Author Archive

Many of our patients blame their aches and pains on their own bad postural habits; the implication is that if only they could maintain good posture in the chair at work, they would not encounter the same problems. Whilst good posture can help, it is part of a wider picture, and in most cases Osteopathic treatment is a very effective part of the solution. Here are ten reasons why:

1. There is no such thing as perfect chair posture; human beings are not designed to sit in chairs all day
2. A degree of objectivity is needed to evaluate the problem; this is very hard to do for yourself, and the trained eye of an Osteopath will quickly focus on the key issues
3. Assessment means that all related health problems may be identified at the same time, and treated appropriately in a structured and integrated manner
4. The result of sitting in chairs from schooldays onwards is that your body will have adapted e.g. certain joints will be stiffer; treatment can identify and modify those factors
5. Personalised exercise prescription can focus your efforts onto the most effective, relieving and restorative exercises for you as an individual
6. The first aim of treatment is to guide you back towards a sustainable state of relative comfort
7. Treatment is also aimed at improving your general health and mobility over the very long term
8. Consideration of lifestyle factors (such as work patterns or dietary habits) means that improvements are more likely to be sustained
9. It is common for patients to express surprise and delight that they are experiencing a state of physical ease and wellbeing they had forgotten was possible
10. The experience can equip you with the understanding and means to tackle similar health issues as and when they arise in the future

We’ve posted a few entries about posture at work – on a wide variety of topics such as

• what sort of bag is best for my back?
• Top tips for good posture at work (in the office)
• It’s just my posture … the slippery slope towards work related injury

I’ll post again in the next day or so some simple 2 minutes exercises that can help with good posture.

Carpal Tunnel Syndrome is a condition affecting the junctional area between the wrist and the heel of the hand. This narrow space carries important nerves and tendons supplying the palm and fingers; when it becomes congested, there may be symptoms such as pain, numbness, tingling or weakness in the fingers or hand, or problems with manual dexterity. The congestion may be the result of a number of different general conditions involving fluid congestion, including pregnancy and rheumatoid arthritis, or it may be more local in nature. Careful evaluation of the cause needs to be made, as the appropriate treatment will vary accordingly.

Although Carpal Tunnel Syndrome is a common finding, it is also often misdiagnosed, such as in cases of problems with the base of the neck, where the nerves that supply the hand exit from the spinal column, or general tightness and congestion in the forearm itself, which is frequently found in deskbound computer operators.

Treatment

Standard medical treatment includes splinting, steroid injections or in severe cases, surgery, but it is worth starting with physical therapy such as osteopathy, because the treatment will be based on careful evaluation and diagnosis, and may prevent the need to consider more invasive methods.

Can an osteopath help?

Mathieu, Jessica and I are registered osteopaths in Ealing and Uxbridge. Please call either clinic – 020 8566 0767 (Ealing) or 01895 20050 (Uxbridge) – to speak directly to one of us about your symptoms, whether we can help and the options available (no obligation – read more about what to expect on your first visit here).

We often hear this from patients when they first come to our Uxbridge or Ealing clinic, and although there are conditions where “it’s a muscle problem” is a reasonable (if limited) statement, there are far more instances where it really is not the case.

Muscles are the galley slaves of the body; they do the hard work, but do not make the decisions about what work is to be done or issue the orders, and they tend to work faithfully under whatever circumstances they encounter to the point of exhaustion and failure. Their persistent complaints (aches and pains) are usually the warning sign that something is wrong, i.e. muscle pain is the symptom, but the problem is wider, and the solution should accord with that.

A typical example would be where a patient has persistent neck and shoulder tension; massage may help, but the tightness returns, often because of restrictions in the vertebral joints around the base of the neck.

At the very least, more aspects of the musculoskeletal system will be involved. Muscles move bones like levers in relation to each other by articulating joints, and they must coordinate in a cascade of events for their effort to be synergistic with the whole. The nervous system performs this role of communication and coordination of action and movement, and the cardiovascular system takes care of the raw materials (such as oxygen and nutrients) and disposal needs of the muscles themselves. Any compromise in the function of any of these systems is likely to produce symptoms local to the site of action, i.e. the muscles. How a problem is defined will most likely tell you something about the practitioner – e.g. a massage therapist may tend to describe conditions in terms of muscles. As Abraham Maslow said

“If the only tool you use is a hammer, you are going to tend to hit things”.

How can an osteopath help?

It is the task of an Osteopath to strive to understand the processes involved in creating a condition of unease or pain, and introduce appropriate measures (such as treatment, exercise or nutrition) to relieve the symptoms and undo the causes.

In fact the Osteopath aims not only to provide symptom relief, but also to ensure that the patient is equipped to reduce the incidence and severity of recurrences as well. Or to put it another way, Osteopaths can help you keep your galley slaves happier and for longer.

Can we help you? We are registered osteopaths in Ealing and Uxbridge. Please do explore our website to see what we treat and learn more about us.

Frozen shoulder is the colloquial term for adhesive capsulitis.

What is Frozen Shoulder?
As the name implies, it is a condition affecting the capsule surrounding the shoulder joint, which is quite loose in order to accomodate the wide range of movement that your arms require. At rest, the necessary laxity manifests as an exta fold or pouch below the joint under the arm. The sides of this fold can become stuck together, no longer offering any reserve flexibility to the joint movement. This can exist as a stand-alone condition, but is often seen in conjunction with related issues such as injury, infection, immobility, diabetes, arterial disease or arthritic conditions.

Symptoms
The symptoms usually start with pain in and around the shoulder which may resolve, leaving stiffness on movement, especially preventing the arm being lifted above the head. This in itself does not easily distinguish it from a number of other conditions affecting the joint, ligaments or muscles nearby, and many more people are ‘diagnosed’ with Frozen Shoulder than actually have it. However, a trained manual therapist such as an osteopath should be able to distinguish between them by careful attention to case history and examination.

Recovery
It is not adviseable to treat prior to a clear diagnosis as the approach needs to be relevant to the individual condition, but in most cases there is significant improvement with appropriate treatment and exercise. The condition often self-resolves over a two year period, but suitable treatment can reduce recovery time to a fraction of that.

If you have been diagnosed with or you are in pain because of Frozen Shoulder ask your local osteopath if they can help. We are osteopaths in Ealing (telephone 020 8566 0767) and Uxbridge (01895 20050) – telephone either clinic to speak directly to myself, Jessica or Mathieu about your issue and the options available (I promise no obligation – click here to read more about what to expect on your first visit).

We frequently see patients who are convinced that they have a ‘trapped nerve’, but although the turn of phrase is highly descriptive, it is somewhat misleading.

On the face of it, it seems to make sense: it describes a feeling of sudden pain brought on by movement. It sometimes refers to low back or buttock pain, but perhaps more commonly to neck pain when turning the head.

The sensation occurs when a particular joint motion becomes impaired or difficult; under these circumstances, the body uses pain signals to inhibit movement and ensure that it is reduced to a more manageable speed or range. The nerves are working perfectly in the sense that they are telling you that there is a problem, but they are not the problem itself.

Osteopathy is a good choice of investigation and treatment for anything that feels like a trapped nerve because it strives to uncover the underlying cause that is producing the sensation. Treatment can then be specific and effective, rather than vague and hopeful.

There are exceptions, but often the catching sensation resolves as normal movement and activity are restored to the area in question. Diagnosis and appropriate treatment will also usually produce a more complete resolution than just waiting for it to recover; otherwise, the body simply gets used to the compromise and adapts to it, which may seem like recovery, but often results in recurring epsodes of similar discomfort. Over time, the accomodation can become more ingrained, and athough it is never too late to make a change for the better, the sooner the underlying problem is treated, the more complete the recovery is likely to be.

Can an osteopath help you? Bridge to Health are osteopaths in Ealing (020 8566 0767) and Uxbridge (01895 20050) – do telephone either clinic to speak directly to a fully qualified and registered osteopath. (click here to read more about what to expect on your first visit)

The term sciatica can be expanded to “irritation or inflammation of the sciatic nerve”.

The nerve roots emerge from various spinal levels in your low back and then gather together before running through your buttock region and down the back of your leg. If the nerve is irritated, symptoms can include loss of muscle power and/or sensory changes such as pins and needles, numbness or sharp pain. The affected area is usually the lower leg and/or foot. The nerve irritation can be associated with structural problems in the low back, such as a disc bulge, but the actual vertebral level of the irritation can vary widely and there are other possibilities such as pinching in the sacral or buttock region.

Many more people are told or believe they have sciatica than actually have it. For example, if you have low back pain radiating into the back of the leg, sciatica is one possibility but by no means the only issue. If your symptoms do not extend below the knee, it is less likely that the sciatic nerve is involved.

When you have your condition evaluated by an osteopath for the likely cause you will be able to get appropriate advice and/or treatment. Bear in mind that the term sciatica tells you nothing about where the nerve irritation is, or why it is happening. However, if your symptoms are severe, or are affecting the saddle area or you have disturbances to bladder or bowel function then you should treat it as an emergency (i.e. go to your nearest hospital’s Accident & Emergency).

An osteopath will consider your symptoms, your medical history and their examination findings in coming to a diagnosis as to what is happening to cause your discomfort. Treatment should then be specific and effective; occasionally, there may be cause for further investigation, but then you will be advised about appropriate action in the meantime. Even if you already have a diagnosis such as disc herniation, you may well benefit from treatment because an improvement to the function of the local musculoskeletal structures usually offers some relief and can speed up tissue recovery.

I have been pondering lately about why it is that osteopathy seems to be such a useful tool for improving physical comfort and mobility; surely we are built to self-maintain in good health and working order? Yet most people seem to benefit greatly from treatment, whether they are physically active or not.

The answer is complex in detail, but simple in summary: lifestyle!

The truth of the matter is that we are living in a man-made environment, whereas we have spent millions of years evolving in the natural world. Our mind and body have been honed by nature to do one thing, whilst we are steadfastly determined to do something else entirely. Osteopathy respects this natural heritage, and tries to redress the balance somewhat.

What does this have to do with your stiff back?

Put simply, if you don’t use your body the way it was designed to work, it (i.e. you) will suffer. (Notice that I am distinguishing between your body and your self, which is a man-made distinction, and will be the subject of another blog in the near future). For example, human beings were not designed to sit in a chair all day, year upon year. I find it ironic that much is made of “the right way to sit”, whereas ultimately there is no right way; it’s a bit like saying “what’s the right way to hurt my body?”.

Many of the physical, stuctural problems that people encounter with their body is the result of the chair, but it is by no means the only culprit. I mention it here, because it is the accepted way most people spend a huge amount of their precious life, slouching in a chair, just like I am right now. Chairs are a fact of life, but the ill-effects of using them can be greatly moderated by what else you do with your body.

So what do you do about it?

This is a very good question. As someone once said, a good question is difficult to answer, and a very good question may have no answer at all! The point I am making is that it is worth keeping an open mind to what might constitute an answer, because it can be a constant source of enrichment in your life. Many of the wisest souls in the world of health and welbeing have been driven to their understanding through extreme illness or disability; the Chinese character for ‘crisis’ also means ‘opportunity’. So your back ache could be the start of a new chapter of investigation, discovery and enrichment in your life. The most important thing you can do about it is to begin looking for health: investigate, experiment (within reason), and gradually you will begin to make a difference to your own health experience.

Whilst there can be no universal answer, there is a good chance that your back problems are going to improve with conservative treatment. There are always exceptions, and this is a good reason for seeking advice as to whether there is any cause for concern, but most back ache can be at least improved if not transformed by regular, focussed exercises. By that I do not mean a 30 minute run on concrete roads in an old pair of trainers. An osteopathic assessment will look at the structure of your back and the way it moves. Treatment is then designed to bring the structure back towards alignment and balance, and work on the mechanics of joint motion to create ease of function (i.e. movement). And as the musculoskeletal structure (i.e. your spine and limbs) begins to return to functioning in the way it was designed, there is commonly a corresponding sense of ease and wellbeing that patients often comment on as an unexpected bonus.

I am an osteopath in Ealing (and also Uxbridge twice a week) where I provide treatment and pain relief for back pain, neck or shoulder ache… Do get in touch if you have questions or want some advice whether osteopathy can help you.

Tomorrow (christmas eve) the Uxbridge clinic is open, but Ealing will be closed and both clinics are closed on Friday (25th), Saturday and Monday 28th.

Next week – if you need to see an osteopath in Ealing or an osteopath in Uxbridge appointments are available. Both clinics are:

• Open Tuesday 29th
• Open Wednesday 30th
• Open Thursday 31st December
• Closed Friday 1st and Saturday 2nd January
• Open as normal from Monday 4th.

Mathieu, Jessica and I wish everyone a merry christmas and a happy and healthy 2010. Thank you for your support.

This was a question from a patient who was concerned that he might have something seriously wrong with his neck because the clinical treatment alone was not enough to maintain relief of his symptoms. As an osteopath, it is an interesting statement because it points to a fundamental misconception of what constitutes

“doing something to your neck”.

For the patient, sitting in a chair at work 5 days a week was a natural way of life, and not something he expected to result in too many consequences. In terms of biomechanics, that starts to look suspect on many levels, not least in terms of the moulding effect on posture. There is an old saying,

“of all the inventions of Man, nothing is as cruel as the chair”.

What happens to your neck when you sit down is this.

When you sit, you lose the natural inward curve of your low back; the result is that your upper body and head is tilted forward, and therefore you will pull your head back to level your gaze. The modern preference for eye-level screens will exacerbate this unless you maintain the curve in your low back; similarly, leaning forward will exaggerate it. The net effect is that the back of your neck is compressed, much as if you were stood looking at the night sky, or painting a ceiling for hours at a time. The difference in these activities may seem significant to you, but as far as your body is concerned, you are squashing the base of your neck whichever way.

This means that over time, the region around the base of your neck will tighten, and movement will be reduced due to joint compression. Taken over days, weeks, months and years, the effects become more ingrained in the body structure, and you lose the ability to move freely.

Osteopathic treatment can help to counteract the long-term consequences of deskwork, but prescribed exercises will play a big part; without restoring adequate everyday motion to an area, your body will tend to trade off mobility for stability.

The stiffening that my patient was experiencing is a natural economy of needs that your body performs: where motion is used, it will tend to be maintained; where it is not used, it will be discarded. There is truth in that other old saying “use it or lose it”.

I am a registered osteopath in Ealing, and neck pain and back pain are just two complaints/conditions/injuries that we treat. If you have any questions or need some advice, please do contact us. (The Ealing clinic is on The Green, literally a four minute walk from Ealing Broadway).

At the end of a recent treatment session, a patient asked me what was the best type of bag to get from an osteopathic perspective.

My mouth opened and closed a few times before anything came out, followed by a few embryonic thought bubbles. Since then I have given the question some more thought in order to identify what I see as the salient issues concerning bags and backs.

1. Make sure it is fit for purpose
   If you have any specific equipment you have to carry such as a laptop, camera, etc. Someone else has already worked out some of the ergonomic issues for you, so looking at relevant task-specific bags will help you make an informed choice, even if you subsequently buy something else.
2. Make sure it is appropriate for you
   This is less easy to define as we are all unique individuals, but the sort of issues you should take into account are any specific medical or physical conditions that may be affected by carrying the bag. Beyond that, we all have certain postural tendencies and movement patterns that will be influenced by carrying (see below).
3. Carry as close to your body as possible
   This affects both your choice of bag and how you use it. The further away from your body it is, the harder a bag will be to carry, and the more it will alter your posture and movement. This means that a bag should be as flat as is practical, so that you can position the extra weight around your body rather than away from it (bags that you can fit under your arm are much easier to carry than wide bags that bash against your legs).
4. Consider where in relation to your body the extra weight will be placed
   You will automatically use your body to lean away from a bag in order to maintain balance, and then you will use your neck to restore your head to level, with your eyes looking straight ahead. The more weight you are carrying, the more exaggerated this compensatory pattern will be, and the more worthwhile considering whether a wheelie bag is more appropriate.

5. Chose a bag that allows you as many carrying options as possible
   The more variety of carrying options you have, the less you will exaggerate any one postural tendency, and the easier it will be to relieve any stains that develop in the course of everyday use. A bag with back straps, a shoulder strap and a handle gives you plenty of options for variety; a bag with a single strap may limit you to a single carrying method.
6. The way you use the bag is generally more important than what type of bag it is
   Buying a spanking new bag that you carry in the same old way probably wont make much difference to your posture, health or symptoms. By all means try to find something that suits you, but take the opportunity to increase your awareness of your habit patterns, and if eg. you always carry on one shoulder, try changing shoulders regularly; you may discover something that helps you for free.

Lastly, if it all seems too confusing you can always get in touch with us; we may be able to make some suggestions, although there is no substitute for talking face to face in a treatment session (we are located in Ealing and in Uxbridge).

nb. At the recent back show at Earl’s Court, Mathieu saw something called the healthy back bag. The company are in the process of redesigning their computer carrying bag, and have a wide range of fashionable bags; well worth a browse.