Neck pain problems make up a large proportion of the conditions suffered by our patients and can be sharp or dull, gradual or sudden. It can be very frustrating and limit the range of movement. It can present as localised headaches or stiffness in the neck and shoulders. There are many causes of neck pain. Your Osteopath will make a diagnosis of the cause, and discuss a treatment plan and options.
Poor posture contributes to a large proportion of neck and upper back pain and could be due to repetitive or static working posture. It is common among office workers who present with a rounded shoulder posture, with the head dropping forwards causing the chin to stick out. These patients are referred to in the trade as The Chin Pokers. Other common, posture issues are sleeping on your front and causing your neck to be twisted to one side, or sleeping on a Pillow Mountain. Poor posture can contribute to migraines and dizziness. Your Osteopath will be able to advise you on rehabilitation exercises, correct ergonomic desk set up and which pillow is most suitable for your neck.
In some cases of neck pain, the joints may trap a nerve in the neck, which causes pain into an arm and can also result in pins and needles or numbness in the hand or finger. Joints of the neck can become restricted after a mild twist or awkward movement causing, a Facet Joint Lock. Your Osteopath will take a case history and discuss the best treatment options to get you back in action.
Whiplash injuries after a car accident can cause muscles to go into a painful protective spasm. The head and neck are jerked, backwards and forwards, causing immense strain on the muscles and ligaments of the neck. Initially, symptoms can appear to be minor. However, weakening of the ligaments and muscles that help support the head and can cause pain and problems for years after the initial trauma.
"Wear and Tear" is often found in the neck for people aged 50 and over. Spondylosis or osteoarthritis as it is commonly known causes stiffness and tightness in the surrounding muscles. Both of these respond well to osteopathy and acupuncture treatment.
Common knee injuries
Knee injuries are frequently found, within active sporty people and the older population who have degenerative issues.
Your Osteopath will ask you lots of questions to decide the best course of action and rehabilitation.
They will want to know if:
You heard something ‘go’?
A ‘pop’ or a ‘snap’?
Is there swelling around the kneecap or behind the knee?
Increased range of movement?
Inability to stand on the leg?
Knee ‘gives way’?
Knee ligaments are long and stringy collagen molecules. Their job is to connect bones, to each other to provide support and movement. They can become damaged by direct trauma, such as a football tackle, changes in direction, or jumping up and landing badly. Ligaments, tendons and muscles all work together to keep the knee stable.
The meniscus acts as a shock absorber between the femur and the tibia. The meniscus is often associated with a locking or clicking of the knee. In the younger patients, these are usually damaged by, twisting on a slightly flexed knee whilst playing sport. In the older patient, the tear may be due to a natural age-related degeneration of the meniscus or a rough arthritic femoral bone surface tearing into the softer meniscus.
During your consultation, your Osteopath will explain how all the soft tissues around the knee are related and may be contributing to the problem as they compensate for the injury. All of these will be, assessed during your consultation, and a rehabilitation plan discussed.
Knee swellings can cause pain above, below or around your kneecap. The prepatellar bursa lies just above the kneecap between the skin and the kneecap and commonly referred to as “housemaid’s knee”. We mostly see this condition with patients whose work necessitates kneeling for extended time periods, such as carpet layers, gardeners, roofers and plumbers. Your Osteopath will discuss how to reduce the swelling and get the knee functioning well again.
Knee problems in Older adults
Knee osteoarthritis is a degenerative knee condition. That might be as a result of a previous injury or just part of the ageing process. In this condition, the articular cartilage of your knee joint slowly wears away, exposing and irritating the underlying bone. This wear affects the femur and tibia (leg bones), and also the patella and femur (knee cap and thigh bone).
As your knee arthritis changes over time, bony outgrowths develop in and around your knee joint in response to the change in load distribution and biomechanics.
Your Osteopath can’t give you ‘new knees’, but during the consultation will explain how all the soft tissues around the knee are related and may be contributing to the problem. All of these conditions will be assessed during your consultation and a treatment plan discussed.
A cervicogenic headache is simply another name for a headache which originates from the neck. It is one of the most common types of headache and although this type of headache can occur at any age, it is most commonly seen in patients between the ages of 20 and 60.
How can osteopathy help?
Although this type of headache may respond to medication including analgesics, anti-inflammatories, stronger opioid-based medication, even nerve-blocking injections, these drugs usually treat the symptoms of the headache and not the primary underlying cause.
Unless the origin of the headache ie. the upper neck dysfunction, is treated and corrected, the headache will return in time. Physical therapy treatment will focus on the soft tissue and joint restrictions in the upper neck as well as areas like the front of the neck and upper back area. It may also involve some exercises to strengthen weak muscles and stretch tight muscles.
Cervical spine (neck) manipulations and mobilisations
Myofascial release (a type of deep massage) to release tight structures and muscles in spasm
Trigger point therapy to release restricted tight muscles
Strengthening exercises of the deep neck flexors and upper back muscles
Thoracic spine (upper back) mobilisation and manipulation Posturecorrection and re-education of postural muscles
Treatments may include the use of electrotherapy for muscle release and pain relief as well as acupuncture or dry needling or postural taping or bracing.
It is estimated that British businesses lose an estimated 4.9 million days to employee absenteeism through work-related back pain. 80% of the population is likely to develop back pain at some point in their life.
What causes my back pain?
There are different types of back pain. Some are sharp and occur as a result of injury, while some are more of a dull background noise as a result of poor posture. Most back problems will resolve within 6 weeks. However, some can have a more sinister cause. Your Osteopath will do a full case history and refer you to your GP if necessary.
Patients with dull aching backs usually get relief from keeping gently mobile and using a cold compress on the sore area. These types of backs do not like static postures such as waiting in a queue or standing doing washing up. Your Osteopath will show you the best rehabilitation exercises and posture tips for your condition.
Some back issues present themselves as stiffness in the morning or from being in one position for too long. Many patients find treatment helps to keep them flexible and out of pain. We can give help and advice on sleeping positions, and morning exercise routines as part of a treatment and management plan.
Muscle spasms can be very sudden and severe and often confused with a trapped nerve. Your Osteopath will show you the best way to tackle these when trying to do things such as get out of bed or get out of a chair.
Joint pain is usually sharp and often associated with painful muscle spasm on movement and change of direction of movement. Twinges occur with movements such as getting up out of a chair. Patients often report feeling a few twinges before ‘something just went’. These twinges are the body’s warning bell that you should get your back looked at.
Trapped nerves do occasionally happen. Usually, this presents as pain and tingling into the leg. Nerves can be trapped by a disc, a bone or even from some soft tissues. You can get tingling in the legs, buttock or saddle area with, or without, back pain.
If you are experiencing tingling in the saddle area you should go to the hospital and seek a medical opinion.
People often say that they have ‘slipped a disc’. Discs don’t actually slip, they bulge or herniate. This can occur in your lower back, thoracic mid-back or neck.
A discs bulge is somewhat like the inner tube of a bicycle tube bulging through the tyre. When the disc bulge is severe enough the centre of the disc pushes out through the outer layer of the disc. This is known as a herniated disc or disc prolapse. It can cause pain and tingling into the leg. Pressure on the sciatic nerve from a herniated disc usually causes sciatica.
Degeneration of joints in the lower back occurs as we get older. This is called Spondylosis. It is found on X-rays to some degree in most people. This usually presents itself as joint stiffness and muscle tightness and usually responds well to osteopathy and acupuncture treatment
The shoulder is the most mobile joint of the body. Whilst that means under normal circumstances, we have a great range of movement. Unfortunately, this also means the joint is quite vulnerable to problems. Your shoulder joint is a highly mobile ball and socket joint, that is moved and controlled by a small group of muscles collectively called the rotator cuff.
The most common shoulder problems Osteopaths see, are as a result of poor working posture, this can cause pain and tension across the shoulders, neck and upper back. It is commonly related to stressful lifestyles. Patients often complain of pain at the end of the day after work. Fortunately, this type of issue responds well to osteopathic treatment and exercise.
Rotator cuff impingement syndrome is a condition where your rotator cuff tendons become squashed and trapped during shoulder movements. This entrapment causes injury to the shoulder tendons resulting in painful shoulder movements. Some patients complain of pain when trying to lift things off a high shelf. Shoulder bursitis is an inflamed shoulder bursa. The bursa is a fluid-filled sac that helps to reduce friction in your shoulder. Shoulder bursitis and rotator cuff issues often occur together. Patients often complain of pain whilst putting their arm in a coat.
Frozen shoulder, also called adhesive capsulitis and is a common source of shoulder pain. It occurs commonly in the 40 to 60-year-old age range, with women more likely to suffer than men. Diabetic patients also seem to be at a greater risk.
No one knows what causes a frozen shoulder. Sometimes it occurs postoperatively, or as a result of a trauma in patients who are more protective of their arm. Your Osteopath will discuss suitable treatment and rehabilitation exercises.
Pain around the elbow is not uncommon. It can be one-sided or both sides.
Ironically most tennis elbow and golfers elbow problems we see, are not from tennis or golf. Most of our patients have occupations that require repetitive actions such as gripping and twisting of the wrist, using a screwdriver, or hammering. We also see many typists, plumbers and electricians. For elbow issues, your Osteopath will look at your elbow, wrist and shoulder, as well as lifestyle and occupation to see what is causing your symptoms.
What Causes Tennis Elbow and Golfer’s Elbow?
Tennis Elbow and golfers elbow are caused by damaged muscle tissue at the point where it joins the arm bone at the elbow and is usually due to poor technique and the wrong sized grip. Studies have shown that Shockwave Therapy can be very good at helping resolve this condition. Always make sure you see a professional to have your equipment sized to prevent bad habits and injuries from occurring.
Wrists and Fingers
Are commonly seen in office workers who spend their time typing or production line workers who use their hands repetitively. Repeated use of the hands in the same movements causes inflammation and damage to the soft tissues. This is called Repetitive Strain Injury (RSI). Usually, patients are not taking enough breaks, they are working too long and too fast, or sometimes the equipment used may not be set up correctly. If you are suffering due to your work, ask for an ergonomic assessment to be done and try to vary the work that you do to avoid overstraining muscles.
Carpal tunnel syndrome is a painful condition caused by compression of the median nerve as it goes through the carpal tunnel of the wrist. Pregnancy, arthritis and RSI can cause swelling of the tissues in the wrist and can lead to symptoms.
Commonly, the median nerve is compressed in both the wrist and the neck. This often gives pins and needles into the fingers, which are usually worse at night. Night splints have been shown to help by reducing wrist bending easing the symptoms.
Our hands do an incredible amount over our lifetime. Osteoarthritis of the fingers is very common as we get older. Many patients find osteopathy and acupuncture helpful at relieving symptoms. Traumatic injury to fingers is common in ball sports such as netball or cricket. These usually respond well to rehabilitation. Occasionally finger pain can be caused as a result of inflammation due to an autoimmune problem such as Rheumatoid arthritis. If your Osteopath thinks it is necessary they will send you to your GP for blood tests to check for these conditions.
Hand pain caused by cycling fits into two categories, numbness and tingling down the outside of the hand, or the same sensations affecting the thumb and middle of your hand, it depends on the nerve being compressed. Please see this advice handout for more information.
Hip and Groin Pain
Groin pain in younger patients is commonly caused by a mechanical overload from a problem elsewhere, usually from sports activities such as high-speed running, which may involve a change of direction or jumping. The musculature is complex with greatly stressed anchor points around the pelvic joints and lower back. These injuries can cause tendon issues, such, as an adductor muscle strain, more commonly referred to as a groin strain.
Hip, groin or top of the leg pain can also be caused by issues elsewhere such as lower back or pelvis but can be from the knee or even the foot. Careful assessment from your Osteopath will determine the most likely cause of the issue.
Patients with hip and groin issues often find walking very difficult and they will stiffen up after sitting for too long. Chronic groin or hip problems need to be treated to prevent other issues from occurring as people start to adapt the way they walk.
Shockwave Therapy can be effective for people with chronic bursitis issues. Your Osteopath will discuss if this treatment is suitable.
Degeneration of the hip joints is called osteoarthritis, it is a gradual process of wear and tear, which occurs in most people as they get older. This presents itself as stiffness and muscle tightness and is usually worse after sitting or walking for long periods. Fortunately, this usually responds very well to osteopathic and acupuncture treatment.
Hip pain in cyclists could be due to several pathologies including bursitis, snapping hip syndrome, impingement syndrome, labral tears or piriformis syndrome. Although the diagnoses may vary, the causes of cycling hip injuries are usually similar and involve over-training, pushing excessively high gears and muscle imbalances. The two most commonly seen hip injuries are piriformis syndrome and bursitis.
Piriformis syndrome treatment
Osteopathic deep tissue myofascial release, trigger point therapy, neural mobility and acupuncture can all assist rehabilitation.
Shockwave therapy can be helpful for people with chronic bursitis issues. Your Osteopath will discuss if this treatment can help.
The importance of groin strength in football, or any other physically demanding sport, cannot be emphasised enough. Groin strength should include good flexibility and muscle endurance for optimal function. The groin muscles are actively contracting to move you around the field and kick balls, lunge and sidestep. Whilst, at the same time working with your core, lower back, glutes, quads and hamstring muscles to ensure a high strength stable pelvis, able to co-ordinate all the ‘one-legged’ activities.
The three most common causes of groin injury in football are a strain to the adductor muscle, a tendon injury or osteitis pubis, instability around the pelvis.
In the early stages of any of these groin injuries common to football, it is essential to get hands-on physical therapy. Your Osteopath should also assess your posture as your groin as part of your hips are the powerhouse of your lower limbs. Injuries here can be a consequence of lifestyle and work environment like hours sitting at your desk, watching TV, commuting or driving.
Adductor muscle strain
Protect the muscle, rest, ice, compression of that muscle, and elevate the leg.
48 – 72 hours after injury:
Your Osteopath can provide you with, physical therapy to promote tissue healing,
massage and manual therapy to release tight surrounding structures and address any underlying back, pelvis or hip issues. Advice on exercise to provide slow and progressive recovery.
In the early stages:
Regularly ice the injury throughout the day.
Your Osteopath can provide you with manual therapy to release tight structures, Shockwave and Acupuncture to help promote healing.
Your Osteopath can assist with manual therapy to normalise soft tissue and muscle flexibility across groin and pelvis.
If you suffer from regular headaches, don’t despair. There are treatments and advice you can receive from your osteopath to help manage your headaches. If you would like us to send you these additional resources including self-help advice, please get in touch through our website or our Facebook page.
Here's an advice handout that you may find useful: