5o Shades of Pain

Jul 30, 2012
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50 Shades of Pain

Pain is pain, right? Wrong!  Pain can come in a variety of situations, can feel very different and can be slight or severe.  One person’s experience of pain is often very different from another’s.  There are many factors that affect how a person experiences and reacts to pain ranging from their previous experiences of pain to their psychological state at the time they are suffering.

Different structures in the body cause different types of pain.  For example, pain of a muscular origin will behave in a fairly predictable way.  We are all familiar with muscular pain after a long walk or a hard session at the gym and we know that the pain and stiffness is often worse the second day but that it is then likely to ease quickly after that.

Most people will be able to differentiate stomach ache from back pain and neck pain from a headache but there are some types of pain that are hard to tie down.  People often struggle to put their finger on exactly where the pain is in certain shoulder problems.  They know it hurts but can’t quite work out exactly where.

We have all bashed our funny bone at one time or another (which is actually our ulnar nerve, not a bone) and have therefore experienced radiating pain.  Once the nerve is irritated we experience pain, tingling and some numbness in the little and ring fingers despite the fact that nothing has happened to those fingers.  This is because the nerve impulses are interrupted at the elbow and the signals that arrive in the brain are interpreted as pain and altered sensation.

We can also experience referred pain from organs that are suffering in a completely different place to where the organ is.  People who have heart attacks experience pain in their left arm and their throat neither of which overlie the structure of the heart.  The gallbladder, which sits just underneath the liver, can refer pain to the tip of the right shoulder and problems with the function of the lower back and pelvis can be mistaken for knee pain or groin pain.

Often symptoms we see in the clinic are made up of several different aspects and types of pain.  For example, many people we see complaining of lower back pain find they have quite a sharp pain in a very specific area of their back but also have a constant ache in a larger, more diffuse area and stiffness when they try to move.  This may well be because the affected joint in the back is inflamed and therefore causes acute pain when the joint moves whilst the muscles surrounding the area are very tight from trying to protect the joint and cause the aching pain and stiffness.

By finding out which pain is which we can create a much better understanding of the problem and in doing so provide much better and accurately targeted treatment to get rid of the pain.  Once the pain is gone you are free to do … whatever you want with your body!

Breaking News….Exercise is Good for you …. Imagine That!

Jul 19, 2012
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Breaking News …. Exercise is Good for You … Imagine That!

In the news today new research is telling us that inactivity is responsible for almost as many deaths each year as smoking!  That’s about 5.3 million deaths worldwide per year.

We have always known that exercise is good for us.  Plato said “Lack of activity destroys the good condition of every human being while movement and methodical physical exercise save it and preserve it”. But too often we hear excuses for not doing exercise such as not having time or enough money.

I suspect that also people have become scared of exercise, that is to say that when they think of exercise they think of gyms, Lycra and top class athletes that they must emulate.  They see themselves and think “I can’t be like them, I’m so unfit that I couldn’t possibly even get started!”

But we don’t have to run for miles, pump iron in the gym, join a triathlon club or buy a step machine.  If we look at the current health guidelines we should be doing two and a half hours of moderate intensity, aerobic and muscular strengthening exercise.  That equates to less than 26 minutes per day spread over the week.

Exercise can mean anything that raises the heart rate and gets you a bit out of breath.  Walking the dog, going up stairs, gardening, playing with children and even sex all count as exercise.  In fact for human beings exercise as we know it these days is quite an alien concept.  After all sitting still whilst driving several miles to the gym then running on the spot on a treadmill going nowhere for half an hour is completely nuts if you think about it!

According to the Lancet it is about using the body that we have in the way it was designed, which is to walk often, run sometimes, and move in ways where we physically exert ourselves regularly whether that is at work, at home, in transport to and from places, or during leisure time in our daily lives.

So let’s try to think about exercise in a different way.  What if you went for a walk in the evening for twenty minutes, ten minutes from the house and back?  Throughout the working week you would have done an hour and forty minutes exercise already.  Add to that walking up the stairs in the car park rather than taking the lift on Saturday afternoon in town and a bit of vigorous weeding in the garden on Sunday and you are just about there.

People often see exercise as a way to lose weight or get fit for the summer but let’s start to see it for what it should be – for health.  Exercise helps to make your heart stronger, helps to prevent many cancers, tones up muscles preventing back and neck pain and can really help to relieve stress and depression and ultimately helps you live a longer, healthier life.

So let’s all get outside a bit – especially if the weather is about to get better as they promise.  Make a small change and see the benefits – you can always make more changes later.  Let’s get healthier!

In Search of Fitness ….. TRX

Jul 5, 2012
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In Search of Fitness …. TRX
To be honest, I’d never heard of it either and I am told that TRX means Total Body Resistance eXercise (perhaps because its more snappy than TBRE)
I decided to attend the class on a Sunday morning at Phoenix Centre as I knew that the class sizes were small enough to get a good work out and large enough to hide behind others.  Patrizia was the instructor and she quickly got us warming up effectively with various movements and exercises.  After a few minutes of this I was about ready to head home as I realised that my usual running does not really provide a particularly rounded workout.
The TRX is effectively a scaffold with pairs of straps hanging off it.  Each strap has a loop on the end with padded handles.  The idea is that you use your own body weight and lift it to achieve the resistance required.  The good thing though is that by changing the angle or position of your body you can increase or decrease the weight you are lifting.
When I first saw the apparatus I struggled to think of many ways that I could suspend myself from the straps without causing myself some serious injuries but with clear instructions and demonstrations as we went along there were numerous exercise positions used.  These included holding the straps with one or both hands facing forwards, backwards and sideways as well as putting our feet in the straps and doing floor exercises.
Exercises that stand out in the mind are the bicep busting arm curls which involve holding the loops whilst facing the apparatus, leaning away from it and pulling your body upwards.  It feels quite good initially but by the end of the one minute set my biceps were burning with lactic acid.
Also, many people have experienced the Pilates ‘plank’ but imagine doing it with your feet suspended and hovering above the floor where they can swing from side to side!
After 45 minutes of high intensity exercise on the TRX with a period of circuit training in the middle to provide variation I was exhausted.  My muscles felt weak and my legs were most uncooperative when I asked them to allow me to stand up.  I felt muscle fatigue in muscles that I clearly hadn’t used in a very long time and I would happily have stayed lying on the floor for the rest of the day.  However Patrizia was handing around complimentary, freshly prepared protein shakes which would help to reduce the DOMS (Delayed Onset Muscle Soreness) and once I was walking around I began to feel much better, looser and a little smug for having done a really energetic, intense workout.
The next few days I felt some aching in my muscles but nothing too bad.  I found going up stairs felt like hard work but in a funny way it felt good, almost as if my muscles were responding to the workout and becoming fitter as a result.
I enjoyed the class and although it was hard work I did have the option to reduce the workload by altering my body position so I worked as hard as I wanted to.  The class had a really friendly feel and although music was played throughout it helped to keep the tempo of the exercise up rather than being uncomfortably loud.

I did not do this!

Would I do the class again?  Definitely, I feel like this class gives me a good, all round work out, much more than just running or cycling.  Impact is minimal and with guidance from an excellent instructor you know that nothing you do is dangerous.  The class was not daunting in any way and everyone was really friendly.  Anyone would be welcome regardless of their level of fitness or experience.
Booking can be done through the Phoenix Centre on (01403) 800321 and there are several TRX classes through the week to choose from (see  Give it a go – I might see you there.

The Seven Ages of Back Pain

May 30, 2012
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The Seven Ages of Back Pain

The lower back works hard when we lift and we all know that we should be lifting correctly but sometimes it’s just not that easy especially when children are concerned!

1. During pregnancyAs the baby grows your centre of gravity begins to shift and the core muscles get stretched making it more difficult for them to support the lower back during the lifting process.  Extra laxity in the ligaments also means that the lower back and pelvis is in danger of having an acute episode.  Common areas of pain are to one side of the spine or at the top of the buttock.2. With a newbornWhen the baby is small you would imagine that lifting is easy but there is a lot of paraphernalia that goes with a newborn.  The pram, the changing bag, the car seat, not to mention bending to the cot or Moses basket to pick up a distressed child.  Then there is the carrying – all parents will know the subconscious and mildly disturbing rocking that occurs (even when you are not holding the baby).  Holding even a very light infant for prolonged periods of time is very hard work for the muscles of the arms, shoulders, neck and back especially if you are not accustomed to doing so.

3. Pre-toddlers The baby is getting his or her personality and becoming heavier as they are eating more solid food and building their own muscles by learning to crawl and stand.  The lifting required has also changed.  Heavier lifting and often from the floor (or under the table!) means that it may not be possible to get in the correct position to lift making it more likely that your back will suffer.

4. ToddlersEven heavier and now a new challenge … walking and running.  This means you have to keep an eye on them at all times and often have to grab them before they run off in the street or bolt for the hot cup of coffee.  Now your body ends up contorting itself wildly to halt a weighty, fast moving child – recipe for disaster in back terms.

5. Pre-schoolHopefully the children will now be a little more obedient and are not so prone to running off and due to their walking ability and weight lifting becomes heavier but more infrequent and of shorter duration.  Up onto the kitchen counter to put a plaster on a skinned knee and up over country gates when required.  Cuddles are done sitting down though hauling a child up onto your lap from the ground can put an enormous strain on the sacro-iliac joints in the pelvis.

6. School YearsLifting of children is seldom required now but there are bikes to get in and out of the boot of the car and play fights to have on the living room floor.  The child is too heavy to lift now apart from the odd piggy back when its really muddy or way past bed time.  There is also more time now to get back into the sports and activities you used to do but remember you have not done them for quite a long time and adjust the intensity and duration of the exercise accordingly.

7. GrandparentsFar from being immune from the pain children can cause to a back the grandparents can be in even more danger if they are not around all the time.  Children grow quickly and if you don’t lift them regularly your back will not be ‘match fit’ and the shock to the back and neck can be significant when an excited child launches themselves at you upon arrival at your house.

Fortunately, at Back to Health we understand the pain being a parent can cause. And we can help you get back to being pain free – as you like it!

Odd Things You Can Do With Your Body # 2

May 16, 2012
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Win an Arm-wrestle

When challenging somebody to an arm-wrestle it helps to have an edge.  Try this with somebody who is clearly stronger than you.

It is best to arm-wrestle at a low table for this to work best.  You need to stimulate an acupuncture point on your ankle on the same side as the arm you are wrestling with.  For this example we will assume you are wrestling with your right hand.

With your left hand put your finger tip on the point in the midline on the front of the right ankle in the crease.

Stimulate this point by rubbing firmly with your finger throughout the arm-wrestle.  This should make your right arm very strong and make it much more difficult for your opponent to beat you even if they are much stronger than you.

A word of warning – this does not work when you have been drinking!

The acupuncture meridian point on the stomach meridian (Stomach 41) is the tonification point for that meridian.  This means that all muscles on that meridian will be strengthened by stimulating that point.The muscles used during an arm-wrestle are associated with the stomach meridian and are therefore strengthened by stimulating that point.Meridians also have a sedation point which weakens all those muscles thus making it even easier to beat your opponent …. but that’s another story.

Odd Things You Can Do With Your Body # 1

May 9, 2012
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Make your arms float
Standing in a doorway, allow your arms to come away from your sides until they meet the doorframe.  Now push firmly out wards against the frame and keep the pressure up for a minute.  When you release the pressure and walk out of the doorframe your arms will feel like they are floating upwards.
The reason for this is that you are performing an isometric muscle contraction with the Deltoid muscle.  That is to say that you are asking the muscle to contract but not letting it shorten.  By holding the contraction you are reinforcing the neural signals to push the arms outwards.  At the same time there is the phenomenon of synergistic muscles which causes one muscle to relax as another contracts.  For example, when you bend your arm at the elbow you need the bicep to contract but you also need the tricep (at the back of the arm) to relax.  If they both contracted together the arm would not move.
When you walk out from the doorway the neural stimulation causes the deltoid muscles to continue contracting to a small degree and the synergistic muscles are inhibited making the arms feel as though they are floating upwards.

Deltoid Muscle

Pilates and Back Pain

Apr 25, 2012
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Many people that we see in the clinic suffering from back pain, neck pain or any other musculo-skeletal ailment often have an underlying cause for their imbalance.  If the body is not capable of holding itself efficiently then it cannot function properly.  Pilates helps to address the underlying structural imbalances in the body.

We often talk to them about Pilates or Core Strength exercises and can guide them through some simple ways to improve their core strength.  This helps them back to optimal spinal health.


The core is essentially defined by the abdominal wall, the spinal musculature, the pelvic floor and the diaphragm.  In other words, the area below the ribs down to the hips is your core.  There are many muscles that are essential for movement and good posture within this area and Pilates helps you to work on these.


People often talk about posture and think they have poor posture.  What they mean is their ability to align all of the different parts of their body properly.  Good function is more than this though because we don’t often stand still.  We need good alignment or good posture whenever we move.  We need a good dynamic posture.  This allows the body to function normally and allows it to perform daily tasks more efficiently.


The muscles which are largely forgotten are often the most important.  Many of us wish we didn’t have a flabby tummy but instead wish we had a flat “six pack”.  This leads us to hold our tummies in using our six pack muscles (rectus abdominis).  Unfortunately, the muscles we should be using are much deeper than this and cannot readily be seen. Developing core strength allows the correct muscles to be strong and work together well.  It allows them to work to their optimum level at the right time.


By increasing the efficiency of the body’s movement and reducing the strain on the spine and joints we give our body the chance to become more flexible.  It no longer has to work to hold you back from potential injury but can stretch confidently, in the right direction, supported correctly by the other muscles and can achieve better flexibility.


Because we sit for hours in front of computers or do lots of lifting in our jobs we put a great deal of strain on our body without providing it with the strength to be able to cope with those demands.  We also ask it to perform tasks outside of work that are totally different to the ones it is used to doing.  For example, commonly people sit at the desk all week then go and dig the garden at the weekend.  Consequently many people suffer greatly with back pain.

Pilates is a brilliant way to give your body the strength it needs so you can have the freedom to function efficiently.

Marathon Training

Feb 29, 2012
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At this time of year we begin to see more and more people training for the Brighton marathon and suffering from a variety of ailments from back pain, neck pain and muscle strain to headaches and hip pain.  There are a variety of ways in which these injuries are caused and an equally diverse number of ways to treat them.
The following reasons are often the cause of running injury;

Increasing the mileage – At this time of year with Brighton marathon approaching in April people are increasing their mileage
above what their body has ever done before.  As a result the muscles are required to work harder for longer and require more nutrition and hydration.  Poor hydration and lack of nutrients and salts can cause muscle strain and muscle injury.  It is essential to take on plenty of fluids and nutrition before and during the training run as well as the race itself.

Poor technique – As the mileage increases the muscles become tired and find it difficult to keep good running posture and technique.  This results in the body trying to compensate to engage other muscles and use joints differently causing back pain, muscle
pain and joint pain.  Often people find that they are fine running for, say, ten miles but then they will begin to get blisters.  This is because their technique begins to change at the point when their body gets tired and their feet strike the ground differently causing blisters.

The camber of the road – Road running is known to be quite hard on the joints and can cause wear and tear in the knees after long periods.  But also, running on one side of the road all the time unbalances the body quite quickly.  The road is not flat and is higher in the centre than at the sides to aid drainage of rain water into the gutters but this also means that it causes you to run out of balance.  This effect is reduced if running on the pavement, in the park or along Brighton seafront.  The effect is, however magnified in the countryside where there are often no pavements and an increased camber.  Runners should try to run on alternate sides of the road, use footpaths or stay off the road completely to avoid back pain from asymmetrical running.  During the race try to run in the middle of the road.

Stretching and ice – Stretching has long been known about….and long been ignored by people training for marathons.  Stretching can be very useful in reducing the pain and stiffness associated with training session (known as DOMS).  Stretching helps the body get rid of all the lactic acid built up in the muscles which is known to cause pain.  Ice has a similar effect and many top athletes now have an ice bath after races to aid the recovery of the muscles.  Many people can be seen after the Brighton marathon sitting in the sea to gain a similar effect – it’s not icy but it’s still pretty chilly!  Ice baths should only be taken if you have sought advice from your GP as they can
be a big shock to your body and cause sudden health problems.

Sometimes osteopathic manipulation is used to treat these problems but often advice regarding the maintenance of good muscles is important.  We try to make sure that the body is functioning correctly and in a balanced way.  The muscles should be supple and strong and the back and neck free from restrictions (which are often caused by work!)
Follow the advice above for injury free training and an enjoyable
marathon experience.

The Dangers of Holidays!

Jul 22, 2011
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We all look forward to going on holiday to the sun but we often don’t think of the dangers for our backs.  Here are some of the top problems that people suffer with and tips to avoid pain and discomfort while you are away.
Most people are aware of the dangers from Deep Vein Thrombosis when taking long flights but they don’t realise that many peoples bodies are not used to sitting for extended periods of time.  If your job and lifestyle keep you on your feet all the time then sitting for hours on end will be a big challenge for your back.  Try to get up and move around during the flight, walking along the aisles or to the toilet regularly.  Also keep your legs moving.  Rolling your ankles in a circle, pointing your toes and lifting your thighs will all help to discourage joint and muscle pain and DVT.
Arrival at the baggage reclaim area usually means standing around for ages waiting for the belt to begin moving, cramming into the crowd to get to the bags passing by and then dragging them off the conveyor.  This is an ideal time to walk about slowly to get the muscles loosened.  Gentle stretching can make you feel more alert and drinking water will help to rehydrate you.
Try standing away from the crowded areas at the conveyor, that way you can see your bags coming and will have plenty of time to get them off without bending awkwardly between two people.  Bend the knees and get one bag at a time.
The best hotels in the world may have the best bed in the world – but it’s not your bed!  Your body is used to your bed and will often
feel stiff and sore after a night in another. 
Before you get out of bed try rocking your bent knees from side to side and hugging your knees up to your chest. This will help your lower back to loosen.  Get up slowly and carefully and move around the room before charging down to the pool.
Many sunbeds do not fold completely flat which is fine while you are tanning your front.  The problems begin when you turn onto your
front to tan your back.  When lying on your front your Lumbar spine will be held in an extended position (i.e. bent backwards) and the joints will be forced together.  When you begin to feel uncomfortable you may realise that you still have twenty minutes to go before its time to turn over so decide to ignore the aching. 
Don’t!  The discomfort you feel is your body telling you it is not able to cope with that position and that it needs you to move.
If you do get acute back pain use an ice pack immediately for 10 minutes every half hour and keep moving as much
as you can.  Lying on your back on the floor or bed with your knees bent may be comfortable.  Then give us a call when you get back.

5 Ways to Pain Free Gardening

Jun 25, 2011
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At this time of year osteopaths see a lot of people with back pain resulting from gardening injuries.
Whilst back pain is a very common ailment in the population there are ways to prevent back pain and neck pain ruining your love of gardening.
LIFT SMALLER LOADS – Often we see people at garden centres loading up their cars with sacks of wood chips, top soil and compost. 
Bear in mind that you will have to lift them several times; into the car, out of the car and to wherever you are working in the garden.  By taking care to lift one at a time (ideally between two people), bending your knees and keeping your back straight your back and neck will endure minimum strain.
USE A WHEEL BARROW – Moving heavy compost and plant pots around the garden can easily strain your back or give you neck pain. 
By using a wheel barrow even for short trips this risk can be reduced.
LITTLE AND OFTEN – As an osteopath, the majority of people I see at this time of year with acute pain are gardeners who have tried to do too much in one day.  Typically they have a job that does not involve lifting and so their back is not accustomed to that type of
activity.  Also they don’t spend much time gardening throughout the year and consequently they need to do a lot in the spring.  By doing a small amount several times a week the risk of back and neck injury is vastly reduced.
SWAP ACTIVITIES REGULARLY – Gardens and flower beds can be quite large and accordingly keeping them tidy can be big jobs. 
Weeding, pruning and mowing can all be enough to cause injury if done too much.  By doing a period of weeding then leaving it to mow a part of the lawn before returning to the weeding gives the back muscles a chance to recover and therefore reduces the chance of back
KNEEL TO WEED – Osteopaths often see people bending from the hips when working on the ground.  By simply kneeling on a pad the
spine can be supported by leaning on one hand and using the other to pull weeds.
AFTERWARDS – HAVE A HOT BATH OR USE AN ICE PACK – Tired muscles respond very well to heat and helps to prevent them from seizing up.  Alternatively, if you have any pain in the back or in the muscles put an ice pack on the area for ten minutes to reduce any inflammation.  Details of how to use an ice pack can be found on our website
If you do injure yourself and need help don’t hesitate to contact us at Back to Health.  We know about back pain!
  • Not sure if osteopathy is for you?

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