How Does Osteopathy Help Back Pain?
This article was originally published by Intrinsi.ca.
Osteopathic treatment is often the most effective first line of attack in correcting problems caused by back pain. Speedy access to care often averts the possibility of conditions becoming chronic.
By correcting any underlying mechanical disturbances in the musculo-skeletal system, we can greatly relieve pain and distress and minimise dependency on drugs. Osteopathic treatment often negates the need for further medical investigation or surgery. Back problems account for over 50% of the cases most osteopathic therapists see!
By designing an appropriate course of treatments, we can provide an ongoing management program to prevent a recurrence of your back problem. We will look at your back pain in the context of your life, and our treatment will take in to account the many factors that enhance your overall health. To this end, we can provide advice on diet, exercise, posture and many other aspects of day to day life. This comprehensive approach to care and treatment complement the body’s natural way of functioning, not only relieving you from your present back pain but taking you to a greater potential and capacity then before.
Why do so many people get back pain?
The-English-Osteopaths-15According to Statistics Canada, four out of five adults will experience at least one episode of back pain at some point in their lives.. Stats Canada offers some reasons that we might “get” lower back pain, including poor muscle tone, a sedentary lifestyle, obesity, smoking, poor posture and psychosocial factors such as chronic stress and depression.
As osteopathic therapists it seems to us that Stats Canada misses some crucial factors – to name a few: muscle imbalance, postural control, sacroiliac dysfunction and digestive problems. We do agree, however, that back pain is far too common. So let us share some insights into back pain from our perspective.
Osteopathic Insights into Back Pain
1. Muscle Imbalances
In a 2002 study on the relationship between mechanical factors and incidence of low back pain by Nourbakhsh and Arab it was shown that imbalance in hip flexor muscle length, strength and endurance can play a role in back pain. Range of motion differences, in which one hip moves more than the other, have also been proven to affect the lower back. As long ago as 1964, a Czech researcher, Vladimir Janda, observed that weak gluteal muscles, the ones that make up the buttocks, can be significant contributors to lower back pain. From an osteopathic perspective, all these factors are reasonably easy to screen for and, unless there are multiple predisposing reasons for these imbalances, they are fairly simple to correct.
2. Postural Control and Coordination
The spinal muscles should be able to contract in coordination with the other muscles of the trunk, namely the abdominals. For correct muscle contraction, the body relies on clear input about the space around you from the eyes, ears and joints which is then processed by the brain, and then enables the correct sequence of muscle contraction and coordination. For example, if a person bumps into your shoulder while you are walking down the street, your body should reflexively bring your trunk back to an upright, balanced position. Your ears, eyes and joint receptors provide instant feedback to your brain, which, in turn, sends out signals to the muscles in your trunk to contract and stop you from falling over. Any problems with your ears and eyes will have an effect on your balance and therefore your coordination. More commonly we notice that people with old injuries, or scar tissue from operations have poor postural control because tiny joint receptors present all over the body (which are a key component of spatial awareness and therefore coordination) are not giving the brain accurate information because they are no longer being used because a person has stopped using their joints properly since an old injury or since surgery. Our treatment process in this situation is to re-educate the body through the use of exercises as well as hands on mobilization of joints to encourage movement and therefore the ‘switching on’ of joint receptors and manipulation to break down scar tissue.
3. Sacroiliac Dysfunction
In our clinic we have lots of people complaining about sacroiliac (SI) joint pain, a form of pain felt at the top of the buttocks on one side. Although this is not strictly ‘back pain’ most of our clients call it back pain even though it’s actually originating from below the spine. Before treating for SI dysfunction, it is important to ensure the pain actually originates from the SI joints. The problem could originate with the hip and surrounding muscles and ligaments, which could refer the pain to the SI joint. There are some simple tests we use to differentiate between these structures. Vladimir Janda worked out that the big gluteus maximus muscle can be “switched off” (ie don’t contract when they are meant to) if the SI joint isn’t working properly. In addition to that effect, the SI joint can stop one of the supporting muscles on the other side from working, the gluteus medius, which is crucial to pelvic stability. In addition, the latissimus dorsi (the big back muscle) and the gluteus maximus work together to stabilize the SI joint. The latissimus dorsi is attached from the lower back to the arm, via the lower ribs and scapular, so its proper function is affected by the mobility of the upper back. Since most people spends hours hunched over their computers, their upper backs rounded and shoulders raised, it often happens that the latissimus dorsi is negatively impacted and at the root of any SI dysfunction or pain.
4. Abdominal Visceral Problems
The contents of the abdomen – that is, the stomach, liver, intestines, and other digestive organs, known collectively as viscera – are all attached to the spine. In fact, the spine acts as a bony scaffold that gives support to these structures. As the back moves, the abdominal contents must also move. If the structures are not mobile, whether due to surgical scarring or internal adhesions, they can prevent the back from moving as well as it should. This leads to areas of stiffness in the spine and concomitant areas of hypermobility. The hyper mobile areas of the spine are prone to overuse and injury and are commonly at the heart of complaints brought to osteopaths. Clients will experience the pain as originating from their backs, which is true to an extent, but an osteopath will recognize that the source of their discomfort lies in the abdomen. Abdominal adhesions can be helped with gentle visceral manipulation, freeing up the organs and reducing the load carried by the areas of the spine that have become hyper mobile. Once visceral problems have been addressed, the body will be capable of repairing any damage to the back and spine and the associated pain will go.
Treating Back Pain Through A Whole-Body Osteopathic Approach
Popular medicine addresses and successfully treats many causes of back pain but, as reflected by Statistics Canada’s focus on particular causes, other crucial sources of back pain are frequently overlooked. In addition to addressing the usual suspects, namely poor muscle tone, sedentary lifestyle, obesity, smoking, poor posture and psychosocial factors, we will approach the symptoms of back pain from a more holistic perspective. Back pain may be intimately connected to any of the above conditions but often such broad diagnoses fail to recognize the intricacies of the individual body’s systems. As osteopathic therapists, we acknowledge the interconnection between muscles, connective tissue, the nervous system, viscera and the structural skeleton. We are therefore able to thoroughly comprehend and successfully treat the various elements that inform and contribute to back pain.
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