So, for 3 years now I have a neck issue - muscles tighten and sieze with pain after 3hrs, head can't turn to the left after 4-6hrs as a worst case scenario. The post race relief is stretching and Ibruprofen for 3 days or some but it never really goes away. I do have a poor posture due to upper and lower back breaks in my younger years.
For the first 18months I had physio which was a combo of dry needling and shockwave. After it didn't provide a cure I went to an Osteopath as an alternative and now regularly get cracked, massaged an manipulated - 1 year in and again not cured.
Now, It does fade away in winter so is definitely "on the bike" related. I've made adjustments / bike fit etc to help.
But other than being off the bike for an extended period of time, my question is - is one of the above better than the other?
Any other suggestions as this is obviously costly and a major distraction to training and racing?
Physio - Osteopathy is pure bunkum with a zero evidence base for cure and plenty of evidence of harm
Sounds like your physio was not much better!
Physio. Maybe a sports specialist physio though?
Sports specialist physio, and one that knows backs.
Where are you based ?
North London Fossy. I had been using Varney physio who have a good rep. I only moved because of the ever lasting treatment, yet actually the Osteo is no different in that respect - I obviously have an issue that won't be cure until I stop cycling for a while - which I'm reluctant to do.
There are good and bad physios, chiros and osteos. Aims and methods will have a lot of overlap. I had an amazing experience with an osteo who sorted a recurrent neck freeze/spasm in a single visit. I've had subsequent experiences which have been underwhelming. I've had useful and less useful physios.
Doesn't matter how they got to their field, some of this lot^ care a lot and have a huge level of interest in the body, in you, your injury, and bring a huge amount of experience and insight to each appointment. Others less so. I'd ask for personal recommendations form people local to you (ideally cyclists) who've had good experiences recovering from with similar problems, and be open minded about what they call themselves.
There is no such thing as a good osteopath. It has zero evidence base and causes a lot of harm. Pure charletans
Kryton, be open minded. Not like TJ. Go on recommendations. If someone's good, they're good. If they're a charlatan, they're a charlatan, if they cause harm, they cause harm. Try and get one from the first group.
Ned
evidence based practice! I have had osteopathy and plenty of other alternative treatments in the past so I am not closed mind. However I looked into the evidence base - you know the science adn the proof - and there is ZERO evidence that osteopathy does any good and plenty of evidence of harm.
I am trying to save the OP from wasting his money on bunkum that is proven not to work and that is proven to do harm.
No osteopath can do any good. they are all charletans
I had a bad back years ago.
NHS physio was useless, totally uninterested in helping.
I paid up for an osteopath. He fixed the acute issues, allowing me to go on and do Pilates to help fix things long term.
But hey, that's just anecdotal. He must have been a charlatan who got lucky.🙄
Another one with a lucky osteopath!
I've used both physios and an osteopath. The osteopath effectively used the same methods to ease the problems I've had in my lower back and neck as the physio did. I've tended to use him as it's easier to get an appointment, and cheaper.
A physio may be better able to advise on preventative methods to stop a recurrence.
Bedmaker - actually what happened is your back got better anyway - the osteopathy was nothing to do with it. Read the evidence base. there is no evidence of any reduction in pain or total legth of time that the pain occurs compared with not having osteopathy - What yo have there is confirmation bias
Go on - find a single proper study that shows any efficiency for osteopathy - the plural of ancedote is not evidence
Ok, seems I got it wrong.
If you were a bit further north I could recomend my Chiropractor.
However, what does your orthopaedic consultant say about it?
My physio when I broke my back treated Rugby players - she knew her stuff. I do know a very good physio/clinical director who has a tonne of research into back issues, but he is Manchester based.
Finding a good physio on recommendations.
I had recurrent neck spasms over several years which got more and more frequent, longer lasting, more painful and more debilitating. I saw a range of people, GPs at different practices, sports massage theraprists, physios, none of whom were able to help much, and the spasms continued.
I went to see an osteopath, having never seen one before and knowing next to nothing about osteopathy, who examined me, explained what he saw as the problem, treated me with subtle manipulation (not cracking - he said it's a bit of blunt instrument and he prefers to avoid it), and gave me exercises to continue with.
Due to confirmation bias, and not his knowledge and skill, or the exercises he gave me to do, I've not had a recurrence of the problem.
Anecdote is not evidence - the exercise might well have helped - the manipulation does not help at all and indeed can cause damage. But sure - your anecdote trumps loads of proper studies!
what is osteopathy, tj?
A good osteopath doesn't just 'crack bones', they often know as much about musclature as a physio, but also have 4 years training on manipulation whereas a physio that does manipulation will have an awful lot less training in it.
If you are near London the best osteopath I have been to is Xerxes at cityclinic.co.uk, I don't normally see him very often though.
He's something like £90 an hour (it is London) but his massage makes it worth it.
My ex-wife was getting migrainous headaches and he found the muscle causing it, so stopping them. A mate had issues with running and one leg/side having a lot less power than the other, he found that one as well.
I'll punt you half the fee if you are not happy... (just to spite TJ...)
All of these are probably a collection of anecdotes, but here's a summary anyway.
I'm not banging the drum for Ostepathy by the way, just objecting to TJ's black and white-ism.
I wouldn't see anyone that's going to mess with me, mess with the parts of my body that are giving me grief already without a solid collection of anecdotes from people who've coincidentally got better spontaneously after having been seen by them.
I may do that Turney Guy - worth the mention for the free Upper Back exercise sheet, but I can get to Moorgate easily.
Thats supposed to be evidence for it working Ned? from your link!
The authors concluded that “SMT is no more effective for acute low back pain than inert interventions, sham SMT or as adjunct therapy. SMT also seems to be no better than other recommended therapies.
You know what they call alternative medicine that works? Medicine!
Fossy who do you recommend in Manchester? I've a trapped nerve in my back (shoulder blade), I went to a physio last week who said I've a disc pressing against a nerve. My back feels better now (its not right though), but now my right arm aches, feel numb or I get bad pins & needles in my hand. Went to the GP who was no use. I'm not sure who I should be going to see and don't want to wasting money getting the wrong treatment.
Conclusions Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.
The searches identified 32 case reports, four case series, two prospective series, three case-control studies and three surveys. In case reports or case series, more than 200 patients were suspected to have been seriously harmed. The most common serious adverse effects were due to vertebral artery dissections. The two prospective reports suggested that relatively mild adverse effects occur in 30% to 61% of all patients. The case-control studies suggested a causal relationship between spinal manipulation and the adverse effect. The survey data indicated that even serious adverse effects are rarely reported in the medical literature.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905885/
Yes some osteopaths may use techniquies taken from other professions such as physio that may do some good but the spinal manipulatiion simply is proven not to do any good and is proven to do a lot of harm
As I said it's not just bone manipulation with a good osteopath - most pain is from muscles that are often in spasm for some reason.
Often the osteo can relieve the cause by manipulation as well as massage the muscles into relief.
Two more anecdotes.
A colleague at work had a brother that was an osteopath. A patient came to him who did horse dressage as a hobby, but had never been in the medals at competitions.
He manipulated her and she won bronze at the next competion as the horse did not now think she was indicating to turn to the left all the time as her hips were straight.
Another colleague at work always wore cheap suits that looked pretty iffy.
He went to the local osteo because of some pain and came back at the end of the lunch hour with his suit looking strangely much better - basicaly because he was standing straight now.
give over. Your choosing to quote that sentence alone from the document is enough evidence for me to conclude you're trolling or at the very least, not willing to engage intellectually with the subject.
But just in case: did you even read the link you posted? Only 5 of the 47 trials the study looks at involved osteopathic practitioners. I'd be interested to know which parts of that page you think should persuade me away from using a good/(lucky) osteopath.
Kryton: I sent you a PM.
Edit: posts crossed. excuse me.
Because I understand the evidence! Read the stuff about the harm. Spinal manipulation is dangerous bunkum. thats the truth. Yes an osteopath may use physio techniques as well that can do some good - but you would be better going to a physio for that
Evidence based practice. Thats the key. The evidence on spinal manipulation is clear. dangerous and does no good. Ok osteopaths are not as bad as chiropractors.
Did you read the links about the damage?
Still - waste your money and risk your health if you want.
Because I understand the evidence!!
Respectfully, I'm not sure you do.
Practitioners — In 16 studies treatment was delivered by a chiropractor,28293440414445465153545566676970 in 14 by a manual or physical therapist,2730333639434748505758596364 in six by a medical manipulator or orthomanual therapist,313552566068 in five by an osteopath,3238496572 in two by a bonesetter,4271 in one by a naprapath,61 and in one by several different disciplines.73 In another study, it was unclear what type of SMT treatment was delivered or the level or skill of the treating clinicians.37 In virtually all studies, experienced clinicians or therapists delivered the treatment, with the exception of one study where treatment was delivered by a few predoctoral osteopathic fellows.49
You're dismissing as "charlatans" a group of practitioners for one set of techniques they use for treatments of one set of problems, which is the same set of techniques that is used by most other practitioners working on these problems, including your recommended lot (and 14 lots of them in this study, v. 5 osteos.
And that set of techniques:
produces similar effects to recommended therapies for chronic low back pain but results in clinically better effects for short term improvement in function compared with non-recommended therapies, sham therapy, or when added as an adjuvant therapy. Clinicians should inform their patients of the potential risks of adverse events associated with SMT.
That is the conclusion of the metastudy you linked to.
My osteo used to be a doc. She's worked wonders on an imbalance I've got in my lower back that was causing me leg pain. I have nothing more to add.
So it seems like good osteos employ techniques used by Physios and Doctors, and leave the actual osteo stuff out of it. If that's the case I'd just use a good sports physio.
"actual osteo stuff"
What's that, then?
Spinal Manipulation, the stuff that TJ has been talking about.
don't know why people think that's the be all and end all of osteopathy, or even that it's central to what they do. Maybe they're thinking of chiropracty (-ice/-ism/-ology?)
My dad and my sister used an osteopath who sorted long term back issues which going the NHS GP route had not helped with. Just lucky I guess.
There is no such thing as a good osteopath
I thought it was Chiropractors who were the real snake oil salesmen?
I've had very good responses with a couple of osteopaths on my hips.
I’ve had very good responses with a couple of osteopaths on my hips.
jeez, sometimes Xerxes struggles to get a click out of my hips but he hasn't ever had to call a colleague in to help him apply pressure !
Osteopaths are not as dangerous as chiropractors by and large that is true. However osteopathy does zero good - proven! ( apart from what they do with physio techniques and massage both of which you would be better going to someone who is actually qualified to do) Dangers still remain with osteopathy
Read the data, follow the evidence,
I too thought it was Chiropractors that were the charlatans? Still, there's no way I'd argue with TJ what with him being an expert in absolutely everything.
who is actually qualified to do)
I wonder what they spend 4 years studying then ?
Bullshit - thats what the 4 years is. They are NOT qualified physios, they are NOT qualified massage therapists. Have you ever read up on the principles behind it - its total bullshine
Here is a report of an osteopath causing a stoke. The OP has neck issues. Spinal manipulation of the neck is a direct cause of life threaten and limiting stroke. This is why I say these things so strongly - the best outcome for the OP is he has wasted his money, the worst is he is severely disabled
https://www.gerardmaloufpartners.com.au/Publication-1681-Negligent-treatment-by-osteopath-causing-stroke-results-in--24450-2c000-compensation-settlement-at-mediation.aspx
tj speaks the truth*
Any good that osteopaths and chiropractors do is probably a happy accident, achieved while ignoring the ill-conceived unscientific pish that gave birth to their beliefs and practices.
*on this subject 🙂