Tim Hanwell, Principal Osteopath and Director of IDD Therapy at Berkhamsted Osteopaths, gives his expert advice...
If we get out of bed one morning with a bit of back pain it’s easy to put it down to ‘just one of those things’ that will take care of itself. We have no idea how or why it happened but we shrug it off as something everyone has to put up with now and then.
A few days later, when the pain still hasn’t subsided, we might try some over-the counter pain relief such as Ibuprofen or paracetamol.
It’s only probably a week or two later when the pain has become quite debilitating that we might take ourselves off to the GP, who has a whole cabinet of pain relief and muscle relaxants that are bound to do the trick.
By now, if all this has failed, we might start considering Pilates, yoga, swimming, acupuncture and hot and cold packs to change the blood flow to the body.
The worst thing about all this is that we are now possibly three or four weeks into the problem and there has been little relief from the pain, which can be depressing and draining.
Many years ago, the advice for back pain sufferers was always bed rest and pain killers, but over the years that’s changed and we now know that backs heal better when there is movement in the muscles and joints.
However, when you are in severe pain you are unlikely to feel like moving around, so you do instinctively move less. But lying down and resting will not do any good in the long term.
What can you do during lockdown?
During lockdown there are still a number of things you can do to help yourself.
If you have an acute musculoskeletal injury (this is where there has been a sudden onset of pain often due to a memorable incident and the injured area may feel hot and swollen), often placing an ice pack (wrapped in a towel to avoid ice burning the skin) on the injured area for 5 minutes and then removed for 5 minutes and repeated will help ease the pain. If your symptoms are stiffer in nature with no memorable injury then movement and heat can often be beneficial. Taking anti-inflammatories or arnica could help improve your symptoms or rubbing gels and creams into the painful site might help too.
Inevitably, we have been seeing an increased number of people suffering from pain due to poor posture whilst sitting at their PC/laptop at home since lockdown. This is usually non-traumatic in nature but more of a repetitive nature causing neck, shoulder or arm pains. Adjusting your workstation setup is usually a good starting point. Videocalls are available here. Try to avoid sitting for more than 45 minutes at a time and make sure you take your daily allowance of fresh air; this is not only beneficial for your musculoskeletal system but also for your circulation and eye health.
Simple stretches to help offset the hours of sitting are also beneficial, I recommend the cat/cow, pectoral stretches, hamstring, calf and hip flexor stretches. There are plenty of free to view yoga websites if you are unsure of these techniques. Also remember that many osteopathic and physio clinics are still offering advice over the phone or videocall during lockdown if you require one to one help.
Two types of instances when people seek help for back pain
Sometimes the reason is obvious. We remember lifting something awkwardly or tripping clumsily and feeling something ‘give’ in our backs.
For example, manual labourers who are lifting repetitively will often seek help from an osteopath after just one incident – they prefer not to ‘wait and see’ as time off work is lost income.
But then there are those who have no idea what has caused the pain and these tend to fall into the category of ‘postural breakdown’.
We are seeing more people now who are being asked to sit for ridiculously long hours in the workplace.
They are bent over laptops and computers and their backs are fixed into a static position for great swathes of the day. It is essential that we are proactive in minimising the build up to back pain caused by our everyday lives.
Avoiding back pain caused in the workplace and at home
- Leave your desk every 45 minutes. Set a timer on your watch or screen saver to remind you to walk around and stretch. Do a few laps of the office/house.
- Make sure your desk and chair are positioned correctly and in a comfortable position; that puts the least strain on your back.
- Try a sit/stand desk. People have been known to lose weight by making no other changes in their lives than this and it’s a good way to provide some variety for the lower back.
- Don’t be too efficient by trying to multi-task such as taking a loo break and grabbing a glass of water on the way back. Take these as separate breaks and only fill a small glass so that you have to get up again.
- Put a bin in the centre of the office or put your own bin away from your desk so that you need to get up to throw away your rubbish. Likewise, the printer should entail a bit of a walk if possible.
Outside lockdown, the next obvious step to alleviate long-term back pain is…
A visit to an osteopath or a physiotherapist
An osteopath will generally aim to stretch and loosen up the muscles and joints through mobilisation and manipulation while an NHS physiotherapist will tend to opt for a series of exercise-based treatments.
If this fails, the patient will begin to consider…
Steroid injections and surgery
These are a last resort that people reach out for when they have tried absolutely everything else.
Around 6 years ago I was in that hopeless position myself, in such terrible pain that I was considering surgery. People forget that osteopaths and physiotherapists often suffer back pain themselves due to the physical requirements of their work.
Whilst I was researching spinal surgery online, I discovered IDD Therapy, and I felt it could offer me the relief I was looking for. My pain had been caused by a compression injury and the decompression IDD Therapy offered made complete sense.
By my third session I was starting to feel better and I even got back the power in my big toe that I didn’t even realise I had lost. I was so impressed I bought a machine for my own practice.
IDD is a computer-controlled treatment that helps decompress the specific spinal segment causing the pain. Patients lie on a treatment couch where they are connected to a machine with a pelvic and a chest harness. The machine applies a gentle pulling force at a precise angle to take pressure off the targeted disc and to gently mobilise the joint and surrounding muscles.
What is unique is the angle of the stretch. Most of the time our bodies are pressed into the ground due to gravity. Nothing really stretches the spine like this does. The goal is to relieve muscle spasm, and as the pain subsides therapists use gentle manual therapy to strengthen the back.
A patient recently contacted me to say she had run a marathon after her course of IDD. Although she had been a runner in the past, she believed her days of pounding the streets were well and truly over.
Around three quarters of people with long-term back pain who come for IDD Therapy get better and many more see a marked improvement. IDD Therapy aims to reduce the back pain to the extent that it is either no longer present, or, at worst, is so mild that it has no detrimental effect on daily life.
My only problem these days is not being able to get on the machine myself for a treatment as it is so in demand!
About the author
Tim Hanwell is the Principal Osteopath and Director of IDD Therapy at Berkhamsted Osteopaths and an osteopath at the London School of Economics Treatment Clinic in London.
IDD Therapy (Intervertebral Differential Dynamics) is the fastest growing non-surgical spinal treatment for intervertebral discs with over 1,000 clinics worldwide and a network of clinics across the UK.
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