Why does my back hurt?

Back pain is a broad area and the reasons for this are multiple. The back pain you want to come and see me about is mechanical back pain and this, I will be able to deal with for you,educate you comprehensively so that you can self manage effectively.

The analogy I use is a simple one and that is the spine and body (that is the thorax and abdomen or core) are like a land rover coil spring. Things are fine when we are young and trauma free, however, introduce a trauma or shock into the equation and lay on the effects of of gravity and the mechanical integrity of your spine and core will be compromised laying the seeds of a potential show stopping back injury. The problem with falls and traumas like whiplashes, physical viloence, playing contact sports, motor cross and horseriding, 5 aside football on astro turf or gym halls, it is like putting a large spring clamp onto the land rover spring. Continuing to live without the bounce in your spine puts your spine under COMPRESSION.

This compression changes the way in which your spine functions no longer a supple spring but now a fixed lever like a crowbar. Try taking a nail out of a piece of wood with a chain and now with a crowbar. You have to exert a lot more force with a chain than the crow bar, in fact it is easy with a crowbar and that is because it is easy to generate enormous force with a lever. This in very simplistic language is what is happening with your spine when it is under compression.

Ok if my spine is under compression if I hang upside down and have mechanical traction it will right its self?
Yes it will help to a degree but be very careful, if you have high blood pressure raised intracranial pressure are a haemophiliac have artefact, metal work inyour spine have an aneurysm etc etc it would be very unwise to hang upside down check first with your osteopath. There is no way of gauging how the tissues are responding and know precisely the effective duration for traction from one individual to the next(there is no empathy for the tissue). Osteopaths are best positioned to helping you when you have a restricted spinal mechanic. You need to have enough treatment to be effectivley treated but not too much so the problem is exacerbated and not too little so that you are left with the underlying mechanical restriction. Whilst your back may stop hurting you will be left in a vunerable situation with a mechanically restricted spine with the potential (when moving in an unguarded manner) will generate a more serious injury. You are then a chronic patient who will always have back problems that can be managed to a point but may deteriorate to a state where you are a chronic disabled back pain sufferer. Going to a pain clinic on huge amounts of medication.

The objective of my treatment is to maintain optimal mechanical integrity to your spine. The consequence of this is that you can continue to condition effectively which allows you to pursue your physical activities, whether that is work, sports, or just being able to travel and see friends and family. It will allow you to participate in life fully.

Yes but why does it hurt?
When the spine and core are under compression and they generate this excessive leverage force, the force is applied to the soft tissues and intrinsic tissues of the spine like the discs.

These tissues under shear compression and torsion will rip tear, as they tear cells are broken open and enzymes and proteins held within the cell walls are let lose into niebourighing tissues. These enzymes and proteins attack your tissues that they are prevented from doing when they are intracellular. This triggers the inflammatory response which is the the swelling oedema to splint the joints and serve the tissues with the material to heal. You may even rupture capillaries and venuoles and this is red blood leaking ito the soft tissues near your spine. Ever filled a ballon with water, how heavy it gets how easy it is to burst. Think of a fire hose with high pressure water flowing through it, this is how the soft tissues around our spine will become after injury (you cannot compress fluids). This is why its usually a bit better when you go to bed but first thing it the morning you are as stiff and sore as the proverbial board. This means you are vunerable to further exacerbation of your injury.

If its just inflammation why don't i just take ibprofen?
It will help if you are not an unfortunate soul who cannot take NSAID because of allergic intolerance. It is the mechanical restriction that is the cause of the injury so NSAID are useful initially (about as good a regular cold packs) but they won't remove the causative problem, so if you are an interested GP, to get much better results for your patients prescribing them the usual medication and send them to an osteopath who will get them back to full function far quicker. (Beam report 2004). Secondly it is precisely that uncompromised fuction that allows the effcient use of the muscle pump to squeeze the intrinsic tissue like a giant sponge to normalise the fluid content of the tissue. Optimising profusion and the most important aspect osteopathically promoting drainage of the tissue to irrigate the tissue and establish optimal healing of that tissue. This needs to be monitored and guided as sometimes people feel alot better and can re injury because they mistakenly believe they are "cured"... a very strong and misleading word.

The most important bit of information for you the patient is to understand that Osteopaths are rigourously trained to identify the difference between back pain of a mechanical nature and back pain which is the manifestation of pathology ( Red and Yellow flags).

Back pain derived from metabolic,infectious, inflammatory, neoplastic or genetic origins need medical attention first, before osteopaths would then be happy to try to work with whatever mechanical aches and pains you may also have.

What do you mean by metabolic?
Conditions such as Osteoporosis, Osteomalacia, Diabetes, Pagets these conditions need medical supervision and have medical treatments which are effective and it is important that that you the patient are aware of this and follow a treatment course. In these situations osteopathy helps palliative but works in conjunction with allopathy.

Infectious?
Conditions such as bacterial meningitis, osteomyelitis need antibiotics and hospitalisation.

Inflammatory?
Rheumatoid arthritis, Poly Myalgia Rheumatica, SLE, Sarcoidosis, conditions like these need medical supervision and osteopaths can in alot of case help palliate symptoms

Neoplasia?
Multiple myeloma, Bone tumors, abcesses need referral and treatment.

Genetic?
Hereditary, congenital problems. Alot of the time these conditions are just the way you are and there is no allopathic treatment, but that is not saying you will not suffer from musculoskeletal related problems and you can be helped by osteopathy to relieve those symptoms. Your osteopath will find it useful to have as full an understanding of any genetic disorders as possible in order to define in what ways they will be able to help in your case.


To summarise, if you have back pain by all means book to see the osetopath. It is agood palce to start and you can be confident that if your condition is mechanical or systemic in origin the osteopath can guide you to the right treatment for your condition.