Quite a few on here said osteopath and I asked a friend who is a nurse who said the same even if it’s just the one appointment to rule things out, my only loss is £50 which if there’s any improvement or even a better understanding I’m happy enough.

find an osteopath that does massage as well – generally those from the British School of Osteopathy don’t unless they have learnt it after but those from the British College of Osteopathic Medicine learn massage in their course.

Having a deep tissue massage first before any ‘adjustment’ means that those stiff muscles are much less likely to pull you back into that bad position, and so you are less likely to have to go back for another dose of adjustment. And it is those stiff mucles that are causing you the pain.

When seeing well regarded osteos that didn’t manipulate I might have to go see them twice or maybe even 3 times, but when seeing Xerxes at http://www.cityclinic.co.uk I rarely go back unless he is treating muscle issues, so sometimes a year or more between visits.

I have one of these rests that might not actually be the best idea as at full adjustment it probably tries to bend you more than is healthy, but I find it good for lower back pain as you are forced to learn to relax those muscles to avoid the intense pain lying on it causes !

get a TENS machine fro your local pharmacy. They work really well for back pain and sometimes the only thing that keeps me moving. Best £20 I’ve spent.

The key thing is that the induced fast muscle spasms stop the major spasming that stops you moving, getting moving gets you better.

you won’t look back

you won’t look back

is that because your back will still be too stiff and painful to look around ?

LOL

I was a cynic, then the back was in a really bad place, thought it’s £20 of risk, works brilliantly

Getting back on the bike? Any advice? Hints tips? Been off work 10 days and missing not being on the bike, was thinking my plus bike or full bouncer round something tame like the dog at Cannock.

Been lucky as in the pain is now manageable, and I know I should return to work before thinking of biking but would rather see if I can bike before getting back to work. So any pointers??

Osteopathy is pure bunkum. Dangerous charlatans with precisely zero evidence of any good and plenty of doing harm.

The relief you got is from the soft tissue work they do prior to manipulation. Stopped the muscles spasming. spinal manipulation does no good and is dangerous.
Evidence based practice. There’s no evidence that osteopathy does any good

What do you call alternative medicine that works? Medicine!

Osteopathy is pure bunkum

tjagains opinions are mostly bunkum as well but that doesn’t stop you making them…

There’s no evidence that osteopathy does any good

It’s recommended as a form of treatment by NICE…

The two sessions I have had helped massively I can get up in the morning with no pain, yes the pain starts as the day goes on but it’s a start.

My aim is to get back on the bike, I’ve got a couple of weeks off work so that’s my time to get fully fit and able to work and bike again, if I can get through the day with no pain then it’s all good!

Turner
It’s a fact that there is zero evidence of osteopathy doing any good and plenty of doing harm

Nice recommended? Link please

Osteopathy is pure bunkum.

Google bmj osteopathy for debunking of this dangerous pseudo medicine

Also on Google you can find the people paralysed by stroke or spinal injury following spinal manipulation

Medical concensus states one thing. It does no good and sometimes harm.

This is not simply my opinion. This is the medical consensus and what the evidence proves beyond any doubt

Chiropractic and osteopathy both have relatively shonky histories, and depending on the practitioner may or may not follow best advice (but then Physio’s can be just as off target too). Chiro and Osteo are probably a bit more manipulation happy then Physio, and are happier to use cervical manipulations (which have been associated with stroke, and vertebral artery dissection). Depending on the practitioner though i think the end product may not vary, but the clinical reasoning process they followed to get to that outcome might be pretty different…

My personal opinion is no two backs are the same, and different people respond to different things and different approaches. In weighing up the evidence pretty much all types of modern intervention bring about similar responses at the population level… whether that be core strengthening / pilates, education, manipulation.

At the moment, we still don’t really know why back pain persists, and why some people get better when others don’t. We are pretty sure in most cases it isn’t down to any mechanical deformation (as there are many, many people with awful looking back scans / x-rays who have no pain and have never had pain), so the mechanical argument has been debunked, and also it seems as though people who have scans and x-rays tend to have a worse prognosis than those that don’t have them. This is why the guidance has changed to only scan when absolutely necessary (potential for serious problems such as spinal cord compression, tumours etc) as the risk outweighs any potential benefit in most cases.

The best current advice is to try not to stress about your back too much. Your backs are very strong and designed to last you more than a lifetime. Things don’t slip out of place very easily (there is a lot of muscle, connective issue and ligaments around the back). In most instances it will get back to normal in 6-12 weeks, and in that recovery period try to work out what works best for you to control your pain levels. For some that may be swimming or yoga, for others it might be a gentle walk or a slow bike ride. Try to keep as active as you can, take painkillers if you need them (but avoid the opiates) or try TENS, try not to sit still for too long, try not to avoid doing simple things for fear of making your back injury worse (obviously within limits, i probably would advice against starting lots of heavy lifting if you weren’t conditioned for it in the first place).

Nice recommended? Link please

from the main NHS page on it (who’d have thought…)

https://www.nhs.uk/conditions/osteopathy/

“The National Institute for Health and Care Excellence (NICE) recommends manual therapy alongside exercise as a treatment option for lower back pain, with or without sciatica.

There’s limited evidence to suggest that osteopathy may be effective for some types of neck, shoulder or lower-limb pain, and recovery after hip or knee operations. ”

note the word ‘little’, that implies they acknowledge that there is some, at the least.

take painkillers if you need them

also somewhat dodgy, my mate had real problems after taking a lot of ibuprofen for a problem (advised by a doctor).

Something to do with his Scottish genes, but he now can’t take any more.

TurnerGuy…

Yeah, long term use of NSAIDs isn’t advocated. But in the short term, acute window (2-4 weeks) if they provide symptomatic relief they are worth considering. Then again, the evidence of their impact on reducing pain compared to placebo is marginal.

Then again, the evidence of their impact on reducing pain compared to placebo is marginal.

and what was the argument against osteopathy again – I know my osteopath has been very effective at reducing pain when I’ve needed him…

Exactly. That’s why i said

‘pretty much all types of modern intervention bring about similar responses at the population level’

and

‘in that recovery period try to work out what works best for you to control your pain levels’

When looking into the evidence there is no magic bullet that cures / heals LBP. Its finding what works for you, what provides best value for money (for individuals and healthcare providers / insurers) and what has the least likelihood of causing harm. As long as your osteo / chiro isn’t old school and doing risky manouvres (such as cervical manips) then in all honesty there probably isn’t a huge difference between approaches. The more important thing is that if you think it will help you, then in all likelihood it will have a better chance of helping than if you don’t think it will help.

Turnrguy anecdotes are not evidence.

That is not a recommendation for spinal manipulation.

The actual evidence is very clear. Zero evidence of any benefits plenty of evidence of harm. Read the research. I have

Sorry TJ, you’re a little off the mark.

Cochrane reviews state SMT is no better than other recommended therapies for acute or chronic LBP. More recent systematic reviews (not cochrane) indicate it may produce modest improvements in pain and function, and that SMT is better than simple mobilisations.

Sorry TJ, you’re a little off the mark.

he’s always a bit off the mark, especially when it comes to Jeremy Corbyn 🙂

How can a scan or X-ray cause damage or give a worse prognosis?
Sorry I don’t understand that.

I would have said that a Chiro is more likely to cause damage because they try to trap you into an endless course of (possibly needless) treatment whereas I have never experienced or heard of an osteo trying to do that.

Highpeak,

The current thinking is that by having an x-ray or CT unnecessarily (i.e. you have no focal pathology that makes it an emergency), and you are shown to have degenerated discs, OA of the spine, degenerative disc disease, reduced joint space etc all of which are actually totally normal and associated with being age over 25 (ish).

These ‘degenerative changes’ are not thought to be associated with pain (see Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015; 36(4):811-6), and it is a current failing in how many people (including clinicians) approach pain that we still use a very old, biomedical model of pain in that we think pain = tissue damage.

This is not the case, and there have been lots of studies to show this. In fact the international association for the study of pain (IASP) definition of pain is ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.’ So it is an experience, i.e. it is produced by the CNS, not simply an output of sensory information, and it is related to actual or potential tissue damage. So pain can be generated without a noxious stimulus (e.g. in CRPS people can have inflammatory responses by thinking about moving their affected hand, not even moving it).

And here is the rub….

If you have a scan following a back injury when you didn’t need it (i.e. you had no serious focal pathology – here we mean things like signs of cancer or cauda equina syndrome). Then your central nervous system has been given information that your back pain is very serious (you were sent for a costly scan) and therefore should be protected. On top of this, you will be reported to about the condition of your back where you will be told a list of things that appear to be wrong with it (disc protrusions, degenerative disc disease, OA etc).This information is likely taken on board by the CNS and makes it more hyper aware of how fragile it appears to be and that it should be protected further. This, in conjunction with what is going on in your life at the time, how you cope with pain, your health beliefs, what your treating clinicians have said to you, your previous experience of pain etc, all come together (we still aren’t 100% sure how), to produce this experience we call pain.

If you didn’t have the scans, you would have had 2 less threatening inputs into the mixing pot, and would have received less ‘diagnostic’ detail (which is likely irrelevant). In our current understanding of pain, that in all probability will reduce your likelihood of experiencing pain that persists beyond its expected course.

phew that was long…..

Hope that makes sense, but that is a basic run down of about 25 years of quite complicated research. If you want to learn more there are TED talks by a bloke called Prof. Lorimer Mosely, (we have done some work with him), he is a great bloke and a very good scientist/ clinician. He can explain it way better than I…

I cannot heap enough praise on Foundation Training for both recovery and strengthening.

I’ve had back issues for the last 20 years leading to two caudal epidurals around 3 years ago.

I’ve spent a fortune on osteopaths, chiropractors, yoga but this has been life changing.

https://www.foundationtraining.com/

A lot of free content on YouTube as well

https://www.youtube.com/watch?v=4BOTvaRaDjI

Yoga has helped me after a particularly bad do a couple of years ago. Once you are back up and running, so to speak, you need to investigate what is causing it.

So my partner is currently dealing an immense amount of back pain. This has been going on since before Christmas – she went to see a doctor who advised rest, after explaining to them that she had tried that & already been in pain for a few weeks he referred her to an osteopath. Her last appointment was last Thursday & still she’s in a huge amount of pain.
She’s following the advice of keeping it moving, & doing lots of walking, however now with walking she is complaining of knee pain.
The osteopath has said she needs a scan so she’s been trying to get an appointment with the doctor. She had a phone call appointment yesterday & was told she would get a letter in 2-3 weeks advising her of when they can get her in for a scan. The best they can do in the mean time is an appointment on Friday to discuss pain management.
She has now had a phone call today saying there are no appointments & to get in touch with a different surgery, she has phoned them & the waiting list is 12 weeks for a scan… So it looks like she might not know what is causing this until May…

Literally at our wit’s end & don’t know what to do about this. Can anyone offer any advice?!

I can only say what the docs have done for me I’m on naproxen and co-codamol, doing lots of short walks, I don’t sit fit more than 30mins which is annoying my other half a fair bit, I got an exercise mat and have done some exercises advised by the osteopath, I’ve had 3 visits to as well and while still in pain it’s getting better day by day.

Andy, the problem is you can’t easily find out what is causing it…. especially if it is persisting (scans are not really the way forward here). There are a number of different theories / popular ideas that change over time (e.g. muscle imbalance, core strength, tightness in any number of muscles, posture), but i don’t think any of them are predictive for causing pain. I think finding a way to manage it that works for you is the best approach, and whether that is addressing tightness, strength, activation etc will work out as you progress treatment.

PrinceJohn – Sorry to hear about your partner. Advising some increase in rest is a good place to start, this should be interspersed frequent movement (as able), so no bed rest. It would also be worth investigating whether there are any things that help ease her pain (any specific body positions, swimming / floating in the water or being in the bath, TENS etc). A visit to a recommended health care professional (e.g. physio) with a lot of MSK experience is worth it, they will provide advice and tips for management and will likely be able to do soft tissue work / mobs / manips to free things up a bit in the short term.

The thing for your partner to keep in mind, is that her back is, in all likelihood, structurally fine (if the GP was worried then your partner would likely have been referred on for scanning very quickly). Your partners central nervous system has gone into a protective mode in response to the initial injury (this is what produces the intense pain she is experiencing). What she needs to do is start to provide herself and her CNS that the injury is healing (it has bee about 6 weeks, so under normal tissue healing timelines some healing would have occurred depending on the type of injury). A way to do this is by slowly increasing movement and being more active (this would be advised and under the supervision of a healthcare professional), thinking more positively about her back and trying not to worry that it will fall apart (it won’t). Over time, the central nervous system will realise that everything is ok that there is little threat of re-injury, and will switch off the alarms! This typically takes up to 3 months so it is in part about being patient, and not trying to worry when it is taking a long time to heal.

A hot water bottle is good for deflecting pain, or even better is one of these :

and make sure your osteopath is one that does lots of massage, plain ‘clickers’ aren’t much cop imo.

Lots of advice, but the real issue is to find out what is causing your symptoms and pain. I suffer from issues L4, L5 and S1, mainly Herniated disc problems. I’ve had the meds, the x-rays and the scans but little practical advice has ever been forthcoming. The Robin McKenzie book is good for a basic understanding and a recovery system, however I have found a Canadian guy Stuart McGill PhD who has spent most of his career studying Spinal issues has written a book called “Back Mechanic” where he explains how to diagnose the causes of your symptoms and pain. He then goes on to explain the steps you can take to help yourself, the areas to avoid and movements not to make. Having studied the book I had a clearer understanding of my issues and what to do to help the situation. I learnt that some of my Pilates/Yoga exercises are counterproductive. The book is expensive £29, but less than a visit to a Chiro or Osteo practitioner. Here is a link to the cheapest supplier I have found.

plain ‘clickers’ aren’t much cop imo.

I take that back somewhat – in an earlier job my colleague insisted on wearing cheap suits and they looked cheap.

He had some back issues and I recommended a local osteo, and when he came back his suits looked much better as he was now standing stright whereas before he had been locked into a position where his hips weren’t level.

At another job a colleague’s bother was an osteopath with a client who did dressage, but never was in the medals. After he had straightened her up she won silver, because the horse now didn’t think that she constantly wanted to turn to the left…

The cold yesterday and today hasn’t helped, I thought I was on the road to recovery but familiar aches and pains cane flooding back….