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Top 10 lower back pain Myths!

Lower back pain and the unhelpful beliefs that could negatively impact your behaviours

 

Most of us will have inevitably suffered from some form of lower back pain in our lives, to varying degrees of severity and volumes; but it’s almost certain to have affected us somewhere along the way! That opening statement in its itself is a perfect example of how beliefs and experiences around back pain can negatively impact our behaviours, fortunately I am going to now expand on it and point you in the direction of some fantastic editorial research that has recently been published for the benefit of the general public.

back-painLower back pain (LBP) is the leading cause of disability worldwide, but the way we as health care professionals and you as patients understand the pathology may differ. In an ever-progressing world of research; there are even gaps of knowledge within sub-groups of practitioners that negatively impact the way LBP is perceived and treated. We hear about it through all media channels and we have an understanding of the ways pain management is prescribed and how we are instructed as patients to manage LBP. Common beliefs and understanding on these factors can influence the way individuals perceive and understand LBP and ultimately the affect it can have on the way you live your life.

In this blog I will review the aforementioned article and address the fact’s from my own point of view and experience;

Ten unhelpful LBP beliefs;

Unhelpful LBP beliefs are common, culturally endorsed and not supported by evidence.

Myth 1:  LBP is usually a serious medical condition

You can feel debilitated or in an amount of pain that indicates a serious pathology; but the facts are the vast majority of LBP cases are not life-threatening pathologies that cause permanent disability.

Myth 2: LBP will become persistent and deteriorate in later life

There is no strong research to support an association with age and deterioration in LBP; age is not a risk factor – we are all subject to the same level of risk; of which there are very well supported methods of managing LBP.

Myth 3: Persistent LBP is always related to tissue damage

Having a reoccurrence of the same type of LBP doesn’t mean the same structures are being damaged to an increasing degree each time – it may feel that way because the pain can get worse but the soft tissue structure that are involved in LBP will heal within a normal time frame. There are a multitude or internal and external factors that relate to pain replication which can be managed and overcome.

Myth 4: Scans are always needed to detect the cause of LBP.

Scans are unlikely to tell us anything different to what we already know. There can be the same scan presentation in a person with and without LBP; again, it’s the multi-faceted level of factors contributing to our pain which are more important than scan results.

Myth 5: Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity

There are really clear and accurate ways to monitor painful responses during exercise; most of the time – pain is acceptable during exercise/rehab and is more likely to be beneficial than harmful. Increasing your exposure to painful movement/tasks is one of the more effective way to reduce your sensitivity to these painful triggers.

sitting-at-desk-pain

Myth 6: LBP is caused by poor posture when sitting, standing and lifting

A really common one; posture does not cause pain, plain and simple. Stress, anxiety, sleep deprivation, periods of persistent working/inactivity are more likely to be the cause of posture related pain rather than the position its self. Get up, move, meditate, talk to your peers and share experiences; it will make a difference.

Myth 7: LBP is caused by weak ‘core’ muscles and and having a strong core protects against future LBP

Our ‘core muscles’ control spinal movement; so, it makes sense that weakness increases our injury risk, right? Wrong. Varying the degree and quality of movement in our lower back; along with the able to transfer weight through our trunk gives us more dynamic movements; but weak muscles do not cause pain.

heavy-lifting

Myth 8: Repeated spinal loading results in ‘wear and tear’ and tissue damage

Heavy lifting and forward bending do not wear out the spinal discs, it actually lubricates them and some studies have found evidence to support increasing strength of discs with increased loads, just make sure these movements are familiar and build them up.

Myth 9: Pain flare-ups are a sign of tissue damage and require rest

Similar to Myth 5; there are a number of factors that can cause pain replication, sensitivity related to previous movements, tasks, scenarios and intrinsic factors are most likely to be the causes of pain; and your practitioner should talk you through understanding this and how to manage it before you refer back for re-assessment (if needed at all).

Myth 10: Treatments such as strong medications, injections and surgery are effective, and necessary, to treat LBP

These interventions are invasion, have varying success rates, complication risks and secondary symptoms; the long-term benefits are not guaranteed. Of course, there are pathologies and examples where these treatments are more likely to be necessary; but for the majority of LBP patients; they just aren’t needed.

 

adamSo that’s it, also check out this useful infographic about Back Facts
Keep your eyes peeled for more on this subject!
Adam 😊

Blog post by Adam
Senior Physiotherapist at Emma James Physio

 

Treat your Pelvic Floor to more!

Pelvipower_bio-feedback_training_EJPhysioThere is a new Swiss technology-driven treatment for increasingly common issues such as incontinence, pelvic girdle pain, sexual health/dysfunction, and back pain.

The treatment (called PelviPower) is conducted in the form of a customised therapy chair, where specific impulses (Magnetic Field Therapy, PFT) and high-accuracy sensors (Biofeedback Training, BFT) can target an individual’s particular issues whilst producing results that are measurable and can be replicated.

Conventional Approach

Until very recently, both clinicians and patients have been limited to abstract descriptions and poorly located/defined areas of symptoms, relying heavily on vague and subjective instructions to address various pelvic girdle complications; while most of these issues are often sensitive topics to discuss, and the physical assessment itself being quite intimidating as well. Understandably this has led to a general reluctance for both men and women discuss/seek treatment for their pelvic issues. The PelviPower system addresses these obstacles by providing precise real-time data to the clinician without any invasive procedures, and it also gives the patient a much better information and direction throughout the treatment process.

Incontinence

At least 30% of woman experience some degree of urinary leakage in their lifetime especially during and after pregnancy and soon after menopause as oestrogen levels decline. 1 in 4 women will avoid activities such as sports, going to the gym or daily social activities as a result. There is common misunderstanding that it is a normal or inevitable consequence of childbirth or ageing, when in fact it is an issue that needs to be addressed. Common forms of Incontinence include:

  • Stress incontinence: This is urinary leakage due to weakened pelvic floor muscles and tissues. It generally occurs when pressure on your bladder increases — such as when you exercise, laugh, sneeze, or cough.
  • Urge incontinence: You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
  • Bowel Incontinence: Bowel (or faecal) incontinence is the inability to control bowel movements. Severity can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control. Some people have recurring or chronic faecal incontinence.

Mens Health

A healthy pelvic floor muscle(s) can prevent incontinence, erectile dysfunction/premature ejaculation, complex pelvic girdle pain, and lower the incidence of back pain. Amongst men who require a prostatectomy, it is also imperative to optimise the pelvic floor muscle before and after the surgery to prevent these unwanted leakage and/or incontinence.

PelviPower Treatment

Pelvipower_magnetic_field_training_EJPhysioThe PelviPower treatment chair is currently utilised globally, and receiving excellent feedback from expert pelvic floor clinicians in leading-research areas such as Ireland, Australia, and New Zealand.

Your clinician will conduct a thorough non-invasive examination with you, noting the subjective history, symptoms, and your particular goals/expectations from the treatment. You will then be asked to sit in the PelviPower chair so that your pelvic floor contractions can be assessed, and your clinician being provided with specific data about your contraction patterns. From there the clinician will be able to tailor an individualised treatment plan for your needs, which would typically involve 2-5 sessions per week of no more than 20 minutes in the chair per chair (depending on your situation). The entire process is conducted whilst fully-clothed, and is complete non-invasive.

My Conclusion

  • Convention/past diagnosis and treatment of pelvic floor issues can be inaccurate, lacing specific focus
  • Can be a daunting and embarrassing process for the patient
  • A lack of awareness and support
  • PelviPower is non-invasive, relatively easy to use
  • The treatment is measured and can be replicated
  • Noticeable improvement within a short space of time
  • Guided by a trained clinician throughout the entire process

Exciting News!

You will have the opportunity to try PelviPower for yourself as this service will be available at our Hemel Hempstead practice from December 2019.

For more information please visit our PelviPower page, visit the PelviPower website or contact us for more information and how to book.

kelvin

Kelvin
x

Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

 

Stability and posture of the upper back

It is important to have a good stability and posture of the upper back. No matter if you are a runner, swimmer, cyclist or use the gym it is key to incorporate these exercises into your daily routine. If you have a weakness in your upper body, you will learn to compensate through unwanted stress of the lower back, shoulders, hips and knees.

These easy exercises will enhance:

  • Shoulder stability
  • Rotator cuff strength
  • Increase scapular (upper back strength)

back-postureThe scapular area consists of:

Shoulder blades, rhomboids, rotator cuff, middle trapezius, posterior deltoid and subscapularis, These are all stabilizing muscles of the upper back.

Lacking strength in these stabilizing muscles will cause our posture to suffer and will result in stress and pain in other areas.

 

Exercises:

Prone Y over stability ball
Keep thumbs pointed upward and gently bring arms to parallel to the floor. Slowly and controlled.

Prone T over stability ball
Focus on initiating the movement with the muscles between the shoulder blades versus the shoulder being driven forward.

Prone W over stability ball
Squeeze shoulder blades as close together and downwards as you can. Hold this position for 5-10 seconds and then relax.

kerry-gym-managerLook after those backs buddies!
Kerry
x

Blog Post by Kerry
Group Gym Manager & Personal Trainer
Emma James Physio

Back Pain – signs, symptoms & treatments

Back pain is a very common musculoskeletal complaint affecting 80% of adults at some point in their lifetime, although the symptoms and severity will vary greatly. Many factors may contribute to your condition including injury and diseases, but for some cases there is no specific cause and clinicians refer to this type of pain as ‘non-specific’ or ‘mechanical low back pain’.

There are some signs and symptoms that must not be ignored. You should always seek urgent medical advice if you have back pain and:

  • A loss of control of your bladder or bowel
  • Numbness around your genitals, buttocks or surrounding area
  • Chest pain
  • Unexplained weight loss

How can I lower my risk of developing back pain?

  • Carrying extra weight, especially around your belly, puts added stress on the muscles in the lower back and can affect your posture and position of your pelvis; in turn leading to lower back pain

    back-pain

  • Weak muscles and abdominals are unable to support your posture and trunk when you move, which can lead to overloading the small muscles in the back which are not designed to do this job and lead to injury
  • Your occupation could also affect your back. Those with manual jobs are at risk due to heavy lifting and repetitive bending, whilst those with sedentary jobs are at risk due to the amount of time they sit, particularly if they tend to slouch

 

How can I treat my back pain?

Try to keep mobile
It may be tempting to remain on bed rest until the pain subsides however evidence suggests that remaining mobile may actually help reduce the intensity and duration of your back pain as well as prevent it from returning. Start off with low impact exercise first such as walking or swimming

Take pain relief
People often worry that taking painkillers will make the symptoms worse by masking the pain, however by taking painkillers while you are in pain it will allow usually you to continue with your daily routine which in turn will often speed up your recovery

Try Physiotherapy
A physiotherapist can help identify the root cause of your back pain and use a variety of techniques including massage, acupuncture and home exercises to reduce your pain and prevent it recurring

Pilates
There is lots of evidence to support the idea that a weakened core puts pressure on the little muscles and supporting structures in the lower back. Therefore by strengthening the muscles which support our trunk and core, it will minimise your risk of developing back pain as well as help to ease the pain if you are already suffering.

Useful Info:

Dont suffer in silence, contact our friendly team to see how we can help you.
Main Clinic: 01442 870686  reception@ejphysio.co.uk

Blog Post by Jade
Emma James Physio

Ralf – My Apos Story

I have been an amateur runner throughout my life. However I hadn’t actually participated in races up to about 5 years ago. Approaching my 70th birthday also saw me running 10 km and even a semi-marathon in 2017.

In November 2017, training for my first dash of a full marathon I experienced terrible pain on my left knee. It did not come about suddenly but gradually grew over a few days. I stopped running since I was unable to make even a few hundred meters without feeling atrocious stabbings on my lower leg. Even walking became horribly difficult.
Not only my running life seems to have ended but daily chores involving my legs would preoccupy my thoughts for years to come.

The conclusion was evident: left knee arthritis. ‘’You have to alter your whole lifestyle. If you feel that this state affects only a quarter of your daily activity you are not ready for knee surgery. However a few more years of lowered energy and you definitely need one’’.

I was against surgery as I had heard of many cases of unsuccessful results. In May 2018, my sister, who is also a runner but definitely better than me, advised me to look into AposTherapy. She had witnessed the positive results in many of her friends who came back to run after years of forced inactivity.

The therapy started in May and went throughout the summer months, growing from 30 to 60 minutes a day. Some days when I did not find time to walk, I just put the computer on a high table and wrote standing.

In October my first baby runs took place: Only half kilometer or so. I was rejoiced by the fact that the pounding reduced although it came back after some distance. I continued every day with the therapy, even going out to the supermarket with my Apos shoes.
In November my weekly runs were up to 6 km although excruciatingly slow, taking me 1 hour when during that period previously I would have run a full 10 km.
My clearest objective for a nice start to the New Year was a Parkrun. These 5 km courses on Saturdays in parks all around Britain are great introductions for people of any age, who want to change their lifestyles by short runs.
I consistently delayed my first parkrun since even the slowest runner will finish in 45 minutes (9 minutes/km) and I was not sure the volunteers will wait for me, at about 50 – 55 minutes.

Therefore I was astounded when my first Parkrun was completed in 35 minutes. The 400 participants had probably created a magnetic field that just carried me to the end.
This was the most worthwhile gift for the New Year. I could run, respectfully. Of course there still was slight pain afterwards but the progress was evident.

It was nothing short of miraculous for me. I have to admit that Apos was not alone in this marvel. The open sea swims in summer and weekly strength exercises in my local gym were evidently helpful in reinforcing body and legs.

However first award goes to Apos. I am thoroughly happy and naturally reflect it on family and friends.

Blog post by Ralf
Apos Therapy customer

20170525-img_0583

4 facts to look after your back!

In aid of Back Awareness week here’s 4 facts to help you look after your back!

 

1. Your back is stronger than you may think

Most people all over the world will experience back pain during their life. It can be disabling and worrying but it is very common and rarely dangerous.
The spine is a strong, stable structure and not easily damaged so in most instances it is a simple sprain or strain. In these cases, 98 per cent, (according to research data) people recover reasonably quickly. Let your physio guide your recovery.

You rarely need a scan and it can do more harm than good. This is because seeing perfectly normal changes to their spine can cause people to avoid the activities they should be doing to get better, such as exercise and movement in general.

2. You should not fear bending or lifting

Bending and lifting are often portrayed as causes of back pain and while an injury can occur if something is picked up in an awkward or unaccustomed way, it’s most likely to just be a sprain or strain. The important thing is to practice and get your body used to carrying different loads and weights in a way we find comfortable and efficient.

Exercise and activity reduce and prevent back pain.

Exercise is shown to be very helpful for tackling back pain and is also the most effective strategy to prevent future episodes.

3. Painkillers will not speed up your recovery

There is no strong evidence on the benefits of painkillers and they do not speed up recovery.

They should only be used in conjunction with other measures, such as exercise, and even then just as a short-term option as they can bring side effects.

Exercise, guided by a qualified professional, is safer and cheaper, is considered the preferred option.

4. Surgery is rarely needed

On average, the results for back surgery are no better in the medium and long term than non-surgical interventions, such as exercise.

So a non-surgical option, which includes exercise and activity, should always come first.
Physiotherapists provide expert advice, guidance and treatment for back pain.

This is to help reduce your chances of future episodes, while improving your overall health and wellbeing.

Check out these links for more info:

 

Back Pain

Back Pain

back-painBack pain is a very common musculoskeletal complaint affecting 80% of adults at some point in their lifetime, although the symptoms and severity will vary greatly. Many factors may contribute to your condition including injury and diseases, but for some cases there is no specific cause and clinicians refer to this type of pain as ‘non-specific’ or ‘mechanical low back pain’.
There are some signs and symptoms that must not be ignored. You should always seek urgent medical advice if you have back pain and:

  • A loss of control of your bladder or bowel
  • Numbness around your genitals, buttocks or surrounding area
  • Chest pain
  • Unexplained weight loss

 

How can I lower my risk of developing back pain?

  • Carrying extra weight, especially around your belly, puts added stress on the muscles in the lower back and can affect your posture and position of your pelvis; in turn leading to lower back pain
  • Weak muscles and abdominals are unable to support your posture and trunk when you move, which can lead to overloading the small muscles in the back which are not designed to do this job and lead to injury
  • Your occupation could also affect your back. Those with manual jobs are at risk due to heavy lifting and repetitive bending, whilst those with sedentary jobs are at risk due to the amount of time they sit, particularly if they tend to slouch

 

How can I treat my back pain?

Try to keep mobile. It may be tempting to remain on bed rest until the pain subsides however evidence suggests that remaining mobile may actually help reduce the intensity and duration of your back pain as well as prevent it from returning. Start off with low impact exercise first such as walking or swimming

Take pain relief. People often worry that taking painkillers will make the symptoms worse by masking the pain, however by taking painkillers while you are in pain it will allow usually you to continue with your daily routine which in turn will often speed up your recovery

Try physiotherapy. A physiotherapist can help identify the root cause of your back pain and use a variety of techniques including massage, acupuncture and home exercises to reduce your pain and prevent it recurring

Pilates. There is lots of evidence to support the idea that a weakened core puts pressure on the little muscles and supporting structures in the lower back. Therefore by strengthening the muscles which support our trunk and core, it will minimise your risk of developing back pain as well as help to ease the pain if you are already suffering.

 

What is Pilates?
pilatesPilates is a low impact form of exercise aimed at strengthening the whole body, especially the core. Whether a beginner or an elite athlete and regardless of age and gender, Pilates could be beneficial for you. Practioners argue there is a wide array of benefits to practicing Pilates including improving muscles strength, balance, joint mobility and even stress relief.
Here at Emma James Physio, we offer a range of different classes including Clinical Pilates which are led by highly qualified instructors. View our Pilates timetable here >>>

Where can I go for help?

If you have back pain and would like to see how we can help, please call us 01442 870686 or visit our website www.ejphysio.co.uk

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