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Chronic back pain is an extremely common condition, affecting millions of people worldwide. Unlike acute back pain which lasts a few days or weeks, chronic back pain persists for 12 weeks or longer.

Chronic back pain can originate from injuries, underlying medical conditions, posture problems and a variety of other factors. It can severely impact an individual’s quality of life, limiting mobility and activity. We’ll explore the common symptoms to be aware of and the causes of this problem.

Chronic Back Pain Symptoms

Back pain can manifest in a variety of ways depending on the underlying cause. However, there are some common symptoms:

• Aching muscles: Chronic strain and tension in the back muscles can lead to persistent back aches or soreness, which can be localised or widespread.
• Stabbing pains: Compression or irritation of the nerve roots branching from the spine often causes stabbing or shooting pains, which may also radiate into the legs.
• Stiffness and reduced flexibility: Many individuals with chronic back pain experience stiffness in the back, especially in the mornings. A lack of flexibility also makes actions like bending over challenging.
• Numbness/tingling: Compressed nerves can also cause sensations of numbness or tingling in the back, legs, arms or hands depending on the location.
• Muscle spasms: Spasmodic contractions of the muscles surrounding the spine are common but can lead to debilitating pain.

Carefully noting the type and location of symptoms can help determine the source of the pain. While symptoms may be bearable at times, chronic back pain often has flare ups causing sharp increases in intensity. Preventive strategies such as clinical pilates alongside chiropractic or osteopathic treatment can help manage and alleviate the symptoms.

Common Causes of Chronic Back Pain

Muscular Atrophy

One of the most common causes of chronic back pain is muscle deconditioning, also known as muscle atrophy. This occurs when the muscles in the back become weakened or deconditioned over time due to inactivity. The muscles of the back play a crucial role in stabilising the spine and supporting proper posture and movement, and when these muscles atrophy, they lose strength, becoming less effective at protecting the structures of the back.

There are several ways that back muscle atrophy frequently develops. As we age, some degree of muscle wasting naturally occurs, but a sedentary lifestyle and lack of exercise can accelerate atrophy. If an injury causes someone to reduce their normal physical activity, the prolonged inactivity also leads to deconditioning.

Atrophied back muscles struggle to properly support the vertebrae, discs, ligaments and surrounding tissues. This can put excessive strain on these structures, leading to injury or degeneration over time. Strengthening exercises that actively work the back muscles are important for both treatment and prevention. This can help reverse atrophy and its negative impacts on the back.

Poor Posture

Maintaining good posture is crucial for reducing strain on the back and preventing pain. But many common poor postural habits can take a cumulative toll, leading to chronic issues. Slouching, hunching over, and other improper postural alignments place increased stress on the spinal discs, joints, ligaments and muscles over time.

One of the most common postural problems is anterior pelvic tilt, which causes the pelvis to tilt forward and the lower back to overarch. This takes the spine out of its natural alignment, forcing surrounding muscles to overwork to compensate. Prolonged sitting often contributes to poor pelvic positioning, as well as looking down at phones and devices frequently or carrying heavy bags and items on one side.

Correcting long-term postural issues requires retraining the body and building core strength. But maintaining proper posture, especially when sitting, standing and lifting, can help tremendously in preventing chronic back problems.

Trauma and Injuries

Traumatic injuries to the back represent a major cause of acute and chronic pain. Car accidents, falls, fractures, sprains and other trauma can lead to long-lasting issues if not properly addressed. When the intricate structures of the spine get damaged, it often sets off a cascading effect.

Fractures, disc ruptures and ligament tears from trauma cause instability and misalignment in the spine. To compensate, the back muscles spasm and tighten, which then leads to muscle strain and pinched nerves. The initial injury starts the process, but resulting inflammation, scar tissue formation and compensatory muscle imbalances perpetuate the pain.

The key is proper rest and rehabilitation after any trauma to allow optimal healing and prevent long-term consequences. Early intervention with anti-inflammatory treatment, therapy, muscle retraining and physical conditioning is also important to stop acute pain from transitioning into a chronic condition. Paying attention to good posture and core strength after injuries is vital.

Treating Chronic Back Pain

Chronic back pain can be debilitating if the underlying causes are not properly addressed. The good news is that many causes of chronic back pain can be improved with proper treatment. The most important thing to do is find the cause of the problem, rather than treating the symptoms. To this we would recommend an assessment with one of our Chiropractors, Osteopaths or Physiotherapists. Once the cause has been identified they will lay out a treatment plan to focus on alleviating your symptoms whilst correcting the cause.

The team at The Health Hub offer services to help diagnose and treat long-lasting back pain based on your specific condition. Contact us today to make an appointment or seek professional advice.

Are you suffering from osteoarthritis (OA) in your knee, hip or shoulder? Many of our patients come to us with symptoms of this common degenerative disease including pain and stiffness in and around the affected joint and reduced mobility in the body. Sadly, there is no known cure for osteoarthritis other than surgery.

However, the good news is that with the help of physical therapy, your quality of life can be significantly improved. Treatments such as osteopathy, chiropractic care, physiotherapy and massage can achieve a great deal in alleviating chronic OA symptoms, improving joint function and slowing down disease progression.

Here at The Health Hub, we have a team of experienced therapists for various physical treatment disciplines, including physiotherapy, chiropractic, osteopathy, sports massage, massage and Pilates. Our highly qualified and skilled physical therapists can help you to:

Manage your OA pain

Common areas of Osteoarthritis are the knee and hip joint, which causes the protective cartilage around the joint to wear away, resulting in painful bone-on-bone friction. Physical therapy can be used to reduce inflammation around the affected joint, promote blood circulation and release endorphins, the body’s natural painkilling chemicals. Some of the manual techniques used by our physiotherapists including acupuncture, osteopaths and chiropractors may give immediate relief, while targeted physiotherapy exercises are designed to strengthen supporting muscles and stabilise the joint, providing long-term benefits.

Increase joint mobility

Osteoarthritis can make your knee, hip or shoulder stiff, leading to a reduced range of motion in addition to painful movements. You may have trouble walking or climbing stairs, getting up from a low chair or lifting your arm. Our physical therapists employ joint mobilisation, soft tissue manipulation and acupuncture, directed at improving the mobility and function of your knee, hip or shoulder joint. We will often compliment this, with Physiotherapy exercises that will help to keep your joints as flexible and strong as possible to slow down the rate of degeneration.

Improve your balance

Lower body OA sufferers (hips, knees, ankles and feet) may have problems with impaired balance, largely as a result of decreased joint function, mobility and muscle weakness which can lead to instability and a greater risk of falls. Our skilled physical therapists can add balance components to functional strengthening treatment, for instance by using different walking distances and elevation, and changes in terrain, to simulate daily tasks and improve your balance.

Work on your posture

Did you know that a poor body posture – the incorrect alignment and positioning of your body – can add extra stress to your arthritic joints? You may not even be aware of your posture, but a good physical therapist can show you simple ways to adjust the way you sit, stand and walk to improve your posture and take the stress off your joints. Your therapist may also suggest simple modifications you can make to your environment, whether at home, at work or even in your car, to help make your daily life easier.

Slow down OA progression

Osteoarthritis is a degenerative condition, meaning it is likely to get worse over time. That said, there is much that can be done with physical therapy to slow down the rate of decline. Our therapists will work to promote joint health, reduce inflammation and provide additional muscular strength, all of which help to minimise the wear and tear on the joint. With good physical therapy outcomes, you may be able to postpone the need for surgical interventions such as knee or hip replacements.

Contact Us

If you are living with chronic osteoarthritis, rest assured that there are treatment options available to help you feel better and lead a more comfortable and active life. The Health Hub team have a wealth of physical therapy expertise, giving you access to the best available care. As a one-stop-shop for your wellness, treatment and rehab requirements, we offer personalised treatment plans to suit your individual requirements. Contact our friendly, welcoming clinic to make an appointment or book online here.

Bringing a new life into the world is an awe-inspiring experience. As a woman, your body has gone through remarkable changes during pregnancy and childbirth. Now that you’ve entered the beautiful world of motherhood, it’s important to prioritise your own health as well. In this article, we’ll explore when a woman should have her postpartum health check-up, because taking care of yourself is key to enabling you to be the best mum you can be!

The Initial Check-up: Within the Six Weeks 

As you adjust to your new role as a mum, naturally you will be focussed on your baby’s needs and rightly so. However, it’s important to make time to look after yourself too. Now clearly this will depend on whether you have had a natural birth or a c-section. If you have had a natural birth, as the title alludes it’s advisable to schedule your first postpartum check-up within the first six weeks. This allows us to monitor your recovery and ensure everything is progressing as it should. We will often perform a diagnostic ultrasound scan to check your pelvic floor activation and to check for any signs of diastasis recti (separation of your abdominal muscles). We will also discuss any concerns or complications you have following the birth, as we are all too aware despite the best laid plans, it is often more complicated and traumatic than hoped.

If you had a c-section then the time frame is clearly different, as you will be very limited as to what you can do for the first three weeks, progressing to driving at six weeks. It is important to remember you have had major abdominal surgery so as tempting as it is, don’t overdo it! We would advise you to come in from when you are able to drive, so six weeks onwards. As well as going through all the above mentioned, we will also check your scar healing. Please have a look at Georgie’s information on Scar Massage by clicking here.

Fundamentally our focus is to get you back to doing all the things you loved doing before childbirth/pregnancy. Things like, the gym, running, hiking, or swimming. The aim of these appointments is to guide you to a gradual return to your pre-pregnancy physical activities without setbacks. It’s like having a personal trainer for your postpartum journey—guiding you every step of the way!

To understand the different elements of what we look at, I have gone into more detail about each of the key areas below.

The Pelvic Floor

So, what do we mean when we say check your pelvic floor or pelvic floor activation? The realities are that during pregnancy and childbirth, your pelvic floor muscles play a vital role in supporting your growing baby and facilitating the delivery process. However, these muscles can become weakened or stretched during this process, potentially leading to issues like urinary incontinence or discomfort. As part of our women’s health physiotherapy check-up, we will focus on pelvic floor rehabilitation, providing exercises and techniques to strengthen and regain control over these essential muscles. Fundamentally with the aim of getting you back to being you before pregnancy, think of it as a “power-up” for your pelvic region!

Abdominal Reconnection

During pregnancy your abdominal muscles are stretched and therefore can separate, leading to a condition called diastasis recti — an abdominal separation that can affect core strength and stability. Fear not! Women’s health physiotherapy can help you reconnect those abdominal muscles. We will use our diagnostic ultrasound to assess the extent of the separation and then guide you through specific exercises and techniques to promote healing, regain muscle tone, and support your overall posture and back strength. We can then reassess using the diagnostic ultrasound after a six-week period, to monitor the healing process.

Six-Week Doctors Check-up

Around six weeks after giving birth, you’re also likely to have your six-week doctor’s check-up. Unfortunately, from my own experience, this is often not what you would expect. Largely the focus will be on your baby with very little assessment or attention paid to you as the mother. That is why we recommend a women’s health physiotherapy check-up.

While the above provides time frames for when we recommend women’s health physiotherapy check-ups, it’s important to trust your intuition and listen to your body. Every woman’s journey is unique, and you may have specific needs or concerns. If something feels off or if you have questions, don’t hesitate to reach out to me for guidance.

Keep an eye out for our latest blog which will be going live next month. As many of you know, we welcomed our second child 9 months ago. This is the focus of the upcoming blog. Here Jodie explains a bit more.

Recovery the second time around has certainly been slower, but I wanted to share with you all what I did to optimise this as best I could.

Women’s Health has long been a passion of mine and having gone through two recovery journeys myself, it really hit home how little is offered to new mums. So much can be done to aid your recovery to ensure you get back to being you again!

Given what you have been through, both in terms of the pregnancy itself and then birth, whether that be a natural, assisted or c-section, it hardly seems fair that there is literally nothing offered to guide your recovery. Apart from your 6-week check, when often the focus is on your baby, no one really seems to look at mum. Don’t get me wrong, your new baby is hugely important and needs attention but, what about you?

Having now been through this journey twice, I wasn’t sure if the lack of guidance and aftercare for Mum was normal, as the first time was during COVID so it was hard to gauge. I can confirm it is!

Now I am lucky that my professional expertise in this area means that I know what to do and what is available but,  having spoken to friends from NCT, it made me realise that new mums or in fact, any mums often aren’t aware of what can be done to help them recover. So I thought it might be useful to the timeline and document my journey to help you see what options there are available to you to ensure you get back to being YOU!

Over the course of the following year, I will be talking about a number of topics, including:

 

– The differences in recovery from Natural vs C-section

– Top tips in the first 8 weeks

– Scar Healing if you have had a C-section

– Making a safe return to exercise

– How to look after your eldest whilst recovering if this is your second child

 

Look out for the first instalment next month!

Many of us have got a scar we could tell you a story about; a graze from childhood, a joint replacement, caesarean, hysterectomy, and the list goes on. But have you ever thought of what you could do to promote healing and the overall health of your scar?

Scar tissue is a collagen-based tissue that develops as a result of the inflammatory process following injury. This process is necessary for healing damaged tissue, skin, muscles, tendon, ligaments, fascia or nerves. When collagen is used to heal the injury matures, it is referred to as scar tissue. The scar is weaker than the tissue it is replacing, by about 80%.

In 1973 Sharon Wheeler, a therapist from Seattle discovered her ability to improve scar tissue. She developed ScarWork techniques over many decades working with many different types of scars. The techniques used help to release tightness, help restricted mobility, reduce pain and sensitivity, simulate and boost healing, as well as support emotional well-being.

Georgie has recently trained in Scarwork, so if you have a scar that you feel unconnected from, afraid to touch, or want to try and improve come and try a session. Contact us to book an appointment today.

We regularly have patients that call saying they have Sciatica. The only catch is what does Sciatica actually mean?

This is where it becomes a grey area, as the medical definition for Sciatica is as follows…

“Sciatica refers to pain or discomfort associated with the sciatic nerve. This nerve runs from the lower part of the spinal cord, down the back of the leg, to the foot. Injury to or pressure on the sciatic nerve can cause the characteristic pain of sciatica: a sharp or burning pain that radiates from the lower back or hip, possibly following the path of the sciatic nerve to the foot.” – https://medical-dictionary.thefreedictionary.com/sciatica

So, in a nutshell, your pain is being caused by the compression of the sciatic nerve however you don’t know what is compressing it! This is the catch as there are a number of different conditions that can cause this.

Let’s look at the most common cause first…

A bulging or herniated lumbar disc which is commonly termed a “slipped disc”. A term that in itself is misleading as the discs don’t physically slip, instead they are fluid-filled structures that can weaken with overuse or if they are put under too much pressure, such as lifting something too heavy. If the fluid forces its way through the disc lining then it becomes a herniation, which is what is commonly termed a slipped disc. Think of an out-of-ground swimming pool with rubber sides filled with jelly, then put a lid on top. Overuse could be something like repeatedly bending to lift your kids. This is like someone kicking the same spot in the side of the pool which, initially doesn’t cause a problem but, over time, the side starts to weaken then it begins to bulge. Whereas trauma is like having 100 people standing on top of the lid and then all jumping in one spot forcing the jelly into the opposing side with such force it causes the side to bulge or tear.

Disc bulges or “slipped discs” can be diagnosed by our Chiropractor, Osteopath or Physiotherapists. We do this based on specific questions that look at how the pain presents, when it started and how it started. Then we use several special tests to further clarify our diagnosis of a disc bulge or herniation. If after doing all of this we still aren’t certain, or the severity of your symptoms is such that you can’t tolerate any testing, an MRI is the imaging of choice as this enables us to see the extent of the disc bulge or herniation.

The next BIG question is WHY did it happen?

Some are obvious, such as attempting to lift something too heavy out in front of you like a heavy plant pot, deadlifting in the gym or a large awkward piece of furniture. In that instance, we don’t have to spend much time looking for the WHY. Instead, we focus on settling your pain levels and working with you to promote disc healing before strengthening your lower back to try and prevent any future reoccurrence.

BUT…

Sometimes there isn’t an obvious cause. For example, you are working from home (COVID!) then out of the blue you bend down to put your shoes on and feel a twinge in your lower back. You don’t think much of it but over the next couple of days, you start to develop pain in your buttock on one side. Then over the course of the week, it starts to travel further down your leg, making sleeping particularly uncomfortable. These are the cases when we need to work out WHY! Of course, there are far too many possibilities to list but, in this instance, it could be tight hips brought on by the lack of activity working from home creates. Or perhaps you now don’t go to the gym and an old weakness is showing itself. Or perhaps your home desk set-up is all wrong… sitting at a dining room table with a laptop for 8+ hours a day. All of these could be the cause or a combination. That’s where we can really help, as not only will we work at settling your sciatic pain through a combination of different hands-on treatments, possibly medical acupuncture, home exercises and advice, but once we have achieved this, we will work on the WHY!

All that said one key point to make is it isn’t only “slipped discs” that can cause Sciatica.

Hence in our eyes, Sciatica in itself is not a diagnosis. Other conditions that can cause entrapment of the sciatic nerve and give you sciatica are spinal stenosis, piriformis syndrome, osteoarthritis of the hip, sacroiliac dysfunction, sacroiliitis and so the list continues.

For this reason, we would always recommend seeking advice from one of our therapists on your condition, as they will be able to diagnose the cause of your sciatica and advise as to whether they can help. If they can’t help, they will always guide you as to your next step, whether that be an MRI or a different medical professional.

If you would like our help but you’re not sure who you need to see, you can always contact us via the contact form, over the phone or email us on info@thehealthub.co.uk

Sam Pargeter

Sports Chiropractor and Clinic Director

 

We can’t quite believe it is only 1 month to go until Christmas! With constant reports of shortages this year whether it be Turkeys, Toys, or Tech we would like to assure you we have a good supply of vouchers ready for you to treat someone this Christmas. They are available for all treatments or simply a value if you would prefer not to choose. Call or email us today to purchase yours.

What is Maintenance treatment, and do you need it?

Once a patient is pain free we often get asked should I be coming back for treatment to prevent my injury from reoccurring and if so should it be monthly, quarterly, biannually etc?

The honest answer is it is completely case dependent as there are so many variables that go into that decision. Therefor I thought I would try and do my best to explain where it can be useful and why…

A large part of it will hinge on the duration of time you have had the injury, your day-to-day lifestyle and what the day job involves. One thing that we know for certain in the medical world is that the number one risk factor of injury is previous injury. In short if you have hurt yourself before you are more likely to hurt yourself again unless you have gone through an extensive rehabilitative program to eliminate the weakness created by the injury and have addressed the original cause of the injury. In most instances this isn’t the case, as human nature dictates that once it stops hurting, we feel we are better, and we go back to our normal lives.

A common example of this is chronic low back pain, often you will have seen either our Chiropractor or Osteopath as the treatment techniques such as spinal manipulation and mobilisation have a great body of evidence supporting their use in managing lower back pain. Now it is important to point out that if you have never had a back pain episode and come for treatment for the first time this is unlikely to be relevant for you. I am referring to the patient who has had ongoing episodes of lower back pain which are often starting to occur more frequently. For this patient we can gradually increase the spacing between appointments to find the optimal time to have treatment and keep the lower back pain under control. We may also recommend working with our Pilates specialists alongside this to address the weakness that has resulted from their reoccurring injury which in time will reduce the need for treatment.

Another scenario where maintenance can be beneficial is with something like an arthritic knee. Let’s say that it isn’t bad enough that you need surgery but it is painful and preventing you doing the things you enjoy doing. In this instance I would suggest seeing one of our Physiotherapists who use acupuncture in a medical sense which can be a great option to manage your symptoms and enable you to do exactly that. Acupuncture as a treatment modality is now growing a significant body of evidence for its effectiveness in managing chronic pain, as shown here. Of course, the duration of time between appointments will vary from case to case depending on the severity of the arthritis, the degree of pain you are in, and how active you want to be.

Lastly let’s look at Sports Massage and Massage. This is a very different conversation as often these treatments aren’t injury specific. Instead, someone is looking to stay as mobile and relaxed as possible using treatment as a means of doing this. Frequency of massage is much more patient directed in that you could have a massage every week for the rest of your life and it would only do you good. There is no risk of over treating as life creates tension, whether that is stress related, posture related (the good old desk) etc. So when it comes to massage the best thing is to speak to the therapist and they can guide you towards a frequency that will suit you best. Just as an example I have a Sports Massage once a month to help with the tension created from treating, but you may want to come more or less often than this, it will all depend on you.

Clearly, I could go on and on trying to cover every ailment or scenario but hopefully that gives you a rough idea of the options available to you. The best thing to do is simply ask the therapist you see next time you are in, or alternatively get in touch via email or phone and we can look at your case and work with you on what would be the best option.

Sam Pargeter

The Covid Pandemic turned life upside down. Being unable to treat patients, I suddenly had more time on my hands than I have had in years. In addition to the obligatory DIY and baking copious cakes, I thought I should try to keep fit, so I decided to try my colleague Georgie’s online Pilates classes. Well, I loved them with Georgie’s clear, encouraging teaching style. With the focus, the concentration, and the ability to progress the exercises and work at a level which suited me, I felt I was getting a safe full body workout which was still really challenging.

With months of uncertainty ahead and my two daughters heading off to University, I needed a distraction. Having taught exercise classes myself back in the day, I thought maybe this is something I can do that will also really benefit my patients. After some research, I decided to train in the APPI Method, (The Australian Physiotherapy & Pilates Institute). Our physios, Jodie and Rachel, had trained in this form of Pilates and highly recommended APPI as the Pilates gold standard.

APPI lead the way in clinical-based Pilates training. Taking the 34 classic Pilates movements developed by Joseph Pilates, they have progressed and adapted these so they are safe and effective for all. The exercises build strength, stability and mobility. Over the last year, the in-depth Comprehensive Matwork training course has covered every element from anatomy and physiology to teaching one-to-one and group classes. I was lucky enough that between lockdowns, I was able to do both training in person and subsequently on Zoom and in March 2021 I took my practical and theory exams and passed!

Not only is Pilates something I can now use to help others, but it has also really helped me and proved just how transformational it can be. I have always done a variety of exercises from running to aerobics, body pump to badminton, but in 2017 I was shocked when I had a prolapsed disc in my neck.

An MRI showed that the jelly part of the disc had escaped, protruding into a root nerve causing me a lot of pain and weakness in my left arm. Initially I was told I would need surgery. However, being so fortunate to work where I do, with physio treatment, rest and rehab the disc was reabsorbed and over six months things improved. The result of this was that whilst I could return to exercise (avoiding any high impact), I was left with a left arm which was still weaker and with muscles which would often go into painful spasms if I overdid strength work.

Through practising Pilates, my arm is much stronger and I no longer have muscle spasms. Using a range of exercises I have also built up the deep muscles to support my spine and core. I now experience less low back pain which can be an issue for massage therapists who are often flexing forward. I am so much stronger and recently completed a 45-minute hit class that I would never have been able to do a while ago.

However, the most inspirational part of my Pilates training is that I can see how patients can improve their everyday life. By using Pilates they can make their bodies stronger and more functional, making everyday tasks easier and more enjoyable. Age and ability is no barrier as Pilates truly can benefit everyone. The APPI Pilates method is taught to footballers and ballet dancers, new mums to octogenarians and as a teacher, we can continue adding to our skills with many specialist courses.

In addition to offering one-to-one Pilates sessions, I am also planning to run a Pilates for Osteoporosis group class. With 1 in 3 women and 1 in 5 men developing osteoporosis, Pilates can be a key component for preventing both the onset of the disease and managing it.

For information on Pilates with the team at The Health Hub please contact reception.