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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.

New NHS treatment guidelines have suggested that complementary therapies be used in the treatment of certain conditions: in particular, chronic low back pain sufferers may be referred for osteopathy.

Reactions to this have been mixed. Many welcome these developments, but others have questioned whether there is sufficient evidence to suggest that this approach could be an effective use of precious resources.

For those who are concerned about the effectiveness of osteopathy for low back pain, I would draw your attention to 2 aspects of this issue:

1. Low back Pain is a symptom, not a diagnosis. Many people can have similar symptoms, whilst the causative factors (diagnosis) may be different. Throwing any form of treatment (e.g. massage) at a symptom is rather like throwing darts at a board blindfolded.
2. Osteopathy is a system of healthcare, not a form of treatment. The osteopathic approach strives to understand the symptoms, arrive at an accurate diagnosis, and subsequently deliver appropriate forms of treatment.

Anyone concerned about the appropriateness of osteopathy for the treatment of their symptoms or condition is welcome to talk to us on 01895 20 00 50.

Every day of the week, we are visited by patients complaining of lower back pain, neck pain, head-aches, shoulder, elbow or wrist strains.

Many of them are busy professionals from companies and organisations in the Uxbridge and Hillingdon area. As we gather background information relative to the causes of injury, many of these patients will rather insightfully say

“it must be posture-related”.

In a sense, they are right: as office workers sit at their desk all day, increasingly hunched over their computer screen, so their chest and neck muscles tighten, compressing the vertebrae in their neck, straining their mid and lower back muscles, causing their shoulders, elbows and wrists to function at unnatural angles, and to sustain repetitive strain injuries; and as they cross their legs in these interminable meetings, so their pelvis may become twisted, resulting in lower back pain and lower limb complaints. The current prevailing mood of heightened stress is but an extra potential trigger of the injury process…

However, there is a degree of fatalism in incriminating posture, in other words it is often seen as an inevitable fact of life.

As osteopaths, we hope you would expect us to disagree strongly: with a little awareness focussed on understanding the mechanism of injury, altering the layout of work stations, improving working posture and implementing some basic lifestyle and postural exercise routines, the frequency of work-related injuries can be radically altered.

Over the coming weeks and months, Bridge to Health’s osteopaths will be stepping up their campaign to increase public awareness of how to prevent these types of injuries.

Our June health offer to local employees living or working in and around Uxbridge will centre on a postural assessment and osteopathic treatment, coupled with some practical exercises to enhance posture.

We will also be speaking to our corporate clients to encourage them in a pragmatic approach to work-station ergonomic assessments, coupled with employee training in workplace injury prevention practices.

If you believe you’re suffering from the effects of poor posture, feel free to contact your local osteopath on 01895 20 00 50 (the address for our Osteopathic Clinic in Uxbridge is here). If you think that a conversation with your company’s health and safety representative would be helpful, they are welcome to visit our website www.bridgetohealth.co.uk and then to contact us on the same number.

You do not necessarily need an orthopaedic pillow from a specialist supplier (with a specialist price attached); broadly speaking, you just need something that maintains your body in good head, neck and back alignment. Because of this, the sleeping position you favour is important to your requirement:

if you sleep on your side, you will need a higher pillow than if you sleep on your back, and if you sleep on your front, you probably don’t need one at all.

If you sleep on your side, try to use something that supports your neck as well as your head (this is a feature of orthopaedic pillows, but you can achieve the same result with a bit of effort by tucking the pillow under your neck). If you are struggling to find a comfortable sleeping position for your neck, it may be worth seeing an osteopath in order to assess your vertebral alignment and posture.

Finally, the softness of the pillow is a matter of personal preference so long as the support is adequate.

In April, Peter joined Bridge to Health in Uxbridge, and in his first post on our blog he describes his approach to osteopathic healthcare. Welcome, Peter.

Having trained alongside Mathieu and Marcus, I do not expect to present a radical departure of osteopathic style; however, I do have my own background influences.

I came to osteopathy in the interests of developing and consolidating my awareness of anatomy, physiology and biomechanics; prior to that, I worked with a number of Oriental disciplines, most notably Shiatsu, which is a Japanese form of bodywork performed on a futon mat that manipulates the circulation of Ki (or chi) within the body to enhance health and wellbeing.

The great therapeutic strength of energetic forms of bodywork is in the harnessing of what you might call “life-force”; the great therapeutic strength of western biomechanical bodywork is in the utilisation of anatomical and physiological knowledge and understanding. The synthesis of the two opens up intriguing possibilities.

However, that is all very well, and reminds me of a quote I came across the other day:

in theory, theory and practice are identical, but in practice, they aren’t.

So what does all this have to do with your frozen shoulder, low back pain, tennis elbow, carpal tunnel syndrome, RSI, runner’s knee, stiff neck, bad posture or whatever it is you have that concerns you?

Well, from a practical perspective, treatment is an ongoing multifaceted concept, which may involve anything from manipulation, mobilisation, massage, circulatory stimulation, lymphatic drainage, cranial osteopathy etc. to stretches, exercise activities, dietary adjustments, work-desk reorganisation etc.

But treatment also involves you as a life-force – i.e. a force of life, with the ability to affect change; you yourself can be a far more effective agent of change than any therapeutic intervention, so somewhere along the line, and in whatever way I feel suits the individual concerned, I try to bring that life-force to bear on whatever may be of concern, in the belief that the best service I can offer is to assist the individual in removing some of the barriers to radiant health that they may have inadvertently acquired, and remind them of their own amazing ability to affect change and flourish.