Relief from joints and muscle pain in West Bridgford - Nottingham
Block 4 Rivercrescent, Waterside Way, Nottingham, NG2 4RE

Blog

Archive for February 2013

Chronic Pain Survival Tips

Self-help is really important in overcoming chronic pain including back pain.  Using cheap, easy and effective strategies to help manage symptoms can give you a great sense of control and save time and money.

Understand Pain

Start by understanding about how chronic pain works.  Recent research suggests that chronic pain isunrelated to the amount of tissue damage.  There is a large neurological, sensory and emotional component to chronic pain. Fear of movement, negative thoughts regarding pain and lack of belief that you will get better are powerful emotions that increase chronic pain and are linked with poor recovery. Painful areas often become hypersensitive, to the extent that even normal mechanical stimulation such as stretch or pressure can cause pain sensation.  Learn more about chronic pain here and try reading ‘Explain Pain’ by David Butler.

Here are a series of simple tips to help chronic pain.

Build normal sensation

Gentle sensory stimulation can slowly reduce hypersensitivity.  This can be achieved is various ways.

  • Use heat or cold whichever feels better, taping, tubi-grips, bandages are also good ways to alter sensory stimulus
  • Self-massage and pressure point massage – or get a friend to help massage of apply sustained pressure to painful spots in muscle
  • Stretch – if it feels good, but stop if it doesn’t feel good
  • Gentle movement also known as mobilisation can reduce sensitivity in an area

Activity and Exercise

Movement is essential for health, healing and tissue repair.  Keep moving in whatever way reduces or at least does not aggravate your pain.

  • Be active – take time out to have a relaxing walk.
  • Mobilise – Mobilisation is planned, progressive movement of joints through a smooth, comfortable and pain-free range of motion. Mobilisation can reduce sensitivity in painful areas and relax muscle and loosen restricted joints. Mobilisation is common in Western Pilates and Eastern Tai Chi or Qigong.
  • Balance – working on balance requires muscle co-ordination and helps restore normal sensation in painful areas.  Try sitting on a stability ball or wobble board or cushion for back pain or stand on one leg for ankle or knee pain (as long as this is pain-free)
  • Get in the pool – the pool is a great place to exercise.  Water reduces the load of gravity, provides support for your joints and can often make you feel safer when exercising
  • Exercise for ‘functional’ strength and muscular endurance – the stronger and fitter you feel the less likely our body will experience pain
  • Try and make exercise interesting and fun.  Exercise should be stimulating for both body and mind. Do something you enjoy.
  • Move in new and interesting ways – learning complex movement patterns and exercise skills is the best way to improve posture.  Try new activities, like swimming, dancing, zumba, yoga or tai chi, anything that interests you.
  • Avoid pain – activities and exercise that makes your pain worse should be avoided.  Painful movement just teaches the brain that movement is painful.  For certain activities that aggravate your pain you will eventually need to go through a process of ‘Graded Exposure’.  Graded exposure is about gradually returning to activities that you find painful.  For example, if long walks are painful start with shorter walks over periods you have no pain and build time gradually.  Talking to a professional about how to do this is often useful.  Starting small and building up is key.  For some people with great levels of pain, just visualizing painful movements like lifting may be the first step.

Pace Yourself

‘Pacing’ is the balance between exercise, activity and rest.  Too much or too little rest or exercise can cause increased stress and contribute to chronic pain.  A recovery plan that incorporates the correct levels of exercise, activity and rest is essential.

  • Micro-breaks – take time out from repetitive movement of any sort.  Take breaks from periods of stasis such as sitting at work or driving long distances by taking short breaks to move, stretch or walk around
  • Sleep enough for you – sleep is essential for health, recovery, and lack of sleep is linked to stress, depression, weight gain in fact a whole multitude of negative health outcomes including chronic pain
  • Meditate – ‘mindfulness’ or meditation involves focused and relaxed attention on a task without distraction and has been shown to have large benefits for chronic pain.  Breathing or mobilisation are excellent focuses for meditation.  Think of meditation as focused relaxation and periods of intense mental and physical recovery.  There are many resources out there that can help you for very little time, money or effort.

Relax

De-stress – emotional and psychological stress is linked to chronic pain. Find ways of coping with stress that work for your, whether it be laughter, socializing with friends, taking time out, setting manageable goals.

  • Breathe – stress is not good for back pain and mindful breathing can be an excellent way to reduce pain
  • Set realistic goals – Don’t try to do everything at once.  Plan and re mind yourself  (Red dot therapy, Timers, Alarms, writing goals down and re-read regularly)
  • Enjoy life – a positive outlook goes a long way

Look after your health

Basic health has a large impact on chronic pain.  Being over weight, smoking, excessive stress, poor diet all have a large impact on chronic pain and recovery.

  • Hydrate – a little water goes a long way
  • Check medication – some medications can often include pain as a side-effect
  • Consider allergies, sensitivities and intolerances.  If you have symptoms of fatigue, bloating, or indigestion after eating certain foods you may be sensitive to them.  Wheat, certain sugars, milk are common examples and consuming these may contribute to pain.
  • Try to avoid processed foods and simple sugars
  • Food as medicine – certain foods have anti-inflammatory properties and can help reduce pain if eaten regularly

Explain Pain

Check out this pain video to understand about chronic pain and how it works.

 

Original Movement Functional Exercise

Stephen Tongue, one of the Original Movement team demonstrating some ViPR drills.  Complex movement is one of the best strategies for improving posture and improving varied, three dimensional movement skills is at the heart of the Original Movement philosophy for Functional exercise

Movement Is Medicine

Move for health and wellbeing

Movement is an inherent part of the body; the heart beats 120,000 times a day pumping arterial blood to our tissues, the diaphragm moves 24,000 times per day to help our lungs draw oxygen from the air we breathe, the intestines produce waves of peristaltic motion to support digestion.

All physical movement assists blood in returning to our heart and helps the lymphatic system draw fluid from the extremities.  Without movement our bodies would literally swell, start to ache and the systems that support our health would gradually collapse.  Movement is essential for physical and mental wellbeing.  It is no surprise that sedentary behavior is associated with the increased chronic pain (back pain, neck pain, headaches) and disease.

“Periodic moderate stress is essential for tissue nutrition and healing” (Eyal Lederman) 

The majority of musculoskeletal aches and pains will get worse with lack of movement.  The medical profession now realises that early movement (or joint mobilisation) is critical in rehabilitation. For example, after hip or knee surgery the initial stages of rehab include passive joint mobilisation and patients are advised to walk as soon as they can.  Acute lower back pain responds far better to normal activity than to bed rest.  Whiplash responds better to movement rather than wearing a collar.  Time spent in casts is reducing.   Many of the chronic diseases we struggle to treat with medication can be helped with moderate low impact exercise, including joint degeneration, arthritis, chronic fatigue etc.

Unfortunately keeping active gets harder as modern society supports ease and convenience.   Gadgets and tools make our lives increasing easy and reduce our requirements to move; remote controls, expensive lawn mowers, escalators etc. etc. all remove our need to move.  People work, play and relax in chairs.   Almost a third of people spend more than 12 hours per day sat down.   Osteopath Phil Beach describes ‘Western seated posture’ as a major cause of mechanical pain and feels that getting rid of chairs would significantly improve our musculoskeletal health.

‘Fidgeting’ is the body’s way of coping with the biomechanical stress of ‘stasis’. 

Guidelines suggest we should be taking 10,000 steps per day for health and wellbeing.  We need to find ways to build movement and activity into our daily lives.  We have to look for ‘workout windows’.  Examples of workout windows could be:

  • Walking to the shops rather than driving
  • Play with children or grandchildren, there is no better workout
  • Use stairs instead or escalators
  • Walk the dog
  • Do the gardening
  • Park a little further away
  • Try a dance lesson

These are all opportunities to move and be healthy.  I would also advise:

  • Don’t exercise sat down
  • Try alternative exercise classes Tai Chi, Qui Gong, Zumba, Hula
  • Try using a pedometer for a week (a pedometer is a cheap tool that measure your steps)
  • Try to get rid of a few ‘energy saving’ gadgets

“Those who think they have no time for exercise will sooner or later have to find time for illness.”  ~Edward Stanley

Back Pain Series No. 3. Movement Is Medicine

Move for health and wellbeing

Movement is an inherent part of the body; the heart beats 120,000 times a day pumping arterial blood to our tissues, the diaphragm moves 24,000 times per day to help our lungs draw oxygen from the air we breathe, the intestines produce waves of peristaltic motion to support digestion.

All physical movement assists blood in returning to our heart and helps the lymphatic system draw fluid from the extremities.  Without movement our bodies would literally swell, start to ache and the systems that support our health would gradually collapse.  Movement is essential for physical and mental wellbeing.  It is no surprise that sedentary behavior is associated with the increased chronic pain (back pain, neck pain, headaches) and disease.

“Periodic moderate stress is essential for tissue nutrition and healing” (Eyal Lederman).

The majority of musculoskeletal aches and pains will get worse with lack of movement.  The medical profession now realises that early movement (or joint mobilisation) is critical in rehabilitation. For example, after hip or knee surgery the initial stages of rehab include passive joint mobilisation and patients are advised to walk as soon as they can.  Acute lower back pain responds far better to normal activity than to bed rest.  Whiplash responds better to movement rather than wearing a collar.  Time spent in casts is reducing.   Many of the chronic diseases we struggle to treat with medication can be helped with moderate low impact exercise, including joint degeneration, arthritis, chronic fatigue etc.

Unfortunately keeping active gets harder as modern society supports ease and convenience.   Gadgets and tools make our lives increasing easy and reduce our requirements to move; remote controls, expensive lawn mowers, escalators etc. etc. all remove our need to move.  People work, play and relax in chairs.   Almost a third of people spend more than 12 hours per day sat down.   Osteopath Phil Beach describes ‘Western seated posture’ as a major cause of mechanical pain and feels that getting rid of chairs would significantly improve our musculoskeletal health.

‘Fidgeting’ is the body’s way of coping with the biomechanical stress of ‘stasis’

Guidelines suggest we should be taking 10,000 steps per day for health and wellbeing.  We need to find ways to build movement and activity into our daily lives.  We have to look for ‘workout windows’.  Examples of workout windows could be:

  • Walking to the shops rather than driving
  • Play with children or grandchildren, there is no better workout
  • Use stairs instead or escalators
  • Walk the dog
  • Do the gardening
  • Park a little further away
  • Try a dance lesson

These are all opportunities to move and be healthy.  I would also advise:

  • Don’t exercise sat down
  • Try alternative exercise classes Tai Chi, Qui Gong, Zumba, Hula
  • Try using a pedometer for a week (a pedometer is a cheap tool that measure your steps)
  • Try to get rid of a few ‘energy saving’ gadgets

“Those who think they have no time for exercise will sooner or later have to find time for illness.”  ~Edward Stanley

Anti-Inflammatories For Back Pain

Inflammation is the body’s protective and restorative response to tissue damage.  We know when an area is inflamed because it will often appear hot, swollen, red, painful and stiff.  Inflammation is associated with increased flow of blood to an area, blood that contains the body’s immune cells that help prevent infection.  Unfortunately the body’s inflammatory response can often be excessive and inflammation can contribute to pain and stiffness.

Non-steroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with orthopedic problems including back pain and arthritis. These medications are available over-the-counter or as a prescription. NSAIDs are effective at pain relief (analgesia), and to reduce swelling (anti-inflammatory).

How do NSAIDs work?


Medications that work to reduce inflammation come in two major categories:

  • Steroids (e.g. cortisone)
  • Non-Steroidal Anti-Inflammatory Medications (NSAIDs)

Steroid drugs are a derivative of a natural hormone produced by the body. These medications can be given orally, systemically, or as a localized injection as is commonly used in orthopedics.

NSAIDs work to block the effect of an enzyme called cyclooxygenase. This enzyme is critical in your body’s production of prostaglandins. It is prostaglandins that cause swelling and pain in a condition such as arthritis or bursitis. Therefore by interfering with cyclooxygenase, you decrease the production of prostaglandins, and decrease pain and swelling associated with these conditions.

Unfortunately Prostaglandins also have other important functions in the body. One type of prostaglandin (there are many varieties) helps line the stomach with a protective fluid (called gastric mucosa). When the production of this protective fluid is diminished, some people are at risk for developing stomach ulcers. The most common side-effect is irritation of the stomach. The cause of this is thought to be due to the effect on the stomach lining.

Ideally NSAIDS and other pain relief medications are a short-term solutions to help ease pain and help a return to normal movement.

There are more natural ways to reduce inflammation.  The body is designed to remove excess fluid via the lymphatic system, a series of vessels similar to arteries and veins that transport extracellular fluid or lymph, rather than blood and function without the help of the heart as a pump.  The most powerful way to assist the function of the lymphatic system is with movement.  The repetitive contraction of muscles and fascia squeeze fluid through our body and back to our central circulation.   This is why our feet swell during a flight because there is not enough movement to help pump fluid back up our body.

The function of the lymphatic system is 40 times more efficient during exercise, so if we want to reduce inflammation the best way is to keep moving and take some light pain free exercise.  Move for pain relief and reduced inflammation.  Also be aware that Food can have pro-inflammatory (increase inflammation) and anti-inflammatory properties.  Keeping properly hydrated can also have a body wide anti-inflammatory effect.

For Osteopathic treatment of back pain or other related issues in Nottingham, see www.omosteopathy.co.uk,www.originalmovement.co.uk

Back Pain Series. No 2. What Should I Do?

The back pain series is a number of articles for people suffering from what may have been described by your GP or health practitioner as ‘non-specific’ or ‘simple’ back pain.  We will provide information, practical advice, exercises and strategies to reduce symptoms and limit the impact of back pain on our daily lives.

In the last article we summarised some very simple differences between acute and chronic back pain.  We see that with chronic pain, the level of pain does not reflect the level of tissue damage.  This is why in most cases a GP will not refer you for x-ray in cases of chronic low back pain.  The evidence suggests that radiological findings will rarely reflect the levels of pain you are experiencing.  Before we analyse why this is, we will first identify some of the simple things you should do if you suffering from an episode of chronic back pain or a recent flare up of familiar aches and pain.

What should I do if my back has significantly flared up and I experiencing significant pain or stiffness?

Keep moving.  Gone are the days where doctors recommended bed rest.  Keep moving as much as you can without exacerbating pain.  You will find that although sitting or resting may be pain free, your back will stiffen and symptoms will gradually get worse rather than better.

Use heat or cold.  Comfortable application of heat or cold either in the form of a hot wheat pack or cold pack applied to the area of pain for about 10 minutes should provide relief.  Which is better?  In chronic pain heat is usually more therapeutic but try both and see what feels best for you.

Pain relief medication or anti-inflammatories.  Don’t be afraid to get advice or prescription from you GP for short-term use of pain relief or anti-inflammatories.  Used appropriately these will give you a break from pain and get you moving more normally, which in turn will speed up your recovery.

Avoid aggravating activities.  Hard though it may be, avoid heavy lifting or other painful or aggravating activities.  This is not the time to be doing the gardening or lifting weights in the gym unless you are under appropriate supervision.

What do I need to do to help my back recover?  There are certain factors associated with back pain, poor posture, inflexibility, weak core muscles, excess weight, excessive stress, poor nutrition, dehydration or too much sitting.  These factors need to be reversed.  Make some small changes to your routines that feel achievable.

We will provide videos and information on exercises you can do in 15-20 minutes to improve mobility, strengthen key muscles.  We will cover each of these areas to give you simple strategies to overcome back pain.

For treatment in and around Nottingham see www.omosteopathy.co.uk, or www.originalmovement.co.uk

Back Pain Series, No 1. Acute Vs. Chronic Back Pain

The back pain series is a number of articles for people suffering from what might have been described by your GP or health practitioner as non-specific or simple back pain.  We will provide information, practical advice, exercises and strategies to reduce symptoms and limit the impact of back pain on our daily lives.

What is non-specific or simple low back pain?

We often associate pain with damage or injury.  If we are hurting it is natural to assume something is torn, broken or a part of our body is not working as it should.   This is frequently the case with Acute low back painin which we injure ourselves falling or lifting something too heavy.  In acute back pain tissues such as muscles, ligaments, tendons or even joints are pushed beyond their limits causing damage, inflammation and pain.  Depending on what is damaged acute back pain will usually recover within 3-6 weeks as tissues repair and inflammation reduces.  Whilst we often worry whether we have ‘slipped a disc’, this is rare and only happens in 5% of back injuries.  Pain usually resolves if you avoid painful or aggravating activities such as lifting, if you keep moving (pain and stiffness will usually increase if you remain still for too long either sitting or lying in bed) and a GP or pharmacist will frequently prescribe a mild pain killer or anti-inflammatory such Ibrufen to ease symptoms and help you move normally.

‘Non-specific low back pain’ (NSLBP) is very different.  In NSLBP pain continues beyond a normal time frame for tissue healing and repair.  Pain can come and go, with ‘flare-ups’ occurring in which relatively minor tasks can cause a major exacerbation of pain and stiffness.  Doctors or health practitioners often struggle to identify which specific tissues damaged or what is the cause of pain and in most cases it is unclear why pain is not recovering.  We will call this type of problem as chronic back pain.

Key point.  In acute back pain, symptoms reflects the level of tissue damage and pain will usually resolve in 3-6 weeks given basic care.  In chronic back pain levels of pain do not reflect tissue damage and pain and stiffness can fluctuate over many months or even years.

Certain factors appear to predispose or increase our likelihood of back pain.  These factors include:

  • Poor posture
  • Joint stiffness
  • Weak core muscles
  • Excessive weight
  • Excessive emotional stress
  • Poor nutrition and hydration
  • Too much time spent sitting

In our next article, ‘what should I do if I am suffering from chronic back a pain?’