PAIN MANAGEMENT–ADULTS & OLDER PEOPLE
SPINE PAIN, SCIATICA (SCIATIC NERVE), LOW BACK PAIN, OSTEOPOROSIS, NECK, SHOULDER & ARMS PAIN
HEALTHY LIFE, introduces advanced pain management treatments & therapies, and has called it – DOULEUR THERAPY. It is a system of manual therapy that is recognised as part of the national health system in many western countries. It encourages the body to move as freely and as pain-free as possible by helping to restore normal function to affected structures.
In addition to standardised tests, machine aided and manual therapeutic care, movement & observation to diagnose and treat physiological or mechanical disturbances in the body. This may include spinal and peripheral joint manipulation, soft tissue techniques such as massage & other aids andwith prescribed exercises to help to stretch and stabilise the body.
Some therapies just concentrate on spinal manipulation while others may only focus on massage and exercises. Douleur Therapy is able to cover both of these modalities.
Shoulder pain or neck pain
If you’ve got shoulder pain or neck pain, a pinched nerve or issues from a neck injury, then you’re in good company with the many patients we’ve helped. And if you’re one of the many who sit in front of a computer all day, you probably have learned to live with a tight neck and shoulders.
As with all problems, trying to diagnose yourself using the Internet or listening to friends who’ve had neck pain is unreliable — and it’s only half of the problem. The other more critical half is to know what to do about it.That’s where we’re trained to help.
Work and Posture
Is your work giving you grief?
Neck and shoulder pain often go together, which is not surprising given that they share many muscles. The shape of the neck is also directly affected by our posture and how our shoulders ‘sit’ or slouch in relation to the rest of our body.
Poor posture, especially hour after hour at the desk, is a major cause of sore neck & shoulder muscles because these become overworked & irritated from inadequate circulation in the tissues. This leads to weakness in the muscles, which only makes the problem worse. Stress commonly affects pain in these areas too.
You’ll be surprised at how much better you can feel after just a few treatments and some taking on board some common sense advice about work habits and self care.
This will be covered in another section, however many headaches are routinely caused by tightness of the muscles between the base of your skull & your upper neck. These then irritate the nerves passing through them to your head, giving you a headache. This is easy to treat.
Migraines & other types of headaches (e.g migraines linked to hormonal changes) occur for different reasons & the effectiveness of treatment depends on the cause.
Pins and needles or weakness in the arm or hand?
This needs experience to diagnose as the source of the problem could be anywhere along the nerve from the neck to the arm. As an example, Carpal Tunnel (tingling, numbness or pain) is usually confined to the hand, often strikes at night & has its cause outside the neck.
But a disc problem or degeneration in the lower neck also need to be considered as a possible reason. The treatment, of course, will be different depending on the cause, and in some cases we may need to refer you to your GP.
Have you had whiplash or banged your head?
Neck injuries can cause spasm and extreme tenderness in the muscles of the neck and shoulders, and both need caution in assessing to make sure that no serious damage has occurred. They can also lead to dizziness, vertigo (when the room seems to move around you) & headaches, all of which can be helped. Gentle and non invasive treatment is the best way to calm the tissues and reduce the levels of sensitivity.
Lower Back Pain
Lower back pain is one of the most frequent pain .
If you’ve had acute problems with your lower back you’ll know just how much we take a normal back for granted.
You start envying anyone who can move normally & you may experience impatience from other people who have never had bad lower back pain!
Firstly, some re-assurance.
You can have a perfect back on x-ray and still experience severe lower back pain.
This is common. The reverse also applies – x rays that show a lot of wear and tear which is not causing any pain.
In other words, x rays are often of limited value in telling us why someone is in pain. Having lower back pain doesn’t mean you’ve got severe damage.
Many cases of back pain happen because the spine has become progressively more restricted over time. The means that movement is not shared between all the spine, but focused too much on one particular section. This results in too much movement in that section & painful spasm, often with just a trivial movement (e.g. bending down to pick something small off the floor)
The good news is that this is usually easy to treat, with significant easing of pain after your first visit and a quick return to normality soon after.
In young adults, disc problems are more common, often caused by bending and lifting. They cause ‘pinched nerves’, the best known of which is SCIATICA, a shooting pain down the back of the leg as far as the foot. Numbness or tingling in the legs may also be experienced.
Except for the more severe cases, disc injuries do get better, but will often take months to do so, partly because they are constantly under pressure from the weight of the rest of the body, and also because of the kind of tissue they are made of, which takes longer to mend. Milder injuries do occur and can resolve quite quickly.
In both cases, our treatments significantly improve comfort levels and may speed your recovery by making sure the rest of the spine and body are able to move as well as possible. This helps distribute stresses along the whole length of the spine & reducing it on the affected area.
Other causes of low back pain
- These are more common in younger adults and may be due to a severe impact. In the elderly, one has to consider reduced bone density (as in osteoporosis) as a possible cause. The key to relief is often good management, which is something we can help with.
- Osteoarthritis(wear and tear) affects most people more as they age, though this process can start much earlier with heavy manual jobs or a history of injuries.
- Falls & slips. These often change the mechanics of the hop bones (the pelvis), resulting in the spine and body resting on an uneven foundation.
- Pregnancy back pain.Many pregnant women experience back pain and are commonly told that it is ‘normal’ and that there is no effective treatment. The results patients have had say different.
Both the mechanical stresses and the hormonal changes in the body can lead to the onset of this pain. It can also present very early in the pregnancy, particularly if there has been previous back pain history or trauma.
Occasionally the baby can lie on the sciatic nerve in which case treatment may not help.
Our treatment is usually effective & SAFE for both mother & child within a short number of treatments .
During delivery the tissues in the pelvis are easily strained and may not return to their normal position when the delivery is over. Typically the woman should be pain free within two weeks of delivery although it can take longer to feel that her pelvis has returned to normal.
Again treatment at this stage can be very effective.
First things first:
Not all pain down the leg is SCIATICA, but as it’s about the only cause of leg pain most people have heard about, it’s often what they most commonly self diagnose as the reason for their pain. In this respect it’s quite similar to people calling any bad headache a migraine , so over diagnosis is frequent.
Sciatic pain comes from irritation of the sciatic nerve, which runs from the lower part of our spine, through the buttock, down the back of the thigh and leg, usually a bit towards the outer edge. This is where the pain is felt and it’s quite unique – more like a deep toothache or even ‘electric’ compared to simple muscular pain.
Pain down the side or front of the leg or thigh is not sciatic, and some pains in the right area may be due to referred pain from other structures such as spinal joints. This is a bit like neck pain causing referred pain in the shoulder – the location of the pain and the problem are not always the same. This is also true of a problem with the sacro iliac joint, which may refer pain there and/or in the groin or down the inside of the thigh.
Other nerves can also cause leg pain, pins and needles, numbness or even weakness. For example, the femoral nerve is associated with front of thigh pain, whilst the obturator nerve is related to an area on the inside of the thigh.
What causes it?
The nerve can be irritated by mechanical compression from a tight muscle, often in the buttock, or a protruding disc pressing on it in the lower back, or by chemical irritation.
This may happen if a nearby structure in the lower back has been injured. The chemical ‘soup’ produced during the healing process of inflammation is irritating in itself, but the accumulation of liquid pressure in the limited space of the spinal joint can also compress the nerve. In these cases, a course of anti inflammatory medication can be a great help in managing the symptoms.
If the degeneration has gone too far, it may be that the pain will never go completely, but that it can at least be kept to a manageable level.
Chemical irritation can come from an injured disc, for example from heavy lifting whilst leaning forwards, or from a prolapsed disc. The difference is that with the latter, the disc material itself has ballooned out to one side to squash up against the nerve.
SCIATICA in pregnancy is common, and most likely due to the greater postural stresses on the lower back and buttock muscles. This stress comes not only from a growing baby, but also from the changed posture needed to compensate for the growing belly, and it’s most visible in the typical backward lean of the heavily pregnant mother.
In older people, a longer history of sciatic pain may indicate that a condition known as stenosis has set in. Stenosis just means a narrowing of the tunnel through which the nerve passes coming out from the spine so that it is pinched. This is due to to irregular bone growth happening in a rather haphazard fashion. If everything else fails, surgery may be the only alternative to widen and smooth out the tunnels.
There are other less common but serious causes of SCIATICA which cannot be treated with manual therapy, and these will need to be considered and ruled out during your consultation.
Can we help?
The first step is to find the location and cause of the irritation; usually in the buttock or lower back. Most of the treatment will then focus on stretching and relaxing the muscles if that is the fault, or getting more movement in the affected spinal joint. De-compressing the nerve will also help recovery.
- Physiotherapy for Spine, Knee, Joint Pain = Rs.500 per session
- Physiotherapy for Strengthening Weak Bones & Building
Stronger Muscles = Rs.500 per session.
- Accupunture for Pain & Health + Pain Reduction Light Treatment = Rs.500 per session