In any mechanical structure or system, the main areas of potential weakness and compromise are the junctional areas – the joints. The spine is made up of a large number of joints which are necessary to give it its movement and flexibility however this structure also leaves it vulnerable to aches, pains and tweaks.
Back pain can be caused by a ‘one-off’ event where bending over, lifting, or twisting can result in strains and muscle spasms in the joints and connective tissues of the back causing acute pain and discomfort.
Back pain can also be caused by bad posture, such as slouching at a desk all day which puts prolonged pressure on the joints, ligaments and muscles of the spine.
Although we treat pain in all areas of the body, osteopaths are best known for their treatment of back pain.
The majority of back problems are non-serious, short-lived (acute) muscle strains or minor joint inflammations which respond well to osteopathic treatment and advice and generally resolve in 2-3 treatments.
Disc sprains and herniations (‘slipped discs’ – see below) are generally more serious and take longer to heal. They can also respond well to osteopathic treatment and advice however they are likely to require a longer treatment plan.
Longer-term (chronic) postural problems are generally managed by a combination of hands-on treatment along with recommendations and advice on exercise and lifestyle factors such as office workstation set-up etc.
Sciatica refers to an irritation to the sciatic nerve, the longest and widest nerve in the body responsible for carrying information between your spinal cord and your legs.
When the nerve is irritated pain is felt along its path, typically in the lower back, the buttocks, down the back of the leg and into the foot.
With sciatica it is also common to experience other neurological symptoms alongside the pain including ‘pins and needles’, numbness, sensation changes and weakness.
Sciatica is commonly a result of damage to one of the joints or discs of the lumbar spine (see ‘slipped discs’ below) causing inflammation and protective muscle spasm around the area of the sciatic nerve. Irritation of the sciatic nerve results in pain and restricted movement.
Sciatica can also be caused by spasms in the buttock or leg muscles which can also compress on the nerve.
Treatment aims to decompress the nerve along the route which it travels as well as reduce the inflammation that has built up due to any resulting tissue damage.
Massage, articulation and spinal decompression techniques can be used to reduce tensions in your back, buttocks and legs to help the nerve glide more easily. This will reduce the symptoms that you are experiencing and facilitate repair of the nerve itself.
Although a commonly used term, ‘slipped disc’ is actually somewhat confusing and misrepresentative of what happens when a spinal disc is damaged. What is generally referred to as a ‘slipped disc’ is more accurately described as a herniated disc.
Discs are not solid cartilaginous discs as people often think and can’t simply ‘slip’ in and out. The discs of the spine are comprised of a watery gel-like centre surrounded by a tough, fibrous outer layer (a bit like a very tough jam doughnut!).
The tough fibrous part of the disc is attached top and bottom to the adjacent vertebra (spinal bone) and consequently is unable to move. Therefore when a disc is said to have ‘slipped’ this refers to the squeezing out (herniation) of the gel-like substance through the outer fibres of the disc and not a ‘slip’ of the whole disc itself.
When compressive and rotational forces are applied to the spine (e.g. when heavy lifting) damage may be suffered to the tough, fibrous, outer coating of the disc. As a result of this the gel-like inner substance can start to seep towards the edge of the outer coating, or, in more serious cases can squeeze itself out of the disc (like the jam coming out of the doughnut) causing acute inflammation and irritation to the area.
Once the gel-like centre has squeezed out of the disc there is no way back in for it (you can’t put the jam back in the doughnut!) and it therefore sits in the spinal canal causing inflammation and irritation to the surrounding tissues and nerves (see ‘sciatica’ above) until the body is able to break it down and resolve the problem.
Osteopaths may apply gentle traction and decompression to the affected area, improving blood flow and reducing the inflammation. They may also employ gentle massage and mobilisation techniques, reducing muscle spasm and improving the range of movement of the affected area, thereby facilitating the body’s own healing and resolution of the problem.
Osteopaths will also advise on exercises to facilitate the healing process and reduce the likelihood of the incident re-occuring.