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Back Pain, Sciatica and Osteoarthritis

Most patients that book in to see me have a problem with their lower back. This can be obvious to them when movement is painful at the site, however, longstanding issues can result in symptoms at different places in the body.

Sciatica is leg pain, often just one leg, caused by compression in the lower back. If the pain worsens with pressure from sneezing or coughing, the cause is probably a 'slipped disc' - technically a disc bulge affecting the sciatic nerve. In elderly patients discs are less likely to bulge as much so this becomes less of a problem. The older patient is more likely to have bone spurs, less height in the spine - so not so much room for the nerves to exit the spinal cord and hence pain. Stiffness in the mornings in older patients is more likely to be osteoarthritis (OA) which often has bone spurs. Just about everyone over the age of 25 years has some OA but do not notice it if they have an active life.

Lower back problems, especially longstanding may just give neck and shoulder symptoms. You can feel muscles move throughout your back as you move your arms and shoulders. If these are not balanced stiffness, nerve entrapment, numbness and tingling can occur as you move your head and arms, numbness and tingling often in the fingers with sharp shooting 'electric' pain on head movement for certain positions.

What does 'balanced' mean? Every muscle is controlled in some way by the brain and spinal cord. Every muscle when contracting has an opposing muscle which relaxes making the movement controlled. Any nerve interference along the pathway from the brain to the muscle may cause an imbalance to opposing muscle action. This can lead to nerve entrapment, lack of movement and many forms of pain. If you have sat in a draught or had whiplash, the lower back may not be involved in your neck pain, but in most cases there has been no trauma to the neck directly and in these cases it is worth getting your lower back checked out.

There are many ways to balance muscles and all involve the brain to muscle communication. At our clinic the treatment is tailored to the patient, but normally entails gentle adjusting to specific points in the lower back and pelvis. There is an immediate result in smooth movement particularly at the shoulders. This may last any time from a few seconds to months. Repeat visits are necessary to work through a lifetime of imbalances building up in your body but most patients feel improvement quickly once swelling has subsided which may take a few days. Read more about 'balance' in following blog entries.

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