Archive for November 2020

low back pain

The Lower Back, Leg Pain, and Sciatica in Glasgow & Ayrshire

The roots of the sciatic nerve leave the spine at several levels in the lower back, enter the buttocks, and move down to the lower extremities. As strain is applied to the sciatic nerve in the lower back, it may cause discomfort and other sensations down the nerve to one of the legs—a disorder generally referred to as sciatica.

In younger and middle-aged adults, the most common cause of sciatica is herniated disc in the lower back at one or more points. Due to the structure of the sciatic nerve, the characteristics of the patient’s symptoms can guide the Osteopath to see where to look for possible causes in the lower back:

S1-2 Level (S1 nerve root): outer foot numb, difficulty walking on toes, weak Achilles tendon reflex

L5-S1 Disc (L5 nerve root): inner foot numb, weak big toe and heel walking, no reflex changes

L4-5 Disc (L4 nerve root): shin numb, weak heel walking, patellar tendon reflex loss

L3-4 Disc (L3 nerve root): medial knee numb, weak walking up steps, weak patellar tendon reflex

L2-3 Disc (L2 nerve root): front of thigh pain/numb, weak walking up steps, positive patellar reflex

L1-2 Disc (L1 nerve root): groin pain/numb, weak squat and steps, no deep tendon reflex

T12-L1 Disc (T12 nerve root): buttock numb, weak lower abdominal muscles, possible spinal cord compression

In sciatica patients under 55 years of age, the two lowest discs in the lower back—L4-5 and L5-S1—are the problem 95 percent of the time. The good news is that a systematic analysis of 49 published studies showed that spinal manipulation therapy, the main type of care given by Osteopaths, is an effective non-surgical preferred treatment for local and radiant pain relief in patients with a herniated disc in the lower back.

While sciatic pain is often initially acute and extreme, most cases can be successfully treated by non-surgery within three to six weeks; however, referrals to specialists or advanced imaging (such as MRIs) may be required to determine potential causes of pain if patient pain persists. Surgery is typically limited to people with neurological loss and/or intestinal or bladder control issues (the latter can arise in order to prevent persistence). As for many musculoskeletal disorders, the earlier care is obtained in the course of the disorder, the more likely (and faster) a good treatment outcome can be achieved.

Despite Tier 4 restrictions we are currently open and carrying out the strictest of hygiene practise, so you and your family can visit Cram Osteopaths in secure confidence.

Don’t suffer pain this winter and the earlier issues are dealt with, generally the better the recovery. Book online at

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Low Back Pain: Spinal Manipulation vs. NSAIDs

Low Back Pain: Spinal Manipulation vs. NSAIDs in Glasgow & Ayrshire

Low back pain (LBP) is the single biggest cause of disability in the world and the second most common cause of doctor visits. Overall, LBP costs society millions annually in lost income, decreased productivity, legal and insurance overheads.

Studies on the use of spinal manipulation (SM)—a method of treatment provided by Osteopaths —for LBP are abundant and have contributed to a strong recommendation that SM should be considered as the FIRST course of treatment for LBP. The American College of Physicians and the American Pain Society both prescribe SM for people with LBP, who do not improve with self-care.

In 2010, the Agency for Healthcare Research and Quality (AHRQ) stated that SM is an effective treatment choice for LBP – EQUALLY effective as medicine, to alleviate LBP and neck pain.

A 2013 study compared SM and non-steroidal anti-inflammatory drugs (NSAIDs) and found that SM was more effective than diclofenac, a widely prescribed NSAID, in the treatment of LBP. Patients in the SM community have also reported NO adverse side effects. More significantly, the 2015 study found that the use of NSAIDs would potentially slow down the healing process and even worsen osteoarthritis and joint deterioration!

Osteopaths use SM for as many conditions as possible, including LBP—more than any other medical specialty, including physical therapy, medical doctors, and others. Osteopaths often combine other synergistic modes of treatment, such as patient-specific exercise therapy to help patients learn how to self-manage their LBP, as recurrence is a common problem.

If you are suffering from low back pain or any musculoskeletal issues, please book in to see us at

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Shoulder pain

Shoulder Pain Causes in Glasgow & Ayrshire

Shoulder Pain Causes in Glasgow & Ayrshire

Every year, thousands of people make doctor visits related to shoulder / upper arm pain. After pain in the neck and back, shoulder pain is one of the main reasons for patients seeking Osteopathic treatment. So, why are injuries to the shoulder so prevalent?

While there are several potential reasons for this question, there is a straightforward answer: anatomy. Essentially, there are three joints that make up the shoulder: 1) the scapulothoracic joint, 2) the glenohumeral joint, and 3) the acromioclavicular joint. These joints operate at the same time and in unison to carry out the many activities that we throw at our upper extremities, from swimming to swinging a tennis racket or even reaching up to hang a curtain or adjust a light bulb. The overall configuration of the shoulder favours mobility over stability and, as a result, there is a higher risk of injury. So, what should we do to avoid damage to the shoulder?

Perhaps the most effective approach is to think before you act; that is, do not take needless risks, such as over-lifting in extremely uncomfortable positions. Instead, consider asking someone else for help. Also, use the correct form and remain focused. Research shows that a solid core (back and belly) will help avoid damage to the shoulder.

Common shoulder disorders include (but are not limited to): inflammation (bursitis and tendinitis), instability (sloppy joints), arthritis (bone / cartilage injury / wear), fracture, and nerve injuries. Injuries may be acute (from an evident cause) or, more generally, chronic wear and tear, and may occur progressively over time (from no clear, single cause).

It is important to understand that a shoulder complaint can be the end product of weakness in the body, just as a knee issue can put additional stress on the hip (or vice versa). Thus, in addition to direct treatment of the shoulder, Osteopaths can diagnose and treat problems elsewhere in the body (forward head carriage), weak core strength, changes to posture and common spinal conditions that can create shoulder pain.

If you are seeking treatment for shoulder pain, book in now at

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low back pain

Spondylolisthesis: Low Back Pain in Glasgow & Ayrshire

Low back pain can occur from several causes, one of which is called: spondylolisthesis. In 1854, the term was invented with Greek terms, “spondylo” for vertebrae and “olisthesis” for slip. These “slips” are most frequently found in the lower back (90 percent at L5 and 9 percent at L4). According to specialists, the most common form of spondylolisthesis is termed “isthmic spondylolisthesis,” and is a disorder that entails a defect in the back of the vertebra in a region called pars interarticularis, which is the portion of the vertebra that links the front half (vertebral body) to the back half (the posterior arch).

This may occur on one or both sides, with or without a forward slip or move, which is then called spondylolysis. Isthmic spondylolisthesis occurs in about 5-7 per cent of the general population, affecting men over women 3:1. Debate persists as to whether this happens as a result of genetic predisposition triggered by environmental conditions early in childhood, as demonstrated by an elevated prevalence in groups such as Eskimos (30-50 per cent), where young people typically carry papooses, loading their lower spine vertically at a very young age. However, isthmic spondylolisthesis may occur at any point of life if a substantial back bending force occurs, resulting in a fracture but reportedly occurring more often between the ages of 6 and 16 years.

Typically, traumatic isthmic spondylolisthesis occurs during teen years and is actually the most common source of low back pain at this point of life. Sports that most often cause this form of injury include gymnastics, weightlifting (from squats or dead lifts) and diving (from overarching the back). Excessive back bending is the force that overloads the back of the vertebra resulting in a fracture often referred to as a stress fracture, a fracture that happens as a result of repeated overloading over time, typically from weeks to months.

If the spondylolisthesis lesions are not healed by cartilage or bone replacement, the front half of the vertebra can slip or slide forward and become unstable. Luckily, most of these are recovering and being stable and not progressing. Diagnosis can be made by simple x-rays, but it is important to assess the degree of stability, “stress x-rays” or x-rays taken at the endpoints of bending back and forth. Often a bone scan is required to decide whether there are new injury verses and old isthmic spondylolisthesis.

Another very common form is called degenerative spondylolisthesis, which occurs in 30 per cent of Caucasian women and 60 per cent of African-American women (3:1 female to males). This typically occurs at L4 and is more prevalent in older females. It is often referred to as “pseudospondylolisthesis” because it does not contain defects in the posterior arc, but rather results from the degeneration of the disc and facet joints. As the disc space narrows, the vertebra slips forward. The problem here is that the spinal canal, where the spinal cord moves, is crimped or bent by the forward sliding vertebra and causes the spinal nerve root(s) to be squeezed, resulting in discomfort and/or numbness in one or both legs. The good news about spondylolisthesis is that non-surgical treatments, such as spinal manipulation in particular, work well and Osteopathy is a rational treatment approach!

If you are suffering from lower back pain or any issues you may need to seek treatment for, please book in to see us at this link now

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