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.

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Lower Back Pain

Swiss Ball Exercise Program for Lower Back Pain

Today, we will look at why employing a Swiss ball could be more beneficial for the back-pain patient than simply doing floor-based exercises.

In a study back in 2015 published in the journal of Science and Medicine, researchers assigned twelve chronic lower back pain (cLBP) patients to perform either floor, or ball-based exercises, 3 times a week for 8 weeks, performing 4 different motions or exercises.

Whilst subjects in both groups enjoyed progression, the gains witnessed were much greater for those using the Swiss/gym ball in terms of functional improvement. CT scans of partakers in the ball group also found an increase in the cross-sectional area of the deep low back stabilising multifidus (MF) muscles.

The question is, why did the Swiss ball patients gain better outcomes? A likely probability is that the use of an unstable device like a gym ball, promotes the neuromuscular system to work harder to maintain balance.

This process not only improves proprioception i.e. the body’s ability to sense where its varying parts are in relation to one another for purposes of movement and balance, but it also works out additional muscle groups that are involved in normal everyday movement that may not be activated when exercising from the floor or another stable surface.

The four Swiss ball exercises included in the study:

1) Bridge-1: Lay face up (on your back) with the ball under your upper back and bring one knee toward the chest to a 90/90° hip/knee angle; hold ten seconds and repeat five times with each leg.

2) Bridge-2: Lay face up with your upper back on the floor with the ball under the pelvis; push down into the ball with the pelvis for ten seconds and repeat five times.

3) Bird-dog (kneel on all-fours—quadruped position): Place a small ball (4-6”) under one knee (kneel on it) and slowly lift and straighten the opposite leg and balance for ten seconds and repeat ten times with each leg.

4) “See-Saw:” Lay on your stomach with the ball under the pelvis/hips, balance on the forearms, raise the legs, and do a scissors-kick (as if swimming) for ten seconds ten times with each leg.

We encourage proper form and working safely within “reasonable pain boundaries” that you deem acceptable. Gradually increase reps and sets as you improve.

If you would like to learn more or feel a visit to your Osteopath could be beneficial, book online at

We look forward to seeing you!

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Reasons to Eat More Blueberries

Blueberries are closely related to the Scottish “Blaeberry.” Blueberries are incredibly good for you. Which is great as they are both widely available in supermarkets and extremely tasty. So why are they so good for us?

A 2019 review looked at findings from eleven studies that involved blueberry inclusions. The researchers found that blueberries help memory and executive function in both children and adults. Furthermore, blueberries can improve psychomotor function in the elderly, including those with mild-cognitive impairment. The researchers also reported that blueberry intake reduces risks for developing metabolic syndrome (heart disease, stroke, and type-2 diabetes), cancer, cardiovascular disease, and cognitive decline. Furthermore, they are found to improve both recovery from and prevention of muscle soreness.

In a 2018 study involving 215 older adults, researchers observed that those with the highest cognitive impairments who consumed a daily 600mg polyphenol-rich grape and blueberry extract for six months, experienced significant advances with respect to episodic memory.

Not only are blueberries low in calories (only 84 calories per cup) but just one cup of blueberries contains four grams of fibre, 24% of the recommended daily allowance (RDI) of vitamin C, 36% of the RDI of vitamin K, and 25% of the RDI of manganese.

Blueberries are very rich in antioxidants, which can protect the body from the free radicals that are known to damage cells and contribute to aging and diseases, like cancer. These antioxidants can also reduce oxidization of LDL (“bad”) cholesterol, which is a risk factor for heart disease. Further research suggests regular blueberry intake can be associated with lower blood pressure and a reduced risk for heart attack.

Blueberries can improve insulin sensitivity and glucose metabolism—both of which can reduce the risk for diabetes and may provide benefits to diabetics. Similarly, with cranberries, blueberries contain anti-adhesive substances that can help keep bacteria from remaining in the bladder and causing a urinary tract infection.

If you regularly exercise, then the good news is that blueberries reduce soreness and aid in muscle recovery following a strenuous workout.


Adapted Article: Credit

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Weak Core May Contribute to Hip Pain

Weak Core May Contribute to Hip Pain

When patients are suffering hip pain, they generally target hip exercises as a strategy for improvement. However, recent studies suggest there is a direct correlation between weak core stability of the trunk and injury to lower extremities, including the hips.

In March 2018, Belgian researchers examined data from nine formerly published studies with a focus on the significance of core stability and its affiliation to lower extremity musculoskeletal injuries, in a healthy athletic population. The research showed:

  • Core strength
  • Core proprioception (balance)
  • Neuromuscular control (coordination) of the core are directly linked to the likelihood of lower extremity injuries

Let’s look at some core exercises you can carry out from home to aid your core and in turn hip health (you can view several demonstration videos on YouTube if you search for “Stuart Mcgill’s big-3 core exercises”).

1) The Curl-Up (abdominal strength): STEP 1 — Lie on your back, straighten your left leg, and bend your right leg, placing the right foot next to the left knee.  STEP 2 — Tuck your hands under your low back to prop up the lumbar curve (so it does not flatten out).  STEP 3 — Curl up by lifting your head, neck, and shoulders only a few inches off the floor (keep your chin tucked).  STEP 4 — Hold for 7–8 seconds (or work up to this).  STEP 5 — Slowly lower your trunk back to the ground.  Repeat five times with the right leg bent and five times with the left leg bent, while keeping the opposite leg straight.  This exercise helps reduce low back disc compression, which is significant when performing a conventional sit-up exercise.

2) The Bird-Dog (core, back, and gluts):  STEP 1 — Kneel on all-fours (hands and knees).  STEP 2 — Keeping your back flat, lift and straighten out the LEFT arm and RIGHT leg parallel to the floor. STEP 3 — To further activate the core muscles, draw a square with the arm and leg while bracing the abdominal muscles (firm up your abs, as if to brace for being punched in the stomach). STEP 4 — Return to the starting position and repeat on the opposite side (repeat STEP 3 again).

3) The Side-Bridge (obliques): STEP 1 — Lie on your side, elbow directly under your shoulder and bend your knees 90°. To increase the difficulty, keep the legs/knees straight. STEP 2 — Lift your hips off the ground so you are holding your weight with your elbow and knees (or feet). STEP 3 — Hold the “Up” position for as long as possible. STEP 4 — Repeat steps 1-3 on the opposite side.

Osteopaths are trained to evaluate patients from the feet up to the head to identify issues elsewhere in the body that may contribute to or even cause the patient’s chief complaint. For many patients, managing hip-related conditions may involve treatment to address issues in the core (as described in this article), the lower back, and even the feet or knees!

If you are suffering pain book online at

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Factors That Can Hinder Carpal Tunnel Syndrome Recovery

As with most musculoskeletal conditions, treatment plans for carpal tunnel syndrome (CTS) advise non-surgical or conservative management initially, with surgery only in emergency situations or after non-surgical options are exhausted. Can we know who will benefit the most from non-surgical treatment?

A study conducted a two-stage analysis which included an initial evaluation followed by non-surgical treatment and a re-evaluation one year after non-surgical treatment concluded. The main aim of the study was to analyse factors contributing to the long-term effects of non-surgical treatment of CTS and to identify failure risk factors. Read more here.

The study involved patients diagnosed with CTS, of which an occupational cause was identified in (76%). Treatment included a total of ten sessions of whirlpool massage to the wrist and hand, ultrasound, and median nerve glide exercises performed at home. The subjects were divided into three age groups: <50, 51-59, ≥60 years old.

Whilst the majority of patients felt substantial progress in both stages of the study, some did not. Patients with more acute cases, as evidenced by poor results on a nerve conduction velocity (NCV) test, were less likely to respond to care, which highlights the importance of seeking early treatment for CTS as soon as symptoms develop.

Furthermore, participants who did not improve the setup of their working environments and reduce the overuse of their hands at work or who did not modify their routines to reduce the stress applied on the hands and wrist, reported much lower levels of improvements at the one-year point. Interestingly, age was not found to be a significant factor, which is surprising, as past studies have reported that being over 50 year of age is a risk factor.

Not only are Osteopaths trained in the same non-surgical treatment methods used in this study, but they can combine such approaches with nutritional counselling (to reduce inflammation) and manual therapies to improve function in the wrist and other sites along the course of the median nerve to achieve the best possible results for their patients.

You can book online at

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back pain

Jobs that cause Back Pain and what can be done

Back problems are now routine in society. This makes it very important to understand what may be causing this and what factors within your lifestyle could be changed to aid or prevent this issue from arising at all. Whilst we can’t change our DNA and current make up, nor in some instances our jobs, how we interact in our daily tasks and movements can be the difference between minor aches and disabling pain.

Construction industry roles typically are very strenuous on the back for example, Concrete-reinforcement workers and carpenters have more back pain than what is typically seen in office workers.

However, carpal tunnel syndrome can be much more prevalent in office workers. Different roles put different pressures and strains on different areas of the body.

Heavy lifting in awkward positions can put the back discs under load which exceeds the strength of the ligaments. This is called a sprain and in a severe case the disc can bulge and herniate.

If the worker can lift in less awkward positions with good ergonomics, then the discs are less likely to herniate as they are under less load. It’s common that the spine is stiff in the morning and develops higher levels of pressure in the discs, so it is not recommended that the worker does as much heavy lifting at this time.

Being mindful of this it’s much safer to lift lighter loads in the morning. Nevertheless, at any stage of the day lifting and twisting makes the spine far more susceptible to injury. Getting help is the main prevention many people do not consider.

Sitting for lengthy periods of time can be damaging to the spine. Initially because there is the inactivity which causes muscles to weaken. The spine is designed for movement walking. As the saying goes, “an apple a day” is good but a walk a day is better.

The spine is built to move, especially walk. Sitting causes heightened pressure in the discs of the low back. If you add vibration (e.g. bus/taxi driver) the sitting effects are worse. Regular walks and a proper supporting seat help to minimise any future back issues.

Every individual work situation has its own stresses and strain on the body and each and should be assessed appropriately. The correct spinal posture while working is key to overall good health and is the best prevention for back injury.

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knee pain

Causes of Knee Pain

When we experience knee pain, is it the knee the issue is stemming from?

Several studies have been written stating a link with knee pain to problems with the lower back, hips, ankles, and feet. Because we walk on two legs, everything from the ground up affects the rest of the body. The first “link” in this “kinetic chain” is our feet, and the last link is the head.

If any of the lower links are affected this has a ripple effect up through the rest of the body and in most instances, having a negative effect. For example, a “knocked knee” can be a cause of a flat foot or pronated ankle whereby the foot rolls in the way. If you look around you when you are in town or in the supermarket you will see how people walk on their insteps.

You will see this in particular on holiday amongst those wearing shorts and flip flops. It is estimated that the vast majority of us are over-pronating by the age of 30. Many of us are born with flat feet and as a result can be suffering from this from the minute we start to walk.

There are several tissues in the knee that can produce pain. In the over-pronation situation, the knee is overloaded so the medial, or inside compartment, of the knee is opening up excessively whilst the lateral, or outer compartment, over-compresses or jams together. We often find medial and/or lateral compartment pain in the over-pronated ankle/knocked-knee side.

The front section of the knee houses the kneecap that slides in a groove, and the knocked-knee results in overloading on the outside of the knee cap/groove creating a condition called lateral patellofemoral pressure syndrome and/or chondromalacia patella.

When you present for an Osteopathic evaluation, your Osteopath will pay attention to your gait or walking rhythm and look for over-pronation. You can correct the pronation effect with an orthotic foot wedge, which would hopefully prevent any conditions from arising in the future, such as arthritis.

Exercise is key as it is so important to keep the muscles around the knee stretched and strong. There is one muscle in particular, the vastus medialis oblique or VMO that connects our upper/inner kneecap to the medial/inside leg. It is the muscle that counteracts the outward pull by the other quadriceps muscles that attach to the kneecap. Your Osteopath can show you how to specifically exercise and isolate the VMO, if necessary. Book online now at

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