickening of the capsule surrounding the joint – in response to stresses on it.  In that respect, we deal with arthritic joints in much the same way as we would any symptomatic joint:  reduce stress on it by making the joints directly above and below function optimally and strengthen locally and comprehensively.  Research shows that pain due to loading joints (which could mean walking more in the case of an arthritic knee) considerably lessons pain after 6 months.