All posts by Graeme IMC

Treatment for neck pain

Treatment that works best for Neck Pain

Experts estimate that up to 70 per cent of people in their lifetime will suffer an episode of neck pain. Although many alternative forms of treatment are available, little has been released in connection with the different treatment options available to patients with neck pain.

A 2012 study involving 272 patients with neck pain compared three treatment options: osteopathy, medicine, and exercise. The patients who received either osteopathic care or exercise training reported the greatest reduction in pain after 12 weeks of treatment. The researchers followed up with the participants for up to a year and found that patients in the osteopathic and exercise groups tended to experience less discomfort than those in the medication group, and these benefits lasted until the study was completed. The researchers concluded that participants from both the group of Osteopathy care and exercise therapy had more than twice the chance of full pain relief relative to the group of patients.

Since the 1980s, quality studies have been published on the short- and medium-term benefits of exercise and manual therapies applied to the cervical spine in patients with neck pain. Nonetheless, the long-term benefits aren’t as well known. In this regard, 191 patients with chronic neck pain followed a 2002 study for two years comparing spinal manipulation (SM) with and without one of two forms of exercises: low-tech (and low-cost) rehabilitative exercises (LTEx) or high-tech MedX (machine-assisted) rehabilitative exercises (HTEx).

The research team randomly assigned one of three therapies for the 191 patients to eleven weeks: SM only; SM + LTEx; or SM + HTEx. At the start of the study, the authors examined the patients, again after five weeks of treatment, and eventually after the completion of the study’s treatment period before 11 weeks. Four, six, twelve, and 24 months later they followed up with the patients.

The results showed that at both one-and two-year time points SM + LTEx and SM + HTEx were both superior to the SM alone. Overall, patients in the SM + LTEx group reported the greatest reduction in pain, and care satisfaction. This result is even more significant, since the care given to the SM + LTEx community costs less than care requiring more costly, specialised equipment.

It is clear that osteopathic treatment requiring stimulation of the spinal cord and/or activation with exercise training provides the best long-term results. Add to that the use of soft tissue treatments such as myofascial release, active release therapy, and different modalities, and osteopathic patients with acute or chronic neck pain are clearly the best choice.

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Hip Pain Exercises That Work!

Hip Pain Exercises That Work!

There are two types of muscles in our hips and lower extremities which help to facilitate movement: tonic and phasic.

Tonic (postural) muscles work or contract always to keep us upright. Those muscles tend to be tight and short. They contract or shorten when we sleep and are taught at waking, and need to be stretched regularly. Types of tonic muscles include muscles with hamstrings, and muscles with iliopsoas or hip flexors.

For those muscles, here are two perfect stretches:

Iliopsoas stretch: 1) Stand in front straddled position and take a step forward with the left leg. 2) Rotate the pelvic left side forward so that it becomes aligned with the pelvic right side. 3) The rear pelvic tilt is performed by flattening the curve in the lower back while rocking the pelvic forward to create a strong stretch in the left groin / front of the hip. 4) Lean back to the right, raising the left groin / hip stretch higher. Keep going for 5 to 10 seconds, and then repeat. Many times, a day, practise these intervals.

Hamstrings stretch: Lie on your back and put the left leg on a door jam with the right leg flat on the floor extending through the doorway gap. 2) Push the left leg into the door jam and hold the hamstring for three to five seconds, then scoot closer to the door jam to stretch. Hold on for one to two minutes, and repeat on the opposite side, several times a day.

On the other hand, phasic muscles function only when needed, and appear to be sluggish, these demand reinforcement, not stretching. Sources of phasic muscles include muscles in the abdomen and the buttock. Here are two perfect exercises for improving those muscles:

Strengthening the abdomen: 1) Lying on the floor, put your hands behind your low back. Bend one knee / leg and keep the other straight. 2) Raise the breast bone one to two inches (2.54 to 5.08 cm) towards the ceiling and stay for 10 seconds. Repeat multiple times until you lose the abdominal muscles.

Strengthening buttocks: 1) Squeeze the buttocks together while sitting or standing multiple times a day. 2) Lie with your knees bent on your back, and your feet flat on the floor. Raise your buttocks so your trunk lines up while pushing your heels into the floor. Hold for 10 seconds, and repeat 5 to 10 times.

Depending on the nature of your hip pain, your Osteopath may recommend further exercises as part of your treatment plan that you can perform at home.

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knee pain

Are Knee Pain and Running Related?

Knee pain is a common complaint that at some stage in adulthood can affect around 30 per cent of the general population. Because running has a reputation for “wear and tear” causing knee pain, the issue also arises as to whether or not running speeds up knee problems. What does the current research body say, then?

Dr. Christopher Bramah and colleagues reported in a 2018 study published in The American Journal of Sports Medicine that the most frequent injuries in runners include the knee (50 percent), the foot (39 percent) and the lower leg (32 percent). Sounds like running is detrimental, doesn’t it?

Researchers analysed blood and knee joint synovial fluid samples before a 30-minute run, immediately after their run, and after a 30-minute rest, in a small pilot study which included six runners aged 18-35. To the research team’s surprise, the inflammatory factors associated with conditions such as osteoarthritis (OA) are higher before running, and lower after sprint in the two timescales. That would mean running can be OA-protective.

Because of the limited number of subjects studied, the authors are quick to point out that they intend to perform a larger-scale analysis and after running, test the inflammatory marker levels for a week or longer to see how long this “defence” lasts. Some also claimed that a 30-minute run is relatively short, citing a study of marathon runners (26.2 miles or 42.2 km) who found cartilage changes that could indicate injury risk that continued three months after the marathon.

The study compared data from several previous studies on recreational runners, competitive runners and non-runners (a “meta-analysis”) and found that recreational runners had a LOWER frequency of OA than participants in the other categories.

A study comparing 1,207 UK male football players to 4,085 general population men (all around 60 years of age) found that football players were twice as likely to have knee pain (52% vs. 27%, respectively). In addition, about 28 percent of football players vs. 12 percent of non-football players were diagnosed with radiographic knee OA, and the athletes were three times more likely to receive complete knee replacement.

To sum up, short distance running on healthy knees appears to be safe and maybe even preventive against OA. In comparison, engaging in more high-intensity exercise will increase the risk of knee problems. If an individual has OA, walking may be the safer option but it must be determined individually.

Evidence has shown that issues elsewhere in the body, such as the ankle and hips, can put additional pressure on the knees, which can raise the risk of problems in that area. That is why it is necessary to assess the entire patient when presenting for treatment for a condition such as knee pain, as if contributing factors are not discussed, a satisfactory outcome may not be obtained.

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What Do Osteopaths Do for Shoulder Pain?

What Do Osteopaths Do for Shoulder Pain?

Typically, when people think of osteopathic treatment, they picture back pain, neck pain, and headaches, as strong research supports osteopathic treatment for these problems. But what about shoulder pain care with Osteopathic therapy?

The Government conducted ground-breaking reports in 2010 and again in 2014 that examined previously published work on various forms of treatment for many disorders, both musculoskeletal and non-musculoskeletal (like asthma). These reviews noted that the use of Osteopathic treatment with respect to shoulder-related conditions including pain / dysfunction in the shoulder girdle, rotator cuff pain, and adhesive capsulitis (frozen shoulder) is supported by scientific evidence.

As osteopaths seek treatment for patients with shoulder pain, care generally focuses on improving shoulder range of movement using various manipulative and mobilising methods aimed at the three shoulder joints: The glenohumeral joint (ball & socket joint), the acromioclavicular joint (AC) and the scapulothoracic joint (shoulder blade & rib cage). Osteopathic care may also include exercise training to restore mobility, energy, and stability to the muscles and soft tissues that surround the shoulder region. During various stages of recovery following shoulder injury a variety of physical therapy modalities are also used as adjudicative techniques in many osteopathy settings. Treatment is aimed during restoring patients to their normal level of everyday activity.

But what about after surgery with shoulder pain? Can osteopathy continue to help? A study conducted in 2018 found that post-surgical patients receiving mid-back (thoracic spine) manipulation had significant increases in shoulder movement (flexion and abduction) and increased space measurements (neutral and outward rotation). The authors cited other studies that reported similar improvements in shoulder mobility as well as the kinematics (movement & stability) of the shoulder blade (scapular).

Another study examined improvements in pain in the shoulder, impairment and perceived rehabilitation in patients with shoulder pain following two sessions of upper thoracic and upper rib manipulation. In all criteria tested, which lasted for up to three months, participants reported significant improvement here, too.

Given the solid research support of manual therapies aimed not only at the shoulder but also at the neck, upper and mid-back spinal regions, Osteopathic care is simply a must for patients with shoulder pain!

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lower back pain

Low Back Pain – What To Do Immediately (Part 2)

This article is part 1 of a 2-part series. For part 1, Click Here.

As previously stated, low back pain (LBP) can affect most (if not all) of us at some point in time. Learning what to do when the warning signs appear is important to prevent an LBP episode disabling you. We started the discussion in the previous article about providing ways to manage the LBP using activities to stop and reverse a potentially serious degree of LBP. We offered ways to stretch from a seated position that could be done in public. Here are some exercise options from a standing position…

EXERCISE C: THE HAMSTRING & GROIN STRETCH: from the standing position, 1) place your foot on a seat, bench, chair, railing pipe, or anything about knee level (it doesn’t have to be too high). If your balance is not very good, be sure to hold onto a wall or counter in order to maintain your balance. 2) Keep your knee bent 20-30 degrees and arch your lower back by sticking out the buttocks until you feel the hamstrings (back of the leg) pulling or stretching. 3) Slowly straighten the knee (keep the buttocks stuck out and the lower back arched) and you’ll feel the hamstrings getting tighter slowly. 4) Adjust the knee angle and/or the amount of low back arch / pelvic tilt to adjust the strength of pulling in the hamstrings. Continue this stretch for 15-30 seconds, or until the muscles are loosened. 5) Remain in that EXACT SAME POSITION and twist your body inwards (toward the leg on which you stand) until you feel the tug moving from the hamstrings to the groin (to the inside thigh) muscles. You may also go back and forth between the hamstrings and the groin (adductor) muscles and continue the exercise until the back of the leg and groin feel sufficiently stretched (usually 5 to 15 seconds / leg).

EXERCISE D: THE HIP FLEXOR STRETCH: 1) step forward with one leg and stand in a semi-long, steep stride position (one foot before the other). 2) Rotate the pelvis forward on the back-leg side until the hip lines up with the front leg hip (or square pelvis). 3) Add the pelvic tilt (tuck in the buttock / pelvis or flatten the low back). 4) Lean backwards (stretch low rear) holding the position above. When you extend backwards, feel deep within the upper front of the thigh / groin area for the stretch. You can alter the hip flexor to release and re-stretch between the third and fourth steps. Continue stretching for 5-15 seconds or until you feel stretched and repeat on the other side. This one takes a little work but you’ll understand why it’s so good once you feel it!

EXERCISE E: THE ADDUCTOR STRETCH: As an alternative to the second part of EXERCISE C (step 5 of the standing hamstring stretch), stand fairly wide apart with your legs spread. Shift your pelvis from side to side (left then right) and feel in the inner thigh / groin area for the stretch. You should increase the stretch by applying a lean to the side you shift the pelvic to. Try to hold the stretch for 5-15 seconds and alternate 5-10 times between the sides.

Such activities are intended to take place in public, WHEN you need to stretch. Stop the vicious cycle from getting out of control by STOPING, STRETCHING and, if you can, resume your activity!

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Low Back Pain

Low back pain? – What to do straight away (Part 1)

At some level, low back pain (LBP) will most likely hit all of us, at least that’s what the statistics say. How we respond to it can be vital to its advancement or cessation. Here are some “highlights” of what to do if this happens to you.

STOP:  The most important thing you can do is stop what you are doing — that is, if you’re lucky enough to get pre-warned before the LBP strikes crisis point. This move can be crucial, since it may be too late to reverse the cycle quickly once it hurts too much.

The “trigger” of LBP is often cumulative, meaning it happens gradually over time, usually through repetitive motion overloading the area. As previously stated, if you are lucky enough, you’ll be warned that before LBP becomes an occurrence that disables / prevents. Normally, the nerve endings in the damaged tissue activate muscle guarding as a protective mechanism when the tissues in the low back are over-stressed and initially wounded. This “muscle spasm” reflex limits the flow of blood leading to more pain producing a vicious cycle that needs to be stopped!

REACT: This is the “hard part” because it needs you to actually do something, but once you prove to yourself that this strategy really works, you will not hesitate. You will need to determine your preference for “direction,” or the position that reduces LBP. Once you’ve developed yourself, you can do exercises to help relieve back pain. To do this job, you need to be able to do these exercises in public without attracting too much attention, so that you can feel comfortable doing them anywhere at any time.

EXERCISE A: When bending forward feels relaxed, the alternative exercise is to sit down and (a) cross one leg over the other, (b) lift the knee to the opposite shoulder, and (c) push the knee in different positions to adjust the “pull” area. Stretch out each tight area by applying an arch to the lower back, move the trunk to the side of the flexed knee (sit tall and twist — if it doesn’t hurt) and switch between those positions (10-15 seconds at a time) until the stretched area feels “loosened up.” A second exercise is to sit and rotate the trunk until you feel a stretch. Again, during the twists alternate between different degrees of low back arching, feeling for different stretch areas until it feels looser, usually 5-15 seconds per side. A third exercise, as if to tie a shoe, is to sit and lean forward and hold that position until the tightness fades away.

EXERCISE B: When bending backwards feels better, exercise choices include putting your hands in the small of your back and leaning back over your fists, or bending backwards and keeping the position for as long as you need to feel relief (usually 5-15 seconds). Try to place a rolled-up towel from a sitting position (make one with a towel wrapped tightly like a sleeping bag held with rubber bands) in the small of the back to increase the curve. Lying with the roll on your back and a cushion under your lower back will feel great too!

Part 2 to follow!

Adapted article, credit:–what-to-do-immediately–part-1-/

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low back pain

Can Back Pain Outcome Be Predicted?

Patients with low back pain (LBP) are often nervous and worried about responding to the treatment — especially when it comes to getting out of pain and returning to normal activities. Osteopathic care has been shown by a variety of studies to be an effective option for the LBP patient, and although there is no “crystal ball,” there are some tests that Osteopaths can perform during an exam that can help predict results.

A meta-analysis of data from 43 studies published since 2012* indicates that centralisation and directional choice, which may be present in 60-70 percent of LBP cases, provide significant prognostic clues. Directional choice means that the body can be moved in a way that makes the patient more comfortable than others. Centralisation means moving in a way that reduces the spread of pain to a given region.

Let’s say an LBP patient shows up with radiating leg pain from their lower back with numbness and tingling in both leg and foot. The emphasis is on seeking a movement that REDUCES the pain / numbness of the legs, and their Osteopath asks the individual to lean upward, backward and sideways and twist their body, searching for which position is preferred, i.e. lateral inclination. When pain decreases, and AND centralises (leg pain disappears), then the directional preference is the extension.

If centralisation happens, this is a positive prognostic sign indicating that positive change can be expected. Likewise, if all positions or directions raise pain in the legs, this is a bad prognostic sign, which means this is potentially a more difficult situation.

It helps doctors better advise patients about their condition and what to expect from treatment in both the short and long term so that the patient can make REALISTIC goals and plans in time. Directional preference also helps Osteopaths to decide which type of treatment should be emphasised. For example, if the patient feels comfortable bending backward and leg pain disappears, the Osteopath may approach care from that direction with exercise suggestions.

Patient education is an important part of treatment, and educating patients on how to predict the outcome of treatment instils confidence and puts realistic goals in perspective so patients know what to expect. This improves both the health care provider and the patient’s respect for care and trust.


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neck pain

Social Media and Devices Detox

The ability to take out a small device to check email, take photos, connect with friends, play games and answer almost any question seemed like a great idea when smartphones and social media emerged more than a decade ago; but in recent years, many reports have looked at the downsides associated with heavy use of social media and technology.

A 2018 report, for example, found that people who use social media platforms for extended periods of time are more likely to take risky decisions. Another study revealed a correlation between heavy use of social media and an increased risk of physical ailments. Many people are aware of the term “text neck” which results from so much time spent looking down at the phone that it changes a person’s posture for the worse. Other studies have linked the use of social media to poor mental health, especially among teens and young adults. The more someone uses social media, the more likely they are to work with a plastic surgeon to “transform” their look, one study suggests.

Dr. Joseph Rock of the Cleveland Clinic states that these issues associated with the use of social media / devices can be attributed both to how social media affects the brain and to the impact of sedentary activity on mind and body. After all, if you’re all-day looking at your phone, your body probably won’t be moving enough.

One of the big issues with social media is that it creates emotions that keep luring people back for more— to the point that they find it difficult to cope if they don’t get stuck to their computer or device. The best way to determine if you’re using too much of your device is to ask family and friends what they think and if the answer is “too much” regularly, that’s a good indication of a problem. Dr Rock suggests a “cold turkey” approach to assess the severity of the addiction. He warns that although it will be initially uncomfortable, it will progressively improve the situation.

Not only will you spend more time having talks face to face and “smelling the flowers”, but you will probably increase your physical activity levels and take on a healthy posture also.

If you are still having discomfort with your neck / shoulder, your Osteopath can give you some exercises that can help you retrain your body to sit up straight, which can take a great deal of pressure off your neck and upper back.

If you feel you may need some treatment, feel free to book into one of our clinics at our website.

Adapted article: credit

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Neck pain

Osteopathic Neck Pain Care in Glasgow & Ayr

Have you ever had tightness, pain, or stiffness in your neck? With all the time spent using smartphones, tablets, watching TV and working at computer desks, the chances are, you have.

Neck pain is very common due to the complexity, structure and the function our necks undertake. The neck supports your head, which may weigh 10 lbs or more and it moves in several directions. Our heads way roughly 10lbs so, the weigh load is 10lbs provided it is directly over the centre of our shoulders. However, for every inch the head sits forward from centre for example, the weight increases by 10lbs. So, 3 inches forward equals 30lbs of weight strain on the neck. This strain is taken by the spine, discs, joints and nerves. This can cause major neck pain and recurring issues.

These pain symptoms are a sign that something is seriously wrong. Even minor neck stiffness can be an indicator that something is wrong inside your spine and you should Google “Osteopath near me” to seek local professional evaluations from your local Osteopath.

The Cervical Spine

The section of the spine positioned in the neck is comprised of seven bones called vertebrae. These vertebrae protect the spinal cord and nerve roots that exit from the spinal cord. Between the vertebrae are pads of tissue called discs that help cushion the vertebrae as the spine flexes and bends. An injury such as a car accident, whiplash or a bad fall may cause damage to the neck and spinal cords. However, mainly wear and tear from lifestyles i.e. poor posture, lack of movement and exercise, job situation and even emotional stress from bad relationships can cause damage over time.

Injuries and disproportions can cause cervical vertebrae to move out of position or become constrained. Delicate tissues like tendons and ligaments can become inflamed, worn out and exhausted. The cervical discs, which function as cushioning and help with movement, separating and cushioning the cervical vertebrae, can begin to decay and lead to disc bulges or ruptures (herniations) causing neck pains. If the degenerative degradation in the discs continues, this needs to be reversed to avoid additional pain and loss of function.

Ultimately, when we grow older the neck changes. Nerves may become pinched or irritated from misaligned spinal areas or from bulging discs. To cause irritation, it doesn’t take much pressure, just the weight of a coin. There are several age-related changes, also referred to as arthritis, that can occur at the spine. Due to weakening of the muscles or ligaments, the neck can lose its healthy curve, cause degenerating discs, or even develop bone spurs. All of these degenerative changes can cause nerves in the spine and neck to become irritated.

Neck Problem Symptoms

Neck problems can lead to pain symptoms and reduced motion range (normal rotation would cause the chin to be almost parallel to your shoulder). And even seemingly unrelated symptoms can be attributed to neck problems: headaches, inflammation of the sinus and discomfort, ear ringing (tinnitus), and vision disturbances were all associated with dysfunction of the neck. Just as a cavity in the tooth decays long before it reaches the nerve and causes pain, the misaligned vertebrae will irritate the function and damage it before any pain starts.

Keeping and Getting a Healthy Neck

Most people are seeking neck pain remedies such as muscle relaxants, pain killers, or tranquillisers. Such medical treatments should not be the first choice because they only “cover” the pain; they do nothing for the underlying cause which is why the pain returns when you stop taking the pills.

More extreme medical interventions include injections of steroids, or even surgeries that have many risks. Long-term use of drugs can lead to undesirable side effects and damage to internal organs like your liver and kidneys. There are more than 400,000 deaths from improperly prescribed medicines each year.

We are handling arthritis here at Cram Osteopaths with programs that are not just treating the symptoms. The purpose of our initial assessments is to identify and fix the underlying cause.

At Cram Osteopaths practises across Glasgow and Ayr, we will perform a thorough history evaluation and examination, with special attention to the spine and its effect on the nervous system will be carried out. As Osteopaths we are experts in the care of bones, nerves, muscles and connective tissues which make up about 60% of your body.

The conservative Osteopathic approach is to find the source of the neck pain that most frequently dysfunction (subluxation) in the vertebrae, and to repair it to allow the body to heal naturally. Once the dysfunction has been repaired, the spine moves normally and, most importantly, the spinal nerves are no longer irritated or pinched to allow proper nerve flow to the different areas of the body.

Several research studies have shown that Osteopathic treatment is more successful than the other types of medical treatment, also it’s healthier. One study, published in the Journal of Manipulative and Physiological Therapeutics, found that patients receiving Osteopathic care reported significant improvement in neck function and a decrease in neck pain, whereas those just taking pain-killers did not.

If you are suffering from neck pain or are concerned about any symptoms you are suffering, get online and search for “Osteopath near me” or if you live within travelling distance of Glasgow and Ayr, please feel free to visit us at Cram Osteopaths where you can book online here at

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Sleep and Osteopathic Care

Sleep and Osteopathic Care

It is estimated that around 17% of us have a sleep disorder. Bad sleep patterns are associated with several adverse health outcomes, including an elevated risk for musculoskeletal pain.

Whilst the precise mechanisms are not completely understood, the current research proposes that the relationship between musculoskeletal pain and sleep disturbance is a two-way thing. In that, individuals with a sleep disorder are more inclined to develop an issue requiring Osteopathic treatment, moreover people with pain are more likely to have trouble sleeping.

Osteopathic treatment has been researched in many areas around the world where sleep deprivation is prevalent —particularly in patients with fibromyalgia, a condition characterised by insomnia, tiredness and pain in several areas throughout the body. A study published in 2000 stated that fibromyalgia patients who received 30 Osteopathic treatments, experienced sizeable improvements with respect to pain intensity, exhaustion and sleep quality.

In a systematic review, researchers identified 15 studies that connected Osteopathic care with benefits for patients with insomnia. For low back pain and neck pain, which are two of the most common sleep interfering chronic conditions, Osteopathic management not only aids this but it is recommended worldwide, as a guideline for first levels of treatment.

Osteopathy offers the following to help with sleeping difficulties:

Manual therapies such as mobilisation and manipulation
• Soft-tissue work that helps relax the nervous system
• Nutritional approaches
• Weight management (obesity is a risk factor for insomnia)
• Education on sleeping position, napping, relaxation methods (breathing exercises, mindful meditation), no “screen-time” prior to bed, pillow placement and size, and more

KEY TAKEAWAY: Osteopathic care helps manage pain arising from a variety of conditions. Sleep is necessary to avoid chronic, disabling conditions (like FM) and maintain a high quality of life, so seek osteopathic care and do your best to help yourself sleep well every night! If you feel you would like further advice contact us at whereby you can book online.

Adapted Article

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