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Understanding Back Pain

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Written by Mindi Cotton | Posted on January 7, 2019
Melinda Examines for Low Back Pain
Osteopath Melinda Treating the Painful Mid Back

Osteopaths are famous for back pain treatment, but so many people wonder why they get the problems they do with all the different kinds of back pain.
Principal Fulham Osteopath Andrew Cotton explains back pain, what are it’s causes and what treatment is most appropriate for back pain.

What is back pain?

Back Pain, You are not the only one…

Back Pain is something most people suffer with at some point in their lives. But why? We don’t all routinely suffer with elbow pain or finger pain, so what is special about the low back?

Any mechanism, including the human low back, is designed for its purpose. We developed over hundreds of thousands of years to hunt, swim, and farm. Our backs are good at that, and research has shown indigenous native peoples suffer very little with chronic low back pain (CLBP). We are perhaps not so well designed to sit all day, look at laptops in bed or spend hours gaming on a PC or Smartphone!

the neck is in a sharp curve
Here the back is in a long curve backwards which comes back level with a shatp kink in the neck.
Back is straighter, longer
See how the back is straighter, longer, and the neck is now upright.

As you can see the back can be bent and “strained” by how we use it. Some parts get squashed and compressed, while others get stretched and weakened. The spine is a complex structure, and as it moves off of it’s natural, upright balance, so it acquires strains, stiffnesses and pains, which sow the seeds for further strains elsewhere. The picture becomes chaotic, the spine a map or record of the accidents and maltreatments that we have all had. This process is of increasing “Entropy”, or disorder. This may require an external agent to evaluate and remedy the trouble, as the body’s natural powers of self correction are overwhelmed, or even contribute to the problem through overreaction.

It is the mark of a good treatment for your back, or a series of exercises like Pilates or Yoga, if it starts to smooth out these strains and reverses the process of accumulating trouble, so your back feels free, flexible and right again so you can get on with life.

It is not always obvious, but if your back in strained or injured it has to heal itself. We have a fantastic repair system that mops up damage, lays down support to protect the injury and then gets on with repairs. A treatment for your back must help this repair process, find out why it happened (cause), what it is (effect) and what is to be done (a plan!).

This is the art of the Physical Therapist, to read the situation in all its complexity and set the person on the road to recovery, safely and effectively.

Symptoms of Back Pain

Does the following list sound at all familiar?

  • Low back Pain, Mid Back Pain, Neck Pain
  • Lumbago, Backache
  • Soreness after exercise
  • Something “catches” in your back
  • Twinges
  • Spasms
  • Excess tension, Burning, Aching Back Pain
  • Shooting pain
  • Nondescript, hard to explain or vague Back Pain

Back pain can be vague or quite severe. You may have heard of “Psycho Somatic Pain” and wonder if stress or imagination has a role in what you feel. Actually people are quite accurate in what they feel - you shouldn’t feel any discomfort, and if it does not clear up in a few days it will benefit from a checkover and treatment.

Back Pain Treatment

Treatment for the back will usually involve elements from the following.

  • Enquiring how it happened
  • Examining to find tenderness, swelling, mis-position etc
  • Calming the nervous system to move the body from a state of alarm and action to a state of healing and repair
  • Gently balancing and easing the structure to allow circulation and drainage
  • Giving advice regarding rest and or exercise

How is back pain treated? The approach of most therapies is similar. First, is the pain due to an injury, where some tissue is damaged, or is the pain due to sensitivity, where the body reports injury as pain but no damage has actually occurred. There is often an element of both in many cases.

Back Pain due to hypersensitivity (Neurogenic Pain)

It may be in the person’s interest to overreact to a problem, so that the person takes it seriously and looks after themselves. This is a natural phenomenon, and encourages us to listen to our body and alter what we are doing. If one takes a painkiller in this scenario, the wisdom of the body is ignored, and you run the risk of aggravating the back pain. If the problem is due to hypersensitivity - “neurogenic” or nerve created pain which is perhaps an overreaction to an innocuous problem, then sometimes pain relief, if it helps sleep and relaxation, may be helpful. Physical treatment can help more naturally, using techniques which listen and communicate with the body, and calm the nerves down without simply switching them off. This may include discussing stress and diet, as many things often add together to create a state of excitability.

Back Pain and Sciatica due to injury

Back injury treatment will depend on the tissue involved.

  • Muscle Pain - The muscle may be fatigued, tight and stringy. The reason for the overuse must be addressed, and then the muscle relaxed using massage or functional (feedback) approaches
  • Joint Pain - whether due to arthritis, sprain or congestion, the joint needs to be carefully brought into normal relations (straightened out) so that and strain is relieved.This is achieved by articulation (gentle movement of the joint) encouraging balance. Normal micro movements of the joints encourage circulation and drainage, swelling is reduced and repair encouraged. Pain should be eased, but can be briefly increased (healing reaction). This represents a rapid acceleration of the healing process, and typically lasts for 12-24 hours.
  • Disc Pain - Between our vertebrae (back bones) are rubbery pads filled with jelly, much like an old fashioned jam doughnut. If the spine strains forward too much the jam in the doughnut (jelly in the disc) can squidge backwards and irritate the nerves in your back (sciatica- pain down the back of the leg). The treatment is to decompress and straighten the bones either side of the disc, encourage support of the spine with core exercises etc, and swimming or other supportive exercise to promote recovery. Disc healing can be quite slow, and the injury must be respected. If there is weakness or numbness in the leg or foot a scan (MRI) may be required. The trapped nerve causes the dreaded “sciatica”, pain down the buttock and the back of the leg. Because part of the entrapment of the nerve is swelling around the injury, Osteopathy can help relieve sciatica because our treatment will encourage “micro movements” of the cells and tissues, drastically improving drainage and so relieving swelling and pain.


You may have had a diagnosis of Stenosis, perhaps after an MRI scan or X-Ray.

This rather scary diagnosis just means a bit of nerve pinching from compression in the spine or swelling around a small facet joint.

We usually have good success with this and it’s associated sciatica, if you have that. That is because we try to find normal in your body, and in normal conditions the body can heal itself.


Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain

Large Study of Osteopathy Treatment for Back Pain

Back Pain on Wikipedia

"I would fully recommend Melindas insightful way of working"

Category; Osteopathy and Natural Therapies

"Having previously had lower back problems, I was obviously worried when I fell pregnant that my back would flare up again, or get worse. Unfortunately for me it did, with a little sciatica thrown in for good measure, but Melinda at the Fulham Osteopath Practice set me on the right path again. After only a couple of appointments my back was in much better shape, and the sciatica practically gone. With only a few weeks to go until the birth of my first child my back is now in great shape, due a few more maintenance appointments, and I would fully recommend Melindas insightful way of working and also tips for labour and its lead up, ensuring a healthy back, body and mind. Thank you!"

Written by: Jessica Littlewood - PR Manager

Osteopathy Treatment with Melinda
Date published: 10/02/2008

5 / 5 stars

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