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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

 

Sleeping Posture and Lower back pain

How you sleep plays an important role in managing back pain, as certain positions place more strain on the back than others. Generally, back sleeping and supported side sleeping are regarded as most ergonomic, while stomach sleeping tends to be most associated with pain.

Whichever position you prefer, here are some tips for staying comfortable.

good-and-bad-sleeping-positions

 

  • Reclining may be beneficial for your back because it creates an angle between your thighs and trunk. This angle helps to reduce the pressuer on your spine.
  • Disc herniation happens when part of a disc pushes out of its normal space.
    Curling your torso into a fetal position opens the space between vertebrae.
  • Sleep on your side with a pillow between your knees.
    The pillow will keep your hips, pelvis and spine in better allignment.

Alignment is key

Be careful while turning in bed. You can get out of alignment during twisting and turning motions as well. Always move your entire body together, keeping your core tight and pulled in. You may even find it helpful to bring your knees toward your chest as you roll over.

Tips to reduce lower back pain

back-pain

  1. Dont twist your back or make rapid jerking motions
  2. Get in bed by sitting on the edge of the matress. Supporting yourself with your hands, bend your knees and lay on your side. Then adjust your position as needed.
  3. Get out of bed by rolling on your side (facing the edge of the matress) and bend in your knees. Supporting yourself with your hands, carefully swing your legs to the floor and stand up straight. Get up from the seated position.

Special Offer

and-so-to-bed-logo-ejphysio-offerOur friends at And So To Bed are offering a special discount code for Emma James Physio customers which is an additional 10% off all And So To Bed products when purchasing online.

Use online code: ASTB10 at shopping basket. Offer available until 31st December 2020.

 

india-wayland

Bye for now 😉
India
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Blog Post by India
Sports Therapist at Emma James Physio

Exercises you can do at your desk!

Following my post about the benefits of Pilates, heres some useful exercises you can do at your desk!

Note: With all sitting exercises you must be sitting up tall on your sit bones. Keep your core engaged (almost feel like you are pulling your belly button in towards your spine) and shoulders relaxed and down.

desk-exercises-1

Dumb waiter

Sit with your elbows bent at 90 degrees. Keep them tucked into your waist while you open out your forearms and keep your back straight. Keep pressing your shoulders down while you repeatedly open and close your forearms.

Spine twist

Hold your hands on the back of your head. Keep elbows out to the side. Hips facing forward. Inhale through the nose and as you exhale through the mouth twist though the mid-point in your back to one side. Inhale and on exhale come back to center repeat on the other side. Do as many as you want but make sure you keep an even count.

desk-exercises-2

Spine stretch forward

Sitting nice and tall, resting your hands on your lap. Breath in through your nose as you exhale tuck your chin to your chest and start rolling down through from the top of you back, only to half way down your back. Breath in and then on the exhale use your abdominals to pull your torso back up to sitting tall. Rolling through your spine bone by bone.

Lateral/side bend

Sitting up nice and tall, arms by your side as you breath out reach your right arm down one side of your chair with out leaning forward or backwards. Repeat on the other side.

desk-exercises-3

Hip opener/Hip flexors

Cross one leg over the other (ankle on the knee) and bend forward over your legs with a flat back.

Single Leg raises

Sitting nice and tall with feet flat on the floor, extend one leg at a time focusing on activating the quadricep muscles and then slowly lower down. Alternate each leg.

Why not try a Pilates Class?

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Pilates – gain a balanced body and mind

Pilates practice can help you gain a balanced body and mind. … A balanced body is one in which each part of the body works with one another to create and maintain a stable person. A balanced body is one that is mentally, emotionally, and physically stable.
The beauty of Pilates is that anyone, at any age can get started. Through the controlled and progressive movements, you can totally reshape your body.

Improved posture

By strengthening your core and improving your alignment of your spine.
Desk jobs encourage bad posture which can lead to kyphosis (rounding of the upper back) by working on muscular imbalances this can be reversed. Most Pilate moves help with scapula, shoulder and spine stability.

Improve flexibility

flexibilityWith longer hours of sitting we get tight hip flexors and generally stiff. Pilates encourages you to lengthen and expand your muscles.

Strengthen core

All Pilate moves require you to hold your core. Core muscles are not just your abdominals but the deep muscles running from the bottom of your head to your pelvis. They help support the trunk. Having a strong core will help support your back, which will help with pain and injury prevention.

Improve your balance

As you get older your balance becomes worse over time, this can then cause falls and injury. Pilates exercises require a more holistic approach and require activation and coordination of several muscle groups at the same time, which in turn improves your balance reducing the risk of falls.

Mental Health

pilates-classes

In Pilates you are told to regulate your breathing. Breathing is one of Joseph Pilates key principals. Pilates breathing directs your focus inward for the duration of the class, focusing on the present, feeling the muscles work and reconnecting with your body.

Exercising even if low impact helps produce endorphins in the body, which are also known as the happy hormones. It is natural drug to help boost your mood.

 

Pilates Classes

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

Look out for my next pilates post coming soon!
pippaPippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Work related stress & how to manage it

Up to half a million people in the UK experience work-related stress every year, which often results in illness (Health and Safety Executive 2011).

The signs of stress can vary from one individual to the next (NHS Choices 2011). They may manifest physically as an illness, tiredness or lethargy or as symptoms such as sore, tight muscles or erratic sleep patterns. Mental stress can result in depression, mood swings, anger, frustration, confusion, paranoid behaviour, jealousy or withdrawal.
Treatments include medication such as anti-anxiety drugs, cognitive behavioural therapy, relaxation techniques (NHS Choices 2011), acupuncture and floatation therapy.

How acupuncture can help

Stress is a common complaint cited by acupuncture and these individuals present with a variety of symptoms. Can acupuncture help with stress and anxiety? Let’s look at the research…..

One small randomised controlled trial (RCT) suggested that acupuncture might be successful in treating the symptoms of chronic stress (Huang 2011). Another study which looked at healthy individuals subjected to stress testing found acupuncture at an acupuncture point used for stress was more effective than a ‘control’ point (Fassoulaki 2003). A study by Pavao (2011) found acupuncture might be effective in attenuating psychological distress, as well as increasing cellular immunity. acupunctureIn a small pilot study, the use of one particular acupuncture point led to marked reductions in stress (Chan 2002).

Acupuncture is proposed to have many effects, including stimulating the nervous system and causing the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic (state of equilibrium) mechanisms, thus promoting physical and emotional well-being.

Floatation Therapy

In addition to acupuncture, another alternative treatment for stress and anxiety is floatation therapy. During a floatation session you effortlessly float in an Epsom-salt solution. The solution is heated and maintained at skin temperature (37°C) and the environment in the tank is controlled so that the air is also skin temperature.

floatation-therapy
This creates an environment similar to that of the Dead Sea (but nearer to home!) which lets you float effortlessly on the surface of the solution, enjoying a feeling of total  freedom & complete weightlessness!

Preliminary research has shown that floatation therapy may lower stress, anxiety and even depression by reducing how much sensory input the brain and nervous system receive (Feinstein, 2018).

At Emma James we have our own Floatation Tank. Please just call us if you would like any more information on how this, or acupuncture, could help you.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Surgery no more effective than physio for common shoulder condition…

As discussed on Radio 2, Jeremy Vine show, Wednesday last week.

shoulder-painResearchers show that one of the most common surgical procedures in the Western world is probably unnecessary. Keyhole surgeries of the shoulder are useless for patients with ‘shoulder impingement’, the most common diagnosis in patients with shoulder pain.

The Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) compared surgical treatment of shoulder impingement syndrome to placebo surgery. Two years after the procedure the study participants, both those in the group who underwent surgery and the ones in the placebo group, had equally little shoulder pain and were equally satisfied with the overall situation of their shoulder.

“These results show that this type of surgery is not an effective form of treatment for this most common shoulder complaint. With results as crystal clear as this, we expect that this will lead to major changes in contemporary treatment practices,” said the study’s principal investigators chief surgeon Mika Paavola and professor Teppo Järvinen from the Helsinki University Hospital and University of Helsinki.

This research confirms previous randomised studies showing that keyhole decompression surgery of the shoulder does not alleviate the symptoms of patients any better than physiotherapy.

The FIMPACT study involved 189 patients suffering from persistent shoulder pain for at least three months despite receiving conservative treatment, physiotherapy and steroid injections. Patients were randomised to receive one of three different treatment options, subacromial decompression surgery, placebo surgery (diagnostic arthroscopy, which involved arthroscopic examination of the shoulder joint but no therapeutic procedures) or supervised exercise.

Two years after the start of the study, patients were asked about shoulder pain and other symptoms they had experienced, as well as their satisfaction with the treatment and its results. The patients in the decompression or placebo groups were also asked which group they believed they had been in — actual surgery or placebo.

Overall, shoulder pain was substantially improved in all three groups from the start of the trial. However, decompression surgery offered no greater benefit to shoulder pain than placebo surgery.

The group that received exercise therapy also improved over time.

“Based on these results, we should question the current line of treatment according to which patients with shoulder pain attributed to shoulder impingement are treated with decompression surgery, as it seems clear that instead of surgery, the treatment of such patients should hinge on nonoperative means,”

Järvinen states. “By ceasing the procedures which have proven ineffective, we would avoid performing hundreds of thousands useless surgeries every year in the world,”

Järvinen points out. “Fortunately, there seems to be light at the end of the tunnel as the NHS in England just released a statement that they will start restricting funding for ‘unnecessary procedures’ and the list includes subacromial decompression. We applaud this initiative and encourage other countries to follow this lead.”

“We have to spend taxpayers’ money responsibly. If we are spending money on procedures that are not effective, that money is deprived from treatments that are clinically effective and would provide benefits to patients. One component in becoming more efficient is to make sure we are not undertaking unnecessary procedures,” Dr. Taimela concludes.

The FIMPACT research project includes the Helsinki and Tampere University Hospitals in Finland.

lisa

Stay Healthy!
Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Megaboost IV – Vitamin Infusion

IMG_7131A month or so ago I was feeling frazzled.. Rushing about attempting to balance work, kids and home life had left me catching cold after cold, constantly drained, irritable and generally frazzled.

Emma James suggested I try a megaboost vitamin infusion at Champneys. Now, to be honest, the lure of being alone in a room in peace for 45 minutes relaxing on a bed (you can sit if you prefer) for 45 minutes had me signed up! Let alone the benefits of such a vitamin infusion; top restore hydration, replenish vital vitamins and minerals, boost the immune system and deliver a (much needed) energy boost.

The qualified Nurse administering the infusion was lovely and informative and took me through a range of checks, including a health questionnaire and blood pressure measurement. Once I had the all clear, we were all set to go. Inserting the needle into my arm was no more than a sharp scratch- like having blood taken. Then I just relaxed for the time it took for the infusion to be administered and that was it, infusion done.

The benefit of a vitamin infusion over oral vitamins is that the abdomen (where up to 50% of the benefit of the ingested vitamin can be lost) is bypassed so the benefits are greater.

I left Champneys with a spring in my step looking forward to the benefits of the vitamin infusion and signed up for my next one in a few months time. Give it a go!

More information can also be found on our website.

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
Emma James Physio

Fighting the Fear

We all have fear, I have fear daily about many things. The question is do we let our fear paralyse us or do we harness its energy and let it drive us forward.

There are so many reasons to be fearful. Fear of failure, fear of injury, fear of embarrassment, fear of poor decisions. However, nothing changes if nothing changes, often I’m fearful going into new situations or even when I meet a new patient for the first time, what I am asking is what do we do with that fear.

A prime example has been skiing this week with my children. I haven’t skied for ten years as I have been either having IVF, or pregnant or bringing up small children.

I’m heavier than I was, I’m more tired and there was a degree of doubt as to whether I would be able to do the black runs as before. I did however do what I always do and grabbed a metaphorical straw, sucked up the fear and did it anyway.
My daughters on the other hand have no concept of fear and like bullets they shot down the slope tucked in tight, with varying degrees of control.

My best friend on the other hand was also new to skiing and being naturally extremely athletic and strong surely she would take to it like a duck to water?
However this was not the case, her biggest barrier to success was her FEAR, fear of falling, fear of heights, fear of getting it wrong.

We all have our demons and we are all scared everyday, my advice would be f*** it and move on.

You are going to be scared, however the choice is yours, be fearful and do it anyway, or be fearful and allow this sense to paralyse you and halt your progress.
The choice of course is always yours.

I would highly recommend the book below .
Feel the Fear and Do it Anyway (Quick Reads 2017) Paperback – 2 Feb 2017
by Susan Jeffers (Author)

emma-james-2014Emma
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Blog Post by Emma
MD, Owner & Senior Clinical Director
Emma James Physio

 

How to keep your brain young – Just keep moving!

Hiya,

I found this informative article by Celia Dodd about the cognitive benefits of exercise. Researchers at the University of Canberra in Australia found that regular aerobic exercise dramatically improved cognitive abilities such as thinking, reading, learning and reasoning.

Muscle strengthening, meanwhile, had a significant impact on memory and the brain’s ability to plan and organise.

All this is an excellent reason to re-think the exercise you do, with research showing that even those who have done little exercise before the age of 60 can see cognitive benefits almost immediately.

Increasing your walking speed to brisk, carrying the shopping home rather than getting the car out, and digging the garden can make a huge difference.  Consider signing up to a regular exercise class (strength and conditioning, spinning, pilates) to increase the motivation to complete regular exercise and enjoyment exercising in a group.

You can read the full article here:
https://www.dailymail.co.uk/health/article-6178025/How-brain-young-just-moving-says-Celia-Dodd.html

Keen to try something new? check out details of all our Exercise Classes on our Website or you can ring Reception for more information.

lisa

Right… Im off to my Pilates Class! 🙂
Lisa
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Blog Post by Lisa
Senior Physiotherapist
Emma James Physio

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