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What to expect
Your initial visit and diagnosis
At your first consultation, the back pain specialist - be it an Osteopath, Physiotherapist or Chiropractor - will take a detailed medical history including information about your lifestyle, such as your level of physical activity, your work environment and your diet together with any relevant past medical history.
In order to ensure a long-term solution to your problem the practitioner will be just as interested in what is causing your problem as the effect it has on your health. For example, is your back pain and shoulder pain caused by a rotator cuff lesion due to hours spent each day at a desk in front of your computer or is there another cause?
After your history has been taken your ability to move will be examined. You may be asked to remove some of your clothing (it is helpful if you are able to attend the visit in gym clothes) and perform a series of simple movements. The practitioner will assess your mobility by observing your range of movement and by gently feeling your spine, shoulders and muscles as you perform the movements.
It should be noted that Osteopaths, Physiotherapists and Chiropractors are all trained to recognise when they can't help and when to refer a patient to a doctor.
Your treatment plan
After diagnosing the cause of your condition the Osteopath, Physiotherapist or Chiropractor will propose a treatment program which may consist of one or more of the following techniques:
- Mobilisation
- Manipulation
- Massage
- Functional and Rehabilitative exercises
- Postural assessment, correction and advice
- Relaxation therapy
- Laser, ultrasound, electrotherapy and heat treatment
- Massage
In the case of neck pain and back pain, manipulation can be an effective treatment, but it may not be the best option in every situation. After a full examination your back pain specialist will discuss treatment options with you before manipulating your neck or back.
You will also be given exercises to do at home and, in some cases, advice as to how to minimise the impact of your lifestyle on your condition. This 'homework' is a crucial part of your treatment and should not be ignored. The Osteopath, Physiotherapist or Chiropractor will be seeking to promote your body's ability to self-heal and the exercises are a vital part of this process.
Symptoms commonly treated by Back Pain Specialists
Osteopaths, Physiotherapists and Chiropractors are well-known for treatment of back pain in general. In particular they routinely treat, with excellent results, conditions such as neck ache, migraine and headache, frozen and stiff shoulders, disc injuries, trapped nerves, cramps, sciatica, whiplash injuries, and many other soft or connective tissue and joint problems. Not infrequently such conditions may be caused by or related to sports injuries.
Some of the most common symptoms treated by Osteopaths, Physiotherapists and Chiropractors are outlined below:
- Tight or aching shoulders
- Headaches at the base of your skull or top of your spine
- Neck stiffness
- Acute immobilising lower back pain
- Sciatica and trapped nerves
- Pain and stiffness in the shoulder preventing a full range of movement
- Whiplash
Symptom
Tight or aching shoulders
Common Causes
- Sedentary working environment.
- Poor posture maintained for long periods of time. Common examples are driving and operating machinery or computers
- Tightness or aching is typically caused by a build-up of lactic acid, resulting in hardness and pain in the affected muscles
Treatments
- Take frequent breaks to avoid the onset of the condition in the first place and perform exercises such as shrugging your shoulders and stretching your shoulder blades back to meet each other.
- Analyse your posture to ensure you are sitting as upright as possible (i.e., not sitting forward in a "hunched" position) - if necessary seeking assistance from an occupational health professional or specialist retailer
- If your muscles become too hard you will need treatment by a Osteopath, Physiotherapist or Chiropractor to stimulate blood flow in the hardened veins of the shoulder muscles and allow deposits of lactic acid to drain away naturally
- Physiotherapy, osteopathic or chiropractic treatment is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Symptom
Headaches at the base of your skull or top of your spine
Common Causes
- Broadly similar to those described above for tight or aching shoulders
Treatments
- Avoidance of the common causes and exercises to promote blood flow to the sub-occipital muscles at the base of the skull
- Analyse your posture to ensure you are sitting as upright as possible (i.e., not sitting forward in a "hunched" position) - if necessary seeking assistance from an occupational health professional or specialist retailer
- Physiotherapy, osteopathic or chiropractic treatment is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Symptom
Neck Stiffness
Common Causes
- Sudden "locking" of the neck due to muscle spasm. This can occur for an infinite variety of reasons such as, lying too long in one position, violently sneezing or making an unusual movement involving the head or neck muscles
- Degeneration in C5 and C6 spinal discs (typically in older patients)
Treatments
- Application of an ice-pack in the acute initial phase can help. Later a heat-pack or hot water bottle should provide relief.
- A GP will frequently prescribe you pain-killers and/or anti-inflammatories such as ibroprofen
- Wearing a soft-collar neck support for a few days to take pressure off the muscles in spasm
- Physiotherapy, osteopathic or chiropractic treatment is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Symptom
Acute immobilising lower back pain
Common Causes
- Can be set-off by almost any bending movement such as picking up a dropped pen, turning to reach something, or the jolt from missing a step
- The root cause is typically an underlying disc instability which is inadvertently triggered by an unexpected event
- Pain and lack of mobility is caused by muscle spasm which are part of your body's defence mechanism
Treatments
- An ice-pack may help at the acute stage
- Anti-inflammatory drugs and pain-killers will probably be prescribed by your GP.
- Once the spasm begins to ease, osteopathic massage and manipulation will typically be very helpful in restoring mobility and reducing pain more quickly than the bed-rest often recommended by GPs
- The exercise programmes your Osteopath, Chiropractor or Physiotherapist recommends are important to ensuring that the underlying instability which caused the problem is addressed and the injury does not recur
Symptom
Sciatica and trapped nerves
Common Causes
- Sciatic nerves run down the spine from the backside, behind the thigh, the lower leg and into the foot and toes. Pressure on the nerve from a bulging disc can cause pain all the way along the nerve pathway or just part of the way along it
- Sciatica can come on gradually or develop suddenly following a particular event
Treatments
- Doctors typically recommend some or all of bed-rest, pain-killer, muscle relaxants and anti-inflammatory drugs. In extreme case surgery may be necessary if the bulging disc does not naturally subside
- The benefits of physiotherapy, osteopathic or chiropractic treatment in promoting the body's self-healing capabilities are particularly useful - especially in encouraging exercise as a means of managing the presence and/or intensity of sciatic pain
Symptom
Pain and stiffness in the shoulder preventing a full range of movement
Common Causes
- Sedentary working environments
- Poor posture maintained for long periods of time. Common examples are driving and operating machinery or computers
- The condition can be caused by tendonitis - i.e., inflammation - of one of the four tendons in the shoulder joint
Treatments
- Physiotherapy, osteopathic or chiropractic treatment is frequently successful with this condition, with techniques often focussing not just on the shoulder, but also on the spine and ribcage.
- Surgery is sometimes required, but not before fully investigating physiotherapy, osteopathic or chiropractic treatment options
Symptom
Whiplash
Common Causes
- A stiff neck (frequently accompanied by a headache) caused by a violent extension of the neck, e.g., in a car accident or falling forward face-first
- Problems often manifest in the neck but can also appear in the upper-back and even in the lumbar spine region
Treatments
- If the condition does not swiftly remedy itself, then physiotherapy, osteopathic or chiropractic treatment is highly appropriate for speeding the body towards recovery
- Untreated, whiplash symptoms can persist for months or years causing chronic pain