Leyton Osteopaths Osteopathy Clinic in Leyton, East London

Causes of Back Pain

Elements of our home, work and social lives can cause, contribute to or aggravate back problems. We need to identify the 'aggravating factors'.

It is important to study the nuances of your aggravating factors. For example, if your housework is the problem try to establish which specific aspects of the housework are doing it. Don't simply say your work is the problem - figure out if it's being on your feet too long, the lifting that you are doing, or maybe even the journey to and from work that's aggravating your back.

The duration and intensity of activities that may be contributing to your back pain need to be considered.

Not all aggravating factor are physical. Beliefs and social environment can contribute.

Prolonged time off work hinders recovery in most instances.

Failure to manage causative, aggravating and maintaining factors is one reason why back problems can be slow to recover or return.

Understanding Pain & Injury

There are two broad types of back injury: sudden and cumulative. Even if the onset of pain is sudden, the injury may have been developing cumulatively, beneath our awareness, for some time.

Pain is a bodily system like the respiratory system or the cardiovascular system. Its function is to warn of us harm or potential harm. Like the other systems, the pain system can develop dysfunction.

Pain and tissue damage are not the same. Many factors other than tissue damage affect our experience of pain, especially if we've been in pain a long time.

Prolonged exposure to pain decreases our pain threshold.

Relaxation Exercise

Focussing on your breathing and working to relax your muscles can be a great way to supplement your rehabilitation from injury. Try this little exercise as a starting point.

Lie on your back, close your mouth and breathe gently into and then out of your nose. Put your right hand on your chest and the left on your stomach. As you breathe in, your stomach should push out slightly so your left hand rises. Your right hand should be perfectly still. Do not take large, deep breaths. Keep the breath gentle and small, but make sure it's coming all the way down to your stomach.

Once you are breathing correctly, starting with your feet, tense the muscles in them for three seconds by clenching your toes and then relax them. Repeat this once more. Exhale gently through the nose as you relax the muscles.

Now do this with your calf muscles by pointing your feet downwards for three seconds and then relax them. As before, repeat once more. Your focus should be on the relaxation element of the task.

Contract the muscles in the back of your thighs by pushing your heels into the floor. Hold for three seconds, relax and repeat.

Move next to the front of your thighs and contract your quadriceps by beginning to tense your muscles as if you’re going to lift your leg off the ground (without actually doing so). Contract for three seconds and relax.

Clench your buttocks for three seconds. Relax them. Repeat.

Contract your abdominal muscles by preparing to do an abdominal crunch but don’t actually move. Contract for three seconds. Relax. Repeat.

Next move to the hands. Clench your fists for three seconds, relax them and repeat.

Contract the muscles in the front of your arms by bending your elbows. Hold for three seconds. Relax. Repeat.

Contract the muscles in the back of your arms by straightening them. Hold for three seconds. Relax. Repeat. Remember your emphasis here should be on the relaxation.

Now shrug your shoulders up towards your ears. Hold for three seconds. Relax. Repeat.

Next we’re going to relax the muscles of the jaw. Gently clench your teeth for three seconds. Relax them by opening your mouth nice and wide. Repeat.

Tense the muscles in the back of your neck by pushing your head backwards into the ground/pillow. Hold for three seconds. Relax. Repeat.

For the upper back pull your shoulder blades back and together. Hold for three seconds. Relax. Repeat.

Finally for your lower back tense the muscles by initiating the movement of arching your back. When you feel the muscles contract, hold for three seconds. Relax. Repeat.

With this exercise you’re teaching the muscles to turn on and then, crucially, turn off again. This helps to avoid the muscles being stuck in a tensed position without you even noticing it. You may have experienced suddenly realising you’re holding your shoulders up, because of the tension in the muscles there.

The Diaphragm
We obviously don’t actually breathe into our stomachs. Our primary muscle of breathing is a large dome shaped muscle called the diaphragm. The diaphragm separates our thoracic and abdominal cavities. When we breathe correctly, the diaphragm contracts and pushes downwards, pushing on the organs in our abdomen and forcing the belly outwards. If your stomach moves in when you inhale then you’re not breathing correctly.

Rest & Digest for Recovery

You’ve probably heard of the fight or flight response - in response to a threat or a perceived threat a physiological change occurs in the body.

Adrenaline and cortisol hormones are released which have wide ranging effects.

The heart and lungs speed up
Digestion slows or stops
Pupils dilate
Increased muscle tension to provide the body with extra speed and strength
Increased blood pressure, heart rate, blood sugars and fats in order to supply the body with extra energy

These changes evolved to occur to give the body a burst of strength and energy to quickly escape or fight for survival.

However, modern life creates situations that, although not life threatening, can be stressful and activate the flight or fight response. A traffic jam or an unreasonable boss for example will do it.

The fight or flight response should happen in a short quick burst and subside in a similar fashion (when the threat has passed). But in our times of chronic stress we are subjected to the fight or flight response for prolonged periods of time which can be damaging to the body. One reason why I discuss this topic with my patients at Leyton Osteopaths, is that if you are suffering with back pain, neck pain, sciatica or any other injury for that matter - your ability to recover and rehabilitate is inhibited if you are consistently in a fight or flight state.

Research also suggests that chronic stress contributes to high blood pressure, promotes the formation of artery-clogging deposits, and causes brain changes that may contribute to anxiety, depression, and addiction. More preliminary research suggests that chronic stress may also contribute to obesity.

The fight or flight response has a lesser known brother called the 'rest and digest response'.

This response acts like a brake and calms the body down after the danger has passed. It controls homeostasis, or the balance and maintenance of the body’s systems. It restores the body to a state of calm and counterbalance, and allows it to relax and repair.

The body undergoes several specific responses when this 'rest & digest' system is activated.

Increased saliva
Digestive enzymes are released
Heart rate drops
Bronchial tubes in lungs constrict
Muscles relax
Pupils constrict
Urinary output increases

All of these changes are designed to maintain long-term health, improve digestion, conserve energy, and maintain a healthy balance in your body’s systems.

The fight or flight response kicks in automatically, and occurs in response to any perceived threat. This doesn’t have to be an imminent physical threat (we face those very rarely these days). Any perceived threat or stressful situation can trigger this response -imagine giving a speech in public.

Luckily for us it is possible to activate this restorative res & digest response. Simply reading a book does the trick for some people, which may be why so many people read before going to bed for the night. Soaking in a hot bath, getting a massage, or petting a dog or cat are excellent relaxation strategies that will achieve it. Some people react well to breathing exercises or activities like yoga and tai chi.

A visit to your local osteopath in Leyton is of course another excellent way to promote the rest & digest response and to encourage healing from back pain, neck pain, sciatica, frozen shoulder, knee pain or hip pain. At Leyton Osteopaths we also offer a breathing retraining programme called Buetyko breathing which is used to help people with conditions like asthma, rhinitis, stress, anxiety and panic attacks.

By learning to activate your rest & digest response, and reducing the effect of your fight or flight response, you can reduce the stress on your heart, digestive system, immune system and help to heal injury quicker.

Key Message: Activating your rest & digest response is important for general health and more so when recovering from injury. A variety of strategies are available for stimulating it including breathing exercises, reading, petting a dog and osteopathy treatment at Leyton Osteopaths.

5 Steps for a Healthy Week

Taking just 30 minutes on a Sunday morning to complete these five steps is my top tip for ensuring a healthy week.

Step 1 - You are what you eat

Nutrition is extra important when recovering from back pain or any other injury. Your body breaks down the components of the food you eat and later uses them to fuel and repair your body.

You know that shopping when hungry means you are more likely to buy unhealthy, processed and sugary foods. But instead of simply ensuring you don't shop when hungry, go a step further and make sure you are positively health focussed by watching a video or reading an article on the topic of healthy eating.

The five minutes spent getting into a healthy frame of mind will affect your food choices for the whole week. When opening your fridge you'll be confronted with healthy options. It is wise to ensure that some of your healthy option are also quick and easy to prepare.

When recovering from back pain or any other injury the people of Leyton, Leytonstone, Stratford and surrounding areas need proper nutrition. These foods will be used as building blocks by your body to carry out repairs.

Step 2 - Exercise

Next you're going to schedule your exercise for the week.

They key here is to know exactly what you intend to do and when you are going to do it. Personally I like online training programmes. They give you a programme complete with video demonstrations and tell you how many sets and reps you need to be completing. Put your workout times in your calendar. These are now protected - nothing else should be scheduled at these times. They do not change.

You have now removed any friction that might prevent you from working out. If you're experiencing back pain, sciatica, knee, hip or shoulder injury please make sure that your exercise programme is appropriate to your stage of recovery. If you're unsure about what you should be doing give us a call on 02030 961 900 or email leytonosteopaths@gmail.com for guidance.

Step 3 - Meditation

Take 30 seconds and schedule your meditation sessions for the week. Meditation can help your recovery from back pain, sciatica, knee pain, hip pain or any other injury. There is a mental component to rehabilitation and reducing stress levels helps improve your health in a plethora of ways. There are meditation classes available in Leyton, Leytonstone, Stratford and Walthamstow or you can use one of the guided meditation apps.

Step 4 - Information

Modern technology means that travel time is now an opportunity to listen to the information you want and need to hear. Your options used to be limited to whatever was on the local radio station in Leyton, Leytonstone, Stratford or Walthamstow. Now there are countless healthy lifestyle focussed podcasts and some that will discuss specific injuries like muscle spasms, back pain, sciatica, frozen shoulder, arthritis of the knees and hips or whatever else you may be suffering from. Spending five minutes creating your playlist on a Sunday morning leads to hours of useful information about healthy lifestyle and rehabilitation from injury being absorbed throughout the week.

Step 5 - Learning

Similar the previous step, the next one is simply to decide on the books you will read for the week. Go online and order something or select something from your bookshelf that you have previously read but want to re-read and place them on your coffee table. I am undoubtedly biased but I would recommend my book 'The Back Pain Recovery Plan - Your Step-by-Step Guide to a Healthy Back'. Although it focusses on back pain it has useful information that can be applied to recovery from any injury. It also has important lifestyle advice.
Now, making the decision to read something useful, expand your knowledge about pain and injury or watch the telly - it is much easier to make the healthy choice.

You still of course need to prepare the healthy food, do the workouts, complete the meditation, listen to the podcasts and read the books. But you have removed the need to decide whether or not to do them - these actions have become the default. Willpower is no longer required to make healthy choices.

Give it a try. Those 30 minutes spent planning your week can be truly transformational and set you on the road to recovery after injury.

Key Message: Planning is key to healthy week and making the right choices.

Back Pain - Bad Luck?

'I've been incredibly unlucky with a recurring back injury. Now I am feeling good and on track again.'

I overheard this line spoken by a personal trainer to his client in my gym in Leytonstone.

I watched this personal trainer give expert tuition to his client, outlining the many intricacies of the squat. He demonstrated textbook technique and helped his client achieve excellent form with a variety of corrections. The guy obviously knew his stuff.

As the trainer was returning the heavy barbell to the rack, he abandoned all aspects of good lifting technique. His feet were planted, he was stooped over, twisting his back and reaching away from himself while holding the heavy weight.

My suspicion is that luck had much less to do with his back pain than he believed.

"When we identify the things we are doing that may be contributing to our back pain, or any other injury for that matter, it is usually straight forward to eliminate, reduce, or manage them. "

-Shane Morris, Principal Osteopath, Leyton Osteopaths-

Almost always there are things, within our circle of control, that we are doing, or not doing, that are contributing to the problem. Start with this assumption, it should be an empowering thought. When we identify the things we are doing that may be contributing to our back pain or any other injury for that matter it is usually straight forward to eliminate, reduce, or manage them.

For our personal trainer that simply would have meant maintaining good technique when returning the weight to the rack as he did when demonstrating the squat. It wouldn't have required any more time or effort to do so, just a conscious effort.

Key Message: Understanding the things you're doing that are contributing to your pain / injury is vital to recovery.

The Usual

I recently asked an osteopathy Stratford patient if he had any illnesses. He responded by saying ‘Oh just the usual, diabetes, high blood pressure and obviously I need to lose a bit of weight.’

If obesity and diabetes are ‘the usual’ in the circles you mix in around East London, I would suggest you need to find some new friends.

There's a famous Jim Rohn quotation that says 'You become the average of the five people you spend the most time with'.

What impact are the people around you having on your health?

What impact are you having on those closest to you that follow your example?

Key Message: Choose the people and place you surround yourself with carefully.

Can you Trust Pain?

A gentleman recently visited Leyton Osteopaths with intense back pain. It began when he shifted some furniture at home. Instantly he knew something wasn’t right. After waiting three or four days and realising it wasn't resolving of its own accord - he decided to pay us a visit at Leyton Osteopathy.

On examining him it became clear he had strained a muscle in his back. When I told him this he was relieved,but shocked that it wasn’t something more serious.

An important lesson here is that pain isn’t always a good indicator of the extent of an injury.

If you've ever had a paper cut you will relate to this. Muscle spasm is another prime example - it can be horrendously painful but when the spasm stops, there's rarely damage to the muscle.

It was interesting to see how much more at ease this back pain patient at Leyton Osteopathy was when he understood that his injury wasn’t as severe as he’d thought.

Key Message: The fear of what might be and our beliefs about pain can increase its intensity. Don't suffer in silence, if in doubt - get it checked out.

Rest or Keep Active for Back Pain

As an osteopath in Leyton i'm commonly asked by local people who are suffering with back pain whether they should rest or keep active when their back pain is present.

My response is usually - 'Do both.'

Complete rest is almost never a good idea but getting some quality rest will help recovery. Keeping active is generally a good idea but it is important to clarify what exactly is meant by 'keeping active'.

During a recent osteopathy consultation in Leyton a construction worker described his intense back pain. He visited his GP days before and was told to take painkillers and keep active.

This gentleman's interpretation of that advice was to keep going exactly as before. He was steadily taking more and more painkillers to be able to continue working. From our discussion it became increasingly clear that his work was a major factor in his back pain. Without changing some of his practices, he was destined to have back pain for a long time.

Should you keep active with back pain? Absolutely! Keep moving. Resist the temptation to find a comfortable position and just stay there. Should you keep working? Yes! If you can. But if work has caused your problem you need to examine how you are performing your role and make some changes.

For the construction worker we implemented the following measures:

- Improved lifting technique
- Altered body positioning when shovelling
- Reduced labour intensive work by using machinery more effectively
- More regular breaks
- Arranged with his employer to do more driving and less manual work

You should keep active when experiencing back pain but that shouldn’t mean blindly ignoring it and failing to make any allowances for it.

Back Pain Again

Recurring back pain is frustrating, especially when it seemingly happens without cause. By delving deeper and examining what happens when back pain occurs, it often becomes clear it is not as random as first appears.

Given time, most back injuries will heal and the pain will subside.

Pain is a great motivator and modifier of behaviour. When pain is gone, so is our motivation to keep up with the changes that have helped alleviate it. By reverting back to our old ways, we are returning to the conditions that caused or contributed to our back pain in the first place.

By understanding what is causing, contributing to or maintaining your back pain - then taking steps to eliminate or manage these factors it is possible to get rid of back pain permanently.

A patient I treated recently at Leyton Osteopaths had suffered a disc herniation and nerve impingement in his low back. Last year he had a surgery called a laminectomy where part of a vertebra is removed to create more space for the disc. Within days after surgery he felt fantastic - ‘It was like turning off the pain switch’ he said. Thrilled, he returned to playing tennis several times a week. He made no allowances for his injury and made no modifications to his game.

You can probably guess why he returned to Leyton Osteopaths seeking treatment.

I fully support and encourage getting active and returning to the sports you love after injury. But, if like my patient, you have experienced a disc injury, you need to consider the impact a sport like tennis can have.

The biggest mistake here was that he didn't stage his return - he want back to playing full throttle and as frequently as he had before. Giving his body time to adapt by gently stroking a few balls for short periods of time and incrementally increasing could have saved this gentleman a lot of pain.

If you have back pain, you probably have a set of exercises you do to relieve it (if you're a patient at Leyton Osteopaths you definitely have been given some). But when your back pain stops, I'd hazard a guess the exercises do too. This is understandable. It demonstrates the purpose and value of pain.

Change those exercises from something you do when you’re in pain, to something you do every day. Find a sport or type of exercise you enjoy and do it consistently. As you do, you'll start to form a habit. Good habits are key to musculoskeletal health.

The steps you need to take today are:

(1) Keep active,
(2) Examine the things you are doing that may be causing or contributing to your back pain
(3) Eliminate or manage the factors identified in number 2.
(4) CONSISTENTLY do exercise(s) to keep your back, and the rest of your body, active - don't wait for pain.

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