THE SPECIALIST

This month, our woman in the white coat consults Peter Bartlett...

OSTEOPATH

So, does back pain affect everyone?
No. The people who are most likely to suffer are the ones who slouch. You need good posture to keep the back in shape. Keeping an inward curve at the base of your spine is important, but most people slump. This is one of the worst things you can do: the vertebrae and discs can become irritated and then place pressure on the nerve roots, which in turn can cause nerve pain in the legs. The spine also relies on muscles for support - the heavier you are, the more support you need. Men who have beer guts hanging over their trousers aren’t doing themselves any favours.

Are back injuries cornmon?
Yes, and the most common are muscular strains and sprains caused by swift movements or picking up heavy objects [about 60 to 80 per cent of the population will have back pain at some point in their lives]. Sometimes, people will bend over to pick something up and then find they can’t move. That’s usually because a muscle has gone into spasm. Do not force yourself into an upright position. The only way to stop the spasm is to rest and then have deep-tissue manipulation, which promotes circulation and healing.

What’s the worst thing that can happen to your back?
That’s easy: a slipped disc, otherwise known as a prolapsed disc. This is a serious injury where a disc between the vertebrae is punctured and its nucleus slips out to press on the nerve root. The pain is agonizing, and patients can’t move. Surgery to remove the disc is often the most effective answer.

If you’ve got a bad back, should you play sport?
Well, yes, you can but after any injury or period of incapacitation, you should go though an interim training period before resuming normal sporting activities. You should also be careful about the form of exercise you do — jogging on hard surfaces, for example, strains the knees and back. Interval training involving alternate 50-metre sprints and walking is far better running fast forces the body into a less damaging forward plane. Walking while swinging the arms is also good because it gently rotates the spine. Swimming can be good but people with upper back problems should avoid breaststroke, which strains the upper back. The best thing for the back — especially for chronic back pain — is an exercise like yoga, which combines relaxation and stretching.

What kind of movements should you try to avoid?
There are a number of real “no-no’s”: firstly, leaning over in your chair to pick up objects off the floor and bending with your back, not with the knees, to lift heavy objects. Secondly, slouching in your seat and cradling the telephone between your shoulder and chin putting strain on the upper back, sending the muscles into spasm. Thirdly, twisting the neck suddenly or quickly is also very bad, so you should remember to try to turn using the whole spine if you can.

What should you do to keep your back in top form?
First, acknowledge any problems you have and address the cause. Make sure that your office ergonomics are good. Avoid sitting at a computer for more than five hours a day and, when you do, take a break every 30 minutes. Exercise regularly to maintain muscle strength and joint mobility. Diet can also help ease joint aches and pains — fortify the skeleton with dietary minerals found in fruit and vegetables and eat less acid-forming foods like meat, cheese and nuts. These tend to leach minerals out of the body.

When is treatment needed?
Anyone who experiences bad back pain on a regular basis should consult their GP or go to an osteopath. Shooting pain, tingling or numbness in the arms and legs can be due to pressure on nerves in the upper or lower back. The longer the pain is left, the more difficult it is to treat. In rare cases, nerves from the lower spine that govern bladder and bowel movement are caught—that’s a serious problem and should be treated at hospital.

There are so many different forms of treatment on offer. What’s the difference between osteopaths, chiropractors and physiotherapists?
We follow the same fundamental practices, but place emphasis in slightly different areas. Chiropractors are most likely to use high-velocity thrusting techniques to reposition the spine. Physiotherapists tend to focus on the rehabilitation of injuries using soft-tissue massage and mobility. Osteopaths also use these techniques but the approach is more holistic - we concentrate on prevention and rehabilitation as well as other areas of health which can be affected by spinal problems - asthma, for example, can be improved by loosening the thoracic vertebrae which support the ribs - by expanding the ribcage, sufferers can breathe more deeply without the need for drugs.                  

ANASTASIA STEPHENS

November 1998

Peter Bartlett is an osteopath in London
 

For an information pack on back pain, send £2.50 to the National
Back Pain Association,
16 Elmtree Road,
Teddington,
Middlesex,
TW1 I 8SF.

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