Back Pain Treatment In Swansea
Back pain affects 1.1 million people each year in the UK. Of those 1.1 million 95% are lower back pain. Most lower back pain is nothing more serious than a sprain, strain or irritated nerve. Serious causes such as spinal stenosis and trapped nerve are rare.
If you’ve suffered back pain that won’t go away you might have had an MRI scan to ascertain whats causing the damage. Whilst undoubtedly very useful, care must be taken to take MRI information in context.
Ninety eight healthy people with no back pain had their backs MRI’d in a 1995 study by the New England Journal Of Medicine. An astounding 52% had disk protrusions in their lower back but no pain. What you see on an MRI does not alway correspond with the pain you subjectively feel.
So why don’t MRI’s tell the truth?
Well, it’s not that they don’t tell the truth its just that on the whole they only tell part of the truth… and the surgeon or consultant fills in the gaps. They can tell you a lot about the musculo-skeletal & vascular structures such as arteries, but they don’t go in to fine detail. Nerves don’t show up on standard MRI scans.
I see a lot of patients who have been told that their MRI scans show an impingement of a particular nerve at a particular vertebra. Technically this isn’t true, what you normally see is a herniation or protrusion of the disc. The Specialist, with knowledge of the nervous system, then infers that this herniation is pressing on the nerve causing the pain. The truth is though that you can’t see nerves on MRI’s (at the moment).
I’m not trying to be pedantic but rather press home the point that an MRI is a crude diagnostic tool. Not the truth of back pain.
If you’re finding this hard to swallow have a look at the British Association of Spine Surgeons article on MRI and back pain. Quoting them “Magnetic Resonance Imaging Scans (MRI scans) give a very clear picture of the structure of the spine. It does not tell the doctor why the spine is painful. In 85% of patients we are unable to say why back pain occurs”.
So what’s causing the pain?
Two Theories of Back Pain
Before I start its important to realise that any theory for the mechanism of back pain is just that. A theory. No-one – not even neurologists have a water tight theory for the mechanisms of back pain.
I have two main theories that I adhere to:
1. Trigger Points: Trigger points are areas of soft tissue that become starved of blood supply and nutrients. Low on blood supply they are unable to remove waste products from the local tissue and become sensitive to the touch. They can often refer pain to distal parts of the body. One such example is tightness under the base of the skull (occiput). A trigger point in this area can refer pain through to the front of the head. Needling the back of the neck often significantly alleviates this type of tension headache.
2. Misfiring Nervous System:
If I palpate around a painful area and find no tense bands of muscle or tender trigger points, I immediately suspect some sort of malfunction of the nervous system. In this case I choose a method called Distal needling, as developed by Master Tong and his families, and then popularised in the West by Dr Tan and more recently Bob Doane in USA, who runs the busiest (and arguably most effective) clinic in USA.
Specific points are needled away from the site of pain with a view to disrupting proprioceptive nerve impulses. This technique generally has immediate results *.
I stick rigidly to these two theories, because they have proven themselves effective for back pain, headaches and other types of pain. If neither of these two methods work it is probable that there is a serious mechanical injury that will need to be investigated further by your Specialist.
Is There Anything You Can Do To Help Alleviate The Pain?
As much as possible remain active. Activity increases blood flow. Blood flow promotes healing.
Obviously be sensible. If something causes persistent sharp pain, back off. I like to recommend that my patients keep moving but try to minimise shock through the spine. So runnings out, but gentle yoga and tai chi are in.
Before you start any kind of rehabilitation regime its important to consult a professional. If you’d like some pointers here are some ideas for helping with that back pain.
Five Tips For A Better Back
1. Keep Exercising
Movement is the friend to most (but not all) back injury. Good blood flow is essential to get oxygen and nutrients to the damaged tissues. Care should be taken to not over-stress the back. Gentle exercise such as cat-cow is a great idea.
More stressful activity such as running and rowing will possibly put too much strain through the injured area.
2. Pick Objects Up Carefully
When you pick objects up, make sure you bend at your knees, keeping your back straight and the object close to your body. If you’re bending your back to pick up an object the force on your lower spine can be as much as 10 fold as your back acts as lever, stressing the lower spine and sacrum. A prime example is a parent lifting a baby out of a cot. The baby may only weigh 10lb, but leaning over with bent back and straight legs can exert pressures on the sacrum approaching 100lb.
As with everything in life, this advice isn’t black and white. Once your back has recovered its important to bend down using the spine. If you spend your life guarding your back through your knees; legs bent and back straight your back looses flexibility. With the loss of flexibility comes the loss of mobility of spinal segments which ultimately could lead to the facet joints fusing and locking your spine up.
This can then lead to compression of the disc, which increases your likelihood of later nerve impingement.
So general rule of thumb:
– Always pick heavy objects up by bending your knees and keeping your back straight.
– Once your back has recovered, try to bend using the spine for lightweight duties such as tying shoelaces. If you can’t do this make sure you do cat cow. If arching the back (sticking your bum in the air is painful) just work on repeating the tailbone tuck (the cat part).
3. Stop Smoking
Studies have repeatedly shown that there is a strong correlation between smoking and back pain. More recent studies have suggested that smoking damages the arteries and reduces blood flow to the lower back. It also causes degenerative diseases of the intervertebral discs.
- Acupuncture has long been known to reduce pain levels but how? Recent studies of brain MRI scans by Hugh MacPherson suggest deactivations in the brain’s pain matrix deep in the limbic structure.
4. Keep Your Spirits Up
Depression can cause back pain. The exact mechanism isn’t known but its likely the low mood pre-disposes the person to feel more pain. Equally, chronic back pain can create negative mood states.
Studies suggest that depression is four times more prevalent in those with back pain.
As human beings we’re mostly pre-disposed to negative, critical thinking. Trying flipping this on its head by thinking of 3 things you’re thankful for each morning. Write them down and make them your daily mantra. Repeat them till they actually mean something to you.
5. Don’t Sit For Too Long
Sitting in a chair doubles doubles the force through your lower back compared to standing up. This can be further compounded by slouching.
Try to reduce slouching by putting a pillow in the small of your back. Make sure you take regular breaks when sitting working – at a least every hour. Go get a drink, talk rather than send emails in the office or nip out for a breath of fresh air.
Some More Research On Acupuncture For Pain Relief
A recent study by Arthritis Research UK looked at 25 complementary therapies for arthritis. The list included osteo-arthritis, rheumatoid arthritis, fibromyalgia and back pain. The report looked at clinical evidence in favour of each of the 25 therapies. Of interest they found:
- Acupuncture the most effective therapy for osteoarthritis
- Acupuncture the most effective therapy for lower back pain
- Acupuncture the most effective therapy for fibromyalgia
- Tai Chi very effective for osteoarthritis
- Yoga very effective for low back pain
About Tim Wright, Acupuncturist In Swansea
I have a BSc Honours degree in acupuncture and a License to practice acupuncture. I am also a full member of the British Acupuncture Council, have a licence to practice from Swansea County Council. I trained at the College of Integrated Chinese Medicine in Reading and was fortunate enough to have been supervised by some of the best acupuncturists in Europe, including Peter Mole and Angela Hicks.
If you would like to discuss more or book a treatment please contact me on 01792 366288 or email email@example.com.
* Whilst the effects are immediate pain relief, a course of acupuncture is needed to ensure the pain stays away and does not return.