All posts by Graeme IMC

Chronic Low Back Pain

Chronic Low Back Pain & Walking Backwards

A fear of movement, (Kinesiophobia) is a common occurrence in patients with chronic low back pain (cLBP). Sadly, self-restricting one’s physical activity can lead to fatigue and atrophy in muscles. It can lead to more inactivity and muscle fatigue, and consequently low tolerance to regular day-to-day tasks, absenteeism from work, and depression. If the muscles around the lower back or lumbar spine become atrophied and stiff, the likelihood of acute low back pain (LBP) flair-ups increases, which leads to more discomfort and distress.

Reports have indicated that, when comparing the muscles at the front of the lumbar spine (the “flexors”) to those behind the spine (the “extensors”) in individuals with cLBP, the extensors display greater levels of atrophy and weakness. The lumbar multifidus (MF) muscles are essential to the stability of the lumbar spine, while the superficial extender muscles of the erector spinae (ES) are known as “global stabilisers,” which are built to create gross movement and counterbalance while lifting external loads.

Osteopaths typically recommend rehabilitation / exercise programmes for enhancing motor function, muscle strengthening, stretching and aerobic capacity while treating patients with cLBP. One such exercise which might be recommended is to go walking backwards. Studies have shown that walking backwards can lead to better outcomes in terms of cardiovascular health and activation of the MF muscles (which are often weaker in cLBP patients, as mentioned earlier).

In addition, walking backwards works to a greater degree with the lower limb muscles, while reducing stress on the patellofemoral joint (kneecap). This is significant, as knee pain can often co-occur with low back pain, particularly in overweight / obese patients. Walking backwards often stretches the hamstrings which in cLBP patients are mostly short / tight.

Not only can walking backwards help patients who already have back pain, but, adding this kind of movement to the workout routine will also reduce the risk of low back pain!

We are open to see patients in Glasgow and Ayr, book online here

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Scoliosis

Osteopathic Treatment of Scoliosis

Scoliosis is a disorder that affects approximately 3 percent of teenagers, but typically the cause is unclear. The degree of spinal curvature is, for the most part, mild (10-15 degree curve), but in some situations, the curve may begin to increase as the child develops.

Visual symptoms of adolescent idiopathic scoliosis include: skewed shoulders, one shoulder blade “sticking out” (more pronounced) than the other; an irregular waist or hip that is higher than the other; and/or a pronounced rib cage, typically on the convex side of the curve.

When the curve is small, symptoms are often few if any. If the curve deteriorates, however, the child will face difficulties which may require care. Complications associated with scoliosis arise mainly in people with larger curves and involve heart and/or lung complications due to shortening of the spine and weakening of the rib cage as the curve progresses, making it difficult for the heart to pump or for the lungs to expand. Individuals with scoliosis can also experience chronic back pain and other musculoskeletal problems due to changes in the spinal conditions.

In order to assess the degree of spinal curvature more precisely, scoliosis is diagnosed after a routine medical history and physical examination, as well as standing x-rays of the lower and middle back. Treatment may not be required in mild cases; but, if the condition deteriorates or in more serious cases, normal medical care may involve wearing a back brace, or perhaps even surgery.

Is Osteopathy offering an approach to scoliosis care? Researchers studied the case history of 60 patients diagnosed with scoliosis in an Osteopathic environment in a report published in January 2017. Patients were offered a mix of Osteopathic spinal manipulation and exercise methods including cantilever, postural weighting, fulcrum block, and ball exercises for rotating torso therapy. The findings revealed positive outcomes in 38 percent of patients in 90 percent of cases, with 52 percent of patients experiencing curve correction and curve stabilisation. This adds to existing research and case reports regarding the effectiveness of both behavioural activities and manual therapies for scoliosis treatment.

You can book an appointment online, just click here. You can give us a call on 0141 339 0894 or alternatively send us an email to info@cramosteopaths.co.uk and we’ll get back in touch.

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Neck Pain

Headaches linked to the Neck

Experts report that headaches affect half of the population, with up to 25 per cent of headaches from the cervical spine or neck, known as cervicogenic headache (CGH). Several studies demonstrate the effectiveness of Osteopathic management for CGH, often involving a multi-modal treatment approach to address biomechanical dysfunction in the cervical spine that may contribute to or cause a patient’s headache.

Treatment options are:

SPINAL MANIPULATION THERAPY (SMT): There are several strategies or techniques of spinal manipulation to enhance joint mobility, which can be subdivided into two types: high velocity, low amplitude (thrust) where joint noise happens (called cavitation); and low velocity, low amplitude (non-thrust) where joint cavitation is not common. Some refer to the latter as “mobilisation.” Osteopaths frequently make use of both, but eventually, practitioner and patient choice determine the decision.

EXERCISE: Exercise on its own may not appear to be as successful as spinal stimulation, but when exercises — especially those affecting the deep flexors — are combined with SMT, the effects last longer and become more rewarding in the long run.

OCCIPITAL NERVE FLOSSING: CGH effects can be intensified by stress on the occipital nerve as it leaves the brain. The stress can be reduced by nerve flossing. The Osteopath raises the patient’s head whilst sitting on the ground with the face tucked under, then pushes the face into the chest to extend the muscle attachments at the base of the neck (which sometimes squeeze the nerves that trigger headaches) whilst the patient bends the knees to reach their collar bones. When the Osteopath lowers the patient’s shoulders, the patient stretches their elbows and wrists / hands toward the floor and drops their arms. That is sometimes replicated 5 to 10 times (depending on tolerance).

ACTIVITY (ERGONOMIC) ADVICE: This is where your Osteopath reviews your work place and interests, searching for opportunities to reduce the pressure on your neck and upper back. Forward head posture is very normal and he or she will show you how to correct the incorrect posture once identified — often by making small changes to your daily activities.

HOME CERVICAL TRACTION: Traction operates by pushing out joints and the vertebra. While you can do this in the office, you can do it at home much more frequently. An over-the-door unit works well. Typical treatment time is 15 minutes. A typical tolerance level is the steady rise in weight to a maximum acceptable point (10-15 lbs./4.5-6.8 kg). To get the best result, the “Int” is with RELAX.

Bottomline: When you experience headaches, then it might be helpful for you to visit an Osteopath to decide if the headaches could be induced or worsened by neck discomfort. If so, the Osteopath should also have a range of treatment options available to reduce the headaches‘ frequency and severity.

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walking

Increase Your Lifespan with Walking

Many studies in recent decades have reported early-death risk factors such as decreased cardio-respiratory function (CRF), hypertension, smoking, diabetes, cardiac disease, pulmonary disease, etc. Bad CRF appears to be the leading risk factor for early death, of all the causes listed. If CRF is so essential can walking help? If so, how many steps does it actually take for us to live longer and better?

Experts have recommended taking 10,000 steps a day for years in order to lead a long and safe life, but there is not any evidence to support the argument. A 2019 report analysed how many measures a sample of 18,289 elderly women took during a seven-day stretch, and correlated the data four years later with their health outcomes. The researchers linked a decreased chance of death with more steps being taken per day, up to around 7,500 steps a day. Those doing 8,400 steps a day were 58 percent less likely to die over the duration of the study compared to people taking 2,700 steps per day.

Studies compared average step count data gathered between 2003-2006 with health results a decade later in a related study affecting 4,840 middle-aged people, and found a correlation between steps taken every day and a decreased risk of early death.

Neither study concluded that a level of fast or slow walking played a part in the total risk of mortality. Several research, however, have linked a faster walking pace to improved cognitive function and decreased disability risk. Thirteen-year research comparing running club participants with those who didn’t run showed that people who jogged frequently were less likely to suffer physical injury or premature death.

Such research indicates walking and moving the body will boost cardiovascular health and reduce early mortality risk. Staying healthy can also be correlated with a higher quality of life. Certain methods of prolonging longevity include limiting heavy intake of alcohol, not smoking, retaining body weight, preserving / building muscle mass and a balanced diet. If you experience musculoskeletal pain that interferes with your everyday life, contact Cram Osteopaths as soon as possible, so you can restore your normal pain-free activities.

Moreover, we are now accepting more appointments; all available appointments are now available to book online and by calling 0141 339 0894. Our Barrington Drive and Muirhead practices are accepting appointments and this will shortly be extended to Ayr. Patients can attend any practice they choose, regardless of their own location.

We have adapted some of our working practice procedures in relation to Covid-19 which can be found here. If you would like to contact either of us directly, we would be delighted to hear from you.

Michael – michael@cramosteopaths.co.uk

Joanna – joanna@cramosteopaths.co.uk

We hope you have remained well in mind and body throughout this time and we look forward to seeing you soon.

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neck pain

Neck Pain – Exercises to Reduce Risk

As personal computers, notebooks, ipads, e-readers and smartphones are becoming more important in our lives, more and more people are contacting healthcare providers for musculoskeletal problems such as neck pain. Why is this the case, and are there things that can be done in today’s modern world to reduce one’s chance of neck pain?

It’s common for individuals to lean forward and/or look downward while using mobile devices. The muscles in the back of the neck tend to work harder to keep the head straight while the head lies in front of the neck and shoulders.

Over time, forward head posture (FHP) will lead to head / neck back, arms, and upper back discomfort and injury, leading to pain and impairment. Past findings have found that up to 60 per cent of people with neck / shoulder pain have FHP, indicating that taking action to minimise FHP will have a significant effect on the incidence of neck pain in the general population.

The following exercises will help to strengthen one’s posture and therefore reduce the risk of neck pain (patients with neck pain also benefit from these):

  • Stretch the pects, or muscles in the arms, by gripping a door jam and turning away.
  • Shoulder external rotation strengthening. Lay on your side, elbow bent, and lift/rotate a LIGHT dumbbell toward the ceiling and slowly lower it.
  • “Flies”. Reinforce the interscapular muscles by laying prone and lifting the arms to the ceiling (like flying), pressing the blades of the shoulder together.
  • Chin Tucks. Tuck your chin and nod the head to strengthen the deep neck flexors.
  • Neck Stretches. Pull your neck to the side, look up, and turn toward your pulling hand, followed by looking down and turning away from your pulling hand.

Staying physically active will also reduce the risk of neck pain. In a year-long research involving 367 sedentary staff, those who raised their daily average number of steps by 1,000 steps lowered their risk of neck pain by 14%! And, if you’re working in an office, set a timer to prompt you to get up and walk around and/or perform the aforementioned exercises (at least some which you can do from your seat). Breathing and meditation exercises can also reduce muscle strain in the neck.

In addition to the use of physical therapy such as mobilisation and manipulation to treat patients with neck pain, Osteopaths also prescribe home exercises such as those mentioned above to improve forward head alignment and reinforce the neck muscles not only to relieve neck pain but also to reduce the risk of recurrence of neck pain.

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neck pain

Cram Osteopaths – Glasgow & Ayrshire

We are a family run osteopathic practice and have over 70 years’ experience in treating a wide variety of conditions including Osteopathic Care for back, neck, shoulder and hip pain. We also provide shockwave therapy treatment and diagnostic ultrasound. Learn more:

https://www.cramosteopaths.co.uk/conditions/

https://www.cramosteopaths.co.uk/shockwave-therapy/

We care for patients all over Scotland – with the aim to get them out of pain quickly and keep them healthy.  It could be for a specific problem, or just the wear and tear of getting older.

We know how challenging aches, pains and injuries can be and we care about getting your body into the best possible condition to treat or heal the issue that you’re facing.

Cram Osteopaths began with the late Normund Cram in 1946, who whilst studying medicine became dissatisfied with orthodox approaches at that time. He was introduced to Osteopathic theory and opened the first practice, in Glasgow’s west end.

Normund was joined in his practice in 1973 by his son and daughter-in-law, Alex and Heidi Cram, who had graduated from the British College of Naturopathy and Osteopathy (BCNO), now the British College of Osteopathic Medicine (BCOM).

In 2009, Alex and Heidi’s daughter and son-in-law, Joanna Cram and Michael Brown (who both also studied at BCOM), became the third generation of Cram Osteopaths!

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Get the Best Out of Sports

Get the Best Out of Sports

It can be rewarding to participate in sport or keep fit, improve your health and reduce your risk of serious illnesses, such as heart problems, stroke or cancer. It can help to keep your weight under control and improve your self-esteem.

Adults aged 19-64 are advised to do at least 150 minutes of aerobic activity of moderate intensity per week. This could include activities such as brisk walking or cycling. It’s also recommended to do exercises twice a week to strengthen all major muscle groups (arms, legs, and body). You should also aim to minimise the amount of time you spend sitting for extended periods, even if you are active on a regular basis.

For many in the UK, sport has become a way of life, with participants ranging from the elite athletes to those who just want to keep fit.

But if you get an injury what happens?

Too much or too hard engagement in sports can sometimes result in injury. Failure to warm up properly in advance or warm down and stretch after exercise can also lead to strain. Likewise, using inappropriate equipment or wearing the wrong footwear can hinder your performance. An unresolved injury that might not even be related to sport, can make it hard to get even started in physical activity.

Your Osteopath Can Help

After exercise, it is normal to experience some mild discomfort, as the body needs a little time to heal and adjust to the activity demands. Soreness mostly fixes itself quickly, but occasionally it can last for more than a couple of days or make it difficult for you to resume your usual activities. You may want to ask for advice from an Osteopath in these instances.

Osteopathic treatment is based on the patient’s particular needs, and hence varies depending on age, health and diagnosis. Osteopaths use a wide variety of gentle hands-on methods, concentrating on stress release, muscle relaxation and mobilising joints. These are also combined with exercise and supportive guidance along with strapping or taping, both intended to alleviate discomfort, help return to normal levels of activity and preserve the best of health. As well as treating injuries, Osteopaths may provide guidance on proper nutrition or prescribe a diet unique to sport.

The good news is that while sport injuries are common, those who are active and have experience following exercise routines can find that they recover from their injuries more quickly and easily.

How you can help yourself:

  • Start your activity slowly and increase your intensity especially after an injury
  • Drink plenty of water when you are thirsty, particularly when you are doing exercise
  • Take daily exercise and try to change the types of exercise you do for body fitness
  • If you think you have injured a limb, rest, ice, compression and elevation can help, but if you’re worried, seek advice

The usual healing time for soft tissue can be as long as 12 weeks (if no other injuries occur). If you’re concerned about a short, medium or long-term injury it’s worth getting more advice at both.

What to Expect

Osteopaths are highly qualified clinicians who have the ability to treat health conditions, including those which may need more investigation. They will inquire about current symptoms and medical history when they first visit an Osteopath. All details must be considered as confidential by the General Osteopathic Council (GOsC) and the General Data Protection Regulation (GDPR), May 2018.

Concerns over symptoms and cause is normal. An Osteopath should also complete a regular evaluation to test for more severe conditions, advise and discuss any further action that might be required. Following this review, an Osteopath will discuss treatment options and you will then collectively agree on a reasonable and appropriate treatment plan, along with any associated costs. This programme can include multiple visits and occasionally, more tests and/or referrals to another health care provider who is suitable. Treatment can commence at the first appointment. Afterwards, there could be a mild pain, but in most situations, this should dissipate within 24 hours.

Concerned about face to face consultation? Book an online session here

Adapted article, credit: https://www.iosteopathy.org/what-we-treat/osteopathy-in-sport/

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Problems of Fibromyalgia (FM) and Central Nervous System

Problems of Fibromyalgia (FM) and Central Nervous System

If you hurt all over, always feel drained, can’t seem to ever feel “rested” after a night’s sleep, don’t respond to any of your doctor’s prescriptions and no test appears to show something specific, then you might have Fibromyalgia (FM). FM is a chronic/long-term condition involving generalised muscle and joint pain, generally on either end of the body above and below the waist, associated with “tender points,” where mild to firm pressure normally causes pain in the following locations (but possible anywhere):

  • Upper chest
  • Outer elbows
  • Upper hips
  • Sides of hips
  • Inner knees
  • Back of the head
  • Between shoulder blades
  • Top of shoulders
  • Front sides of neck

A widespread hypersensitivity is normal and it seems like you just can’t shut off your brain. It can start with a physical or an emotional occurrence, but it doesn’t have to be especially that, because it may seem to come out of nowhere as well.

In the UK, FM affects about 2 percent of the population, mainly women and especially those growing older. One specific underlying clinical finding is non-restoring night-time sleep with insomnia. The sleep disturbances associated with FM include sleep apnea and restless leg syndrome.

One study involving 168 patients with FM associated fibromyalgia and central nervous system (CNS) dysfunction. Researcher conducted numerous tests including an auditory brainstem response (ABR) that tests the cranial nerve that is responsible for our hearing and balance; a test that specifically measures eye movements while sleeping; and a third test that measures balance functions. Below is a list of the study results:

  • 78% of the FM patients complained of dizziness or vertigo. Most of these cases were mild but 4% complained of constant, severe dizziness.
  • Sensorineural hearing loss was found in 15% of the FM patients.
  • 51 of the subjects (30%) had abnormal ABR test findings.
  • 58% had abnormal eye movement tests and 45% had abnormal findings on the balance test.

Some studies also report that similar symptoms are associated with whiplash associated disorders (WAD).

If you would like an online consultation service throughout this lock-down please book online here.

 

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Low Back Pain

Low Back Pain and Walking

Guidelines advocate pursuing treatment in the acute stage of low back pain conditions, rather than waiting for it to become chronic. Getting back pain better quickly is a top priority for patients. Osteopaths have other goals for the patient’s body too. By relieving the back pain quickly Osteopaths are aiming to avoid stress and compensation patterns on other joints muscle and ligaments. Low back pain compensation patterns can cause more pain in the hip’s, knees, ankles and leave the patient suffering with another painful condition to deal with.

In a study performed in February 2020, researchers studied the lower limb kinematics (function) in 40 participants, half of whom had chronic back pain, using a special seven-camera device that monitored pelvic, hip, knee and ankle joint movements while walking. The data showed that individuals with chronic low back pain in all three lower extremity joints had significantly altered movement.

Another research study used a marker-based motion control device to evaluate 22 adults’ spinal kinematics (half with chronic low back pain) while walking along four parts of the spine: upper and lower lumbar (UL and LL) and thoracic (UT and LT). This experiment showed major variations in behaviour between the two groups.

Using an advanced measurement tool called statistical parametric mapping (SPM) to obtain a 3D visualisation of participants (20 with vs. 20 without low back pain), yet another test established altered patterns of motion for people with low back pain.

Such experiments indicate that individuals with back pain display altered walking kinematics and may be the body’s reaction to pain avoidance. But doing so can put extra stress on certain areas of the body, such as the thighs, knees, and ankles, which can contribute to secondary conditions. On the other hand, there is the risk that in the lower extremities pre-existing instability resulted in irregular activity due to a lower back injury.

Either way, these findings underscore the importance of examining the entire patient to identify any and all problems that may contribute to their low back pain, something that Osteopaths are trained to do to achieve the best outcome for each patient.

Do you need emergency help throughout the COVID19 lockdown? Call: 0141 339 0894.

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Osteopathy for Scoliosis

Osteopathy for Scoliosis

Scoliosis is a term used to define a not “natural” curvature of the spine. Natural curves of the spine have an inward curve in the lower back and neck and an outward curve in the middle back when approaching the individual from the side (“sagittal plane”). Nevertheless, when approaching a person from the front or back (the frontal plane) there should NOT be any curves; the spine should be straight. This is called scoliosis because there is a curve in the frontal plane and is generally either a singe curve, shaped like the letter “C” or a double (or more) curve, shaped like the letter “S.” While there is a scoliosis-specific diagnostic code, it is not a disorder or condition in itself, and it is mostly associated with no or, at worst, limited symptoms. Despite this reason, scoliosis is not detected much of the time until the curve changes dramatically and a friend or family member makes a statement or a school screening picks up on it.

The most common spinal position for the development of scoliosis is in the middle to upper back (called the thoracic spine), but it may also be found at the intersection between the middle back and the lower back, as well as sometimes or more rarely, in the abdomen. Since scoliosis-associated symptoms are uncommon, the way it is detected is by examining one or more of the following:

  • One shoulder is higher than the other
  • One shoulder blade sticks out more than the other
  • One side of the rib cage appears higher than the other (called a “rib hump”)
  • One hip appears higher or more prominent than the other
  • The waist appears uneven
  • The body tilts to one side
  • One leg may appear or actually be shorter than the other

Normally it is necessary to use X-ray to confirm the diagnosis and calculate the amount of curve that can then be used for potential reference and to rule out a possible irregular scoliosis origin. Rarely is an MRI required – only in situations where there are neurological signs and symptoms and in younger children (ages 8-11 years old) because scoliosis almost often occurs within the time period of puberty when hormonal systems (ages 12-14) are kicking in. If scoliosis occurs at an age younger than 11, and if neurological changes (reflex, muscle strength, and/or sensory functions) occur, and/or when the mid-back / thoracic curve bends to the left (as it almost always curves to the right), an MRI is sufficient to rule out the spinal cord strain.

The decision to treat or not to treat depends on two factors: 1) the “patient’s skeletal maturity” (how much development is left to the individual); 2) the degree of curve. Typically speaking, the bigger the curve, and the younger the patient, the greater the risk of curve development or deterioration.

Osteopaths may provide extra treatment by applying spinal changes, minimising defects in the length of the leg where there is a compensatory lumbar / low back curve, and providing scoliosis-specific exercises.

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