Archive for December 2019

hip pain, back back

Do You Have a Hip Problem, Back Problem, or Both?

Back and Hip pain are amongst some of the most common Musculoskeletal ailments, forcing thousands of patients to Osteopaths each week. Because the hip and low back are closely linked within the body structure, many of these conditions often intersect, with only one of the two issues being diagnosed. This can cause wrong or missed diagnosis, leading to ineffective treatment, avoidable costs, and unsatisfying outcomes for the patient with prolonged pain, disability, and mental health distress.

In some instances, a problem somewhere else in the anatomy can send pain in another areas. For example, upper neck dysfunction could result in symptoms in the hand and wrist that could be perceived as carpal tunnel syndrome. Or for example, a problem with a patient’s foot arch, can alter a person’s gait and lead to a problem with the knee. Which can lead to wrong diagnosis and a treatment plan for the knee is undertaken instead of the foot and knee. With the hip and low back, both scenarios can occur, which is why it’s important to focus on the whole patient and not just the area of main concern or discomfort.

This is why Osteopaths consider the whole patient when they qualify patients’ conditions like hip pain or back pain, starting with a thorough patient history. Areas like Pain Location, Medical History (or Mechanism of injury), New, Other Symptoms (or, Onset), Provoking/Palliative, Quality, Radiation, Severity, and Timing.

The remaining history of Past, Family, and Social histories and, a Review of Systems allows the Osteopath to consider other potentially important aspects of the patient’s past such as prior injuries, accidents, surgeries, current medications, genetics, social aspects (smoking, drinking, exercise habits, sleep quality) and more, which can give clues to the current issues. These tactics serve as good outcome tools to determine successful treatment programs and patient care.

The examination includes observing the patients posture, walk and move and their affect (is their condition all-consuming); palpating or feeling for painful structures and performing movements that both increase and relieve their pain; measuring patient’s range of motion; determining what position is favoured or “best” vs. “worst”; and nerve function tests to look for impairments with regards to sensation, strength, and reflexes.

Each part of the Osteopaths examination and qualification process is designed to arrive at the correct diagnosis, so that treatment can accurately target healing and improving the function of ailing parts.

If you have a have a hip problem, back problem, or both, book online

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Neck Pain

Exercise and Posture Training for Neck Pain

Poor posture is extremely common. This may be why thousands of people are Googling an “Osteopath near me” on a regular basis.

If you look around any airport, museum, auditorium or social event, most people are suffering from poor posture. There’s forward head posture, uneven/misaligned heads/shoulders/pelvis-hips and rolled forward shoulders all around us. Many patients shuffle or limp whilst walking as a result of this.

Added strain on various parts of a patient’s anatomy happens as a result of bad or abnormal posture. A result of this can elevate the risk of musculoskeletal pain, including neck pain.

Exercises that can be done from home, can reduce the risk of future episodes of neck pain. These exercises combined with Osteopathic care, can significantly reduce episodes of neck pain, or even stop them from happening at all.

A study that included almost 100 senior patients was undertaken over a six month period, primarily of older adults with a rounding of the mid back and with a bent forward posture. This resulted in findings that a one-hour, three times a week exercise program provided both improved spinal curvature and self-esteem.*

Two groups of young adults with rounded shoulder posture were included in a study that found that shoulder stabilisation and shoulder stretching exercises, resulted in physical benefits in many different ways. This implies that the combination of these exercises may be the best approach to improving posture, strength, balance and flexibility.

Another study showed that scapular stabilization exercises when combined with abdominal bracing exercises, produced greater physical benefits than just scapular stabilization exercise on their own.

It has also been witnessed in a recent  study, that when teenagers incorporate specific neck and shoulder exercises into their physical education, for a 16 week period, their posture improves significantly.

In 2008, the Neck Pain Task Force** suggested exercise for  the management of neck pain, as well as neck pain connected with a whiplash injury. A 2016 literature review published that exercise is also successful for improving grade III whiplash and neck pain. Furthermore, of injury that includes loss of neurological function. One thing that was of note, the review didn’t find any one set of exercises to be more beneficial than another. This suggested that combining several, various exercise routines may be the best advise an Osteopath can give.

Osteopaths are highly skilled in manual therapies, exercise training, and functional assessments – all of which have been found to successfully improve outcomes for patients with persistent neck pain. As with many conditions, treatment of early onset symptoms, yields the best results, so don’t delay in starting your Osteopathic treatment at an Osteopath near you!



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Knee Pain

Hip Exercises to Help Knee Pain

The hip and knee from a functionality perspective are very closely connected. There are many muscles that attach above the hip and below the knee joint. So, depending on the position or activity, the same muscle can move the hip and the knee. This close association crosses over in dysfunction as well, as patients with knee pain move differently, and the hip joint is primarily affected. But which one is the instigator, the hip or the knee?

In an attempt to answer the query, an investigation into patients with patellofemoral pain (PFP) who didn’t have hip pain, were asked to carryout either knee or hip exercises. Each set consisted of nine men and nine women.

The knee exercise group carried out quadricep or knee strengthening exercises while the hip exercise group undertook in hip strengthening exercises. The specific hip exercises included hip abduction (outward resistance) and hip external rotation muscle strengthening exercises. Both groups performed their exercises three times a week for eight weeks.

Interestingly, all participants noted a reduction in pain and improved function; however, the patients in the hip exercise group reported greater improvements than those in the knee exercise group. These results persisted for the next six months.

Why did hip exercises help patients with PFP knee pain more so than knee-specific exercises? Weight-bearing dynamic imaging studies have shown that patients with PFP knee pain frequently have a lateral or outward displacement of the kneecap, as well as lateral tilt due to femur/hip internal rotation (IR) rather than just abnormal patella motion due to muscle imbalance.

Other recently published biomechanical reports stated that patients with PFP demonstrate excessive internal rotation and adduction (inwards positioning) of the hip that isn’t generally found in pain-free subjects. Furthermore, those with PFP usually have weak hip abductors, extensors, and external rotator muscles than pain-free individuals.

Osteopathic treatment focuses on whole body care, and patients are often surprised that Osteopaths frequently treat hip, knee, ankle, and foot conditions. Initial patients examinations frequently reveal abnormal movement patterns, pelvic rotation, lower lumbar spine dysfunction, leg length discrepancy and that may contribute to a patient’s main complaint. Often, treatment must address these issues for the patient to achieve a successful outcome.

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Carpal Tunnel Syndrome

An Osteopathic Approach to Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition that happens when stress on median nerve passes through the wrist creating symptoms such as weakness, tingling or numbness. Surgery usually isn’t required initially, unless there is some cause for emergency action as a result of, for example, a broken wrist. In the main, Osteopaths will recommend perusing all non-surgical practises before consulting a surgeon.

So what happens when you contact an Osteopath for CTS?

First we will qualify existing symptoms and health history. The information you proved enables us to understand more about the intensity and frequency of your symptoms. Understanding a patients history we can understand better elements that are known to contribute to an increased risk for CTS. These elements could be such as hypothyroid, pregnancy, the pill and diabetes.

Next the Osteopath will carry out a thorough inspection, most prominently of the median nerve. The median nerve comes from the spinal cord in the neck as nerve roots meander down through the shoulder, beyond the elbow through to the wrist. If at any point along this journey the nerve is compressed, a patient could possibly feel CTS-like symptoms, so it’s paramount to locate whereabouts the nerve is “pinched” in order to ensure the best possible outcome for treatment.

It can be a very complex issue as the median nerve can be compressed at several points. This can be referred to as a double or multiple crush syndrome. Furthermore, the median nerve isn’t solely the nerve that creates this sensation to the hand. When entrapped, the ulnar and radial nerves can also result in these symptoms in the hand and can be mistaken for CTS by the Osteopath because it’s the most commonly known peripheral neuropathy.

Once all the possibly contributing factors are ruled out and a patients hand and wrist symptoms are identified, the Osteopath will advise a course of treatment that may include manipulation, mobilization, therapeutic exercises, modalities, wrist splinting, and even dietary recommendations, depending on the patient’s unique situation. Sometimes anti inflammatory foods can help. The overriding aim is to reduce pressure on the median nerve by restoring normal motion in the affected joints, as well as in reducing inflammation that may be a result of a variety of causes.

While patients with more extreme cases of CTS can be aided from non-surgical approaches, like Osteopathic care, it’s important to be mindful that it may take longer for such patients to experience improvements in pain and disability, and Osteopaths may not be able to completely reverse the disease if it is too advanced. The sooner a patient seeks care, the better their chance for achieving a desired outcome.

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