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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 www.cramosteopaths.co.uk

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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 www.cramosteopaths.co.uk/book-online

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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 www.cramosteopaths.co.uk/book-online/

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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 www.cramosteopaths.co.uk/book-online

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wellness

Strategy for Wellness in Glasgow & Ayrshire

While some of the aspects of our general well-being are determined by our genetics, there is a lot you can do to live a long and healthy life. Here’s a short list of them:

  • Have enough sleep.  While the average adult requires just 7 to 9 hours of sleep a night to feel rested, younger age ranges typically require a lot more: babies (0-3 months): 14-17 hours per day; 4-11 months: 12-15 hours per day; babies: (1-2 years old) 11-14 hours / day; pre-school (3-5 years old): 10-13 hours / day; school age (6-13 years old): 9-11 hours / day; and adolescents (14-17 years old): 8-10 hours / day. An expectant mother may require additional sleep, particularly at an early stage of pregnancy.
  • Exercise at moderate intensity for at least 30 minutes a day (short stroll, bike ride, jog, yoga, tai chi, etc.). Health board recommendations also prescribe resistance exercises for large muscle groups twice a week.
  • Avoid the inclusion of fats, sugary beverages and refined foods. Eat more whole foods, fruit and vegetables. Not only will it help you achieve a healthy body weight, but you will also improve the make-up of your intestinal microbiota, which can strengthen your immune system.
  • Consider supplementation when the diet is low in essential vitamins and minerals. For example, a 2017 study published in the journal Nutrients, indicated that vitamin C could improve the development of B-and T-cells linked to the body’s ability to control infections. In addition, the study showed that vitamin C deficiency is associated with compromised immunity resulting in higher susceptibility to infection.
  • When (not if) tension strikes, take five long, deep breaths (in your nose and out of your mouth). We recommend mindful meditation or plan calming tasks for the day.
  • Engage in social networks (senior centres, church and book clubs or play, music festivals and art galleries with a friend), usually in person but remotely (phone or video chat) if you are in a Covid-19 lockdown.
  • Laughing decreases stress hormones, boosts white blood cells, and keeps you healthy.
  • Use a hand sanitizer on a daily basis, don’t touch your eyes, nose, and mouth; cover your mouth with your arm while you sneeze, and stay home while you’re sick.
  • Spend time in the sun or take a supplement of vitamin D. Studies suggest that persons with low vitamin D status could be at an elevated risk of upper respiratory infection and compromised immune response.

Of course, if you have musculoskeletal pain, such as neck or back pain, make an appointment with us here at Cram Osteopaths. Usually, the quicker you seek treatment, the easier you will be able to return to your everyday life without any discomfort.

Book online now at www.cramosteopaths.co.uk

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Head Tilt and Headaches in Glasgow & Ayrshire

Head Tilt and Headaches in Glasgow & Ayrshire

We’ve always seen people working on laptops and smartphones in airports, planes, coffee shops, on the subway, walking down the street, you name it! So how does this affect one’s neck and does it lead to headaches?

A 2016 study compared females with posture-induced headaches vs. fit, age-matched female control subjects, to see if there was any substantial change in head-tilt and forward-head orientation, during laptop use.

The research team measured angles for maximum head protraction (chin-poking forwards), head-tilt and forward head position at baseline (neutral resting,) whilst using a laptop. Essentially, they assessed how the participant’s stance “slumped” at rest vs. when working on a laptop.

The findings revealed that the “headache” group showed a raised head protraction of 22.3 per cent relative to the group at rest. When comparing the ratio of forward head orientation to overall head protraction during normal sitting, the researchers observed a substantial difference, greater head tilt in the headache group. Similarly, the position of the laptop work / desk setup in the headache group, was worse.

The researchers concluded that the headache group displayed poorer rest posture in all measures as well as more forward head posture during the laptop analysis, than the control group. They suggested that treatment / therapy for patients with headaches and/or neck pain include posture retraining exercises as a significant component for long-term successful outcomes.

This study shows the importance of this and the need to include exercises such as chin-retraction, conscious repositioning of the head, cervical traction (in some cases), deep neck flexor muscle strengthening, scapular stability management, and more.

When you look at a person from the side, imagine that a perpendicular line passing through the ear canal should pass through the shoulder, hip, and ankle. In cases of forward head posture, the line will move forwards of these bony landmarks.

Previous evidence indicates that the head weighs an average of 12 pounds (5.44 kg), and with any inch of forward head placement, the neck and upper back muscles are filled with an additional 10 pounds (4.53 kg) of load to hold the head upright. That means a five-inch forward head position adds 50 pounds (22.67 kg) of weight to the neck and upper back area. It’s no wonder this faulty posture leads to chronic neck and headache complaints!

Spinal joint manipulation is one of the most patient-satisfied, fast-acting treatments for pain in the neck and other forms of headache treatment provided by Osteopaths. But when manipulation is paired with exercise treatment, findings suggest that this paired strategy results in the greatest long-term effects or outcomes!

If you are suffering from neck pain, headaches or any physical issues you may wish to seek treatment for, please book online to see us at www.cramosteopaths.co.uk

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The Importance of Blocking Blue Light in Glasgow & Ayrshire

The Importance of Blocking Blue Light in Glasgow & Ayrshire

The electromagnetic spectrum extends from gamma rays — which can be deadly — to radio waves that flow in the air around us without any effect. The most significant wavelength for our eyes is between the ultraviolet and infrared sections of the spectrum: visible light. However, research suggests that high-dose blue light can be troublesome, particularly with the use of electronic devices.

Both the sun and incandescent bulbs emit light in a vast spectrum that our eyes have adapted to see. The light originating from our electronic devices may look identical, but it is concentrated in three major peaks of blue, green and red. When using a phone or tablet, this means that more than the normal amount of more energetic blue light is transmitted to the eyes at a short distance and over (often) longer periods of time. Researchers have observed that this can cause the eyes to grow tired and dry, which can lead to discomfort. Exposure to blue light at night will slow down the development of the sleep hormone melatonin, resulting in sleeping problems and negative health effects.

In order to reduce the consequences of excessive blue light exposure, a number of tech companies have created blue light and night time filtration settings that reduce the amount of blue light coming from the devices. Many websites and programmes also offer a dark mode that reduces the amount of white on the screen, which means that less light is emitted by the diodes. Users also report that these features are easier to look at.

Whilst the subject is up for debate, prolonged exposure to blue light may often contribute to an increased risk of macular degeneration, a general cause of vision loss linked with photoreceptor cell damage in the retina. In laboratory studies, researchers have observed that when blue light interacts with the retinal molecule, it can lead to cell damage and even cell death. This result did not appear in other sources of visible light. However, it is important to note that this study was conducted in a laboratory setting and not on the eyes themselves, so although the authors found a mechanism by which the blue light plus the retinal can cause cell damage, they are not sure whether this occurs in the eye itself.

However, given the impact that excessive screen usage can have on eye exhaustion and potential sleep disruption, it is necessary to take eye breaks and use filtering or modes that minimise blue light (or wear glasses that block blue light).

Device related neck pain has also become a huge problem along with postural issues. If you feel you need to seek further advice on any of these topics please contact us at www.cramosteopaths.co.uk

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knee pain

Details to be considered before Knee Joint Repair in Glasgow & Ayrshire

When it comes to chronic knee pain, there are several rehabilitation options available to relieve pain and improve function, including Osteopathic therapy. However, there are cases where a patient can opt for total knee arthroplasty (TKA). In certain cases, they may be able to continue their day-to-day routines, but a section of patients may not reach a successful result. How do we learn from these patients who can advise us when not to recommend surgery for knee pain?

In one study , the researchers evaluated TKA patients one year after their treatment to determine their results with respect to the range of motion and function of the knees, as these are critical for performing day-to-day tasks such as the ability to put on shoes and socks, to squat down to pick items up from the floor, to get up and down from sitting, to climb and descend down stairs, etc. The study team observed that patients with impaired range of motion before surgery, as well as those with poor coordination of the knee (tibial-femoral angle) were less likely to have a favourable outcome.

Several experiments have shown how hyperpronation of the ankle can affect the alignment of the knee, bringing extra tension to the joint, as it can affect the operation of the hip. These matters should be discussed prior to the consideration of TKA. That is why it is necessary for clinicians to examine the patient as a whole for a musculoskeletal disorder because the cause or underlying factors for the injury may be beyond the region of the main concern. In certain cases, a combination of manual treatment and precise exercises offered by an Osteopath can return proper mobility to the injured hip or ankle, which can also help the knee.

Manual treatments can also break up adhesions and scar tissue that may hinder the mobility of the knee. When the knee can function as expected, the pressure from regular activity can help to bring nutrients to the remaining cartilaginous tissue, decreasing inflammation and discomfort.

The take-home lesson is that there might be a time when TKA is the only alternative to a patient with knee pain, but if the knee is poorly balanced or the range of motion is reduced, TKA may not be the solution. Luckily, there are problems that may be treated by osteopathy therapy, which can prolong or even minimise the need for a surgical operation.

If you are having knee or any joint issues please book in to see us at one of our clinics which can be found at this link www.cramosteopaths.co.uk/book-online

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Neck Pain

Workstation Neck Pain in Glasgow & Ayrshire

Neck pain is commonly associated with sitting in front of a screen for lengthy periods of time. So, is there a “correct” or “ideal” sort of desk to use while sitting on a desktop all day?

The sit-stand desk has gained considerable prominence in recent years, particularly with an 83% rise in sedentary employment since the 1950s.

In a report in 2018, researchers contrasted the impact of sitting and standing at a desk for 90 minutes in 20 healthy and active adults. Researchers tracked typing work efficiency and discomfort, vascular / blood flow, and structural improvements in the spine, hands, and arms, and found that standing desk use resulted in greater involvement of the shoulder girdle stabilising muscles (good thing), less pressure on the lower trapezius muscles, less upper body pain, and improved typing efficiency. The authors of the report suggest additional research to establish how standing impacts more complex computer programming functions, over prolonged work periods in symptomatic workers.

A treadmill desk is another form of desk available. In one study, researchers observed that using a treadmill desk resulted in less upper limb discomfort relative to sitting desk use, as well as improved muscle performance from lower back paraspinal muscles, wrist extender muscles, external abdominal obliques, lower trapezius and anterior deltoids.

What about the trend of making a little bicycle unit under the desk? In a 2019 study, researchers observed that participants performed better typing tasks while cycling, particularly at higher intensity.

Osteopaths are often asked about sitting / stand desk solutions, with or without lower limb exercise. The standard approach is to change it up, sit or stand as appropriate, and vary the amount of under-the-shelf exercise based on how you feel. Research supports that standing, walking and/or cycling may be a better alternative than a conventional sitting-only, sedentary desk.

If you need assistance with neck pain please book online at one of our clinics here: www.cramosteopaths.co.uk/book-online/

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Cycling and Low Back Pain in Glasgow & Ayrshire

Cycling and Low Back Pain in Glasgow & Ayrshire

Cycling and Low Back Pain in Glasgow & Ayrshire

Cycling is known to be a very fun and effective way to exercise. There is some doubt, though, as to how posture when riding, can affect the lower back and whether cycling is effective in healing lower back pain.

Cyclists ride either round-back, flat-back, or curved-back, depending on the degree of pelvic rotation and spinal flexion. It seems that the choice of position when riding a bike is mainly related to saddle height, saddle angle or turn, and the form of handlebar. Some handlebars offer multiple options as to where you can place your hands, e.g. on the grips (most upright), on the bar closer to the stem (medium position), or on the drops — the lowest option offered on the under / racing handlebar type curl.

One would imagine flat-back posture might be better for the lower back, precisely because it prevents the two extremes. However, this position is synonymous with greater wind resistance and is likely to be avoided by more serious riders trying to cycle as efficiently as possible. One pilot study looked at the lumbar spine angle of young adult recreational cyclists as they utilised all three postures in ten-minute intervals with different bike configurations and found that the “curve-in back” position caused by gripping the drops resulted in the greatest increase in spinal flexion over time. In individuals with a low back problem, this increased spinal flexion can lead to increased pain and associated symptoms over time.

Another study looked at how a bike is fitted, the position of the cyclist, and the perception of comfort, fatigue, and pain. Twenty bikers raced for 45 minutes in three out of nine possible places at 50 percent of their total aerobic strength performance. The three positions were defined by two parameters: knee flexion angle (20°, 30°, 40°) and trunk flexion angle (35°, 45°, 55°), in a random order. The results showed that having the trunk upright (not bent forward) and the seat height adjusted so the knee flexion angle was 30° was the most comfortable position for participants. In addition, the researchers found that tilting the seat forward reduced the low back discomfort in people with the condition.

As part of the healing process for low back pain, Osteopaths also urge patients to exercise. Due to its low-impact nature, as well as being really fun, cycling is a perfect choice. However, it’s important to make sure your bike suits in such a way that you can ride easily with a good balance and not worsen your condition.

If you are suffering from low back pain or any condition you may feel the need for treatment, please book online at www.cramosteopaths.co.uk/book-online/

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