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Specialist Orthopaedic Doctors

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Back Pain Injections

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Fluoroscopically Guided Digital X-Ray Injections

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Spinal Manipulation

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Exercise & Rehabilitation Programmes for the Young...

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...and the Not So Young

Back Pain

Causes of Back & Neck Pain

 
  • Overuse and Over-activity injuries (e,g, from gardening or unusual activity)
  • Wear and Tear (osteoarthritis) of spinal (facet) joints
  • Trauma and Sports injuries
  • Wear and tear to intervertebral discs
  • Slipped or herniated intervertebral disc
  • Whiplash, typically as a result of motoring accidents
  • Standing, sitting or bending down for long periods
  • Strains from lifting, carrying, pushing or pulling loads that are too heavy.

Back pain can be made worse by:

  • Other illnesses or disease
  • Being overweight
  • Poor core stability and posture
  • Low mood, depression and anxiety

 

There may be other causes of your low back pain, these include:

An Osteoporotic or Fragility Fracture caused by low bone density. This is more common in women after the menopause or people who have used high dose steroids for long periods. Diseases such as hypothyroidism can put you more at risk.

Spinal Stenosis occurs when the space around the spinal cord narrows and puts pressure on the cord and spinal nerves.When intervertebral disks collapse and osteoarthritis develops, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth - called spurs - can lead to a narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that connect vertebrae to thicken, which can narrow the spinal canal.

When intervertebral disks collapse and osteoarthritis develops, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth - called spurs - can lead to a narrowing of the spinal canal. Osteoarthritis can also cause the ligaments that connect vertebrae to thicken, which can narrow the spinal canal. This very painful condition often presents after you have walked for a set distance and the pain settles with rest. The distance is usually very repeatable and may be associated with a feeling of weakness in the legs. This condition may benefit from an epidural injection but some cases require surgery to deal with the symptoms.

Slipped or herniated discs occur when the jelly-like center (nucleus) pushes against its outer ring (annulus). If the disk is very worn or damaged, the nucleus may squeeze all the way through. When the herniated disk bulges out toward the spinal canal, it puts pressure on the sensitive spinal nerves, causing pain. Because a herniated disk in the low back often puts pressure on the nerve root leading to the leg and foot, pain often occurs in the buttock and down the leg. This is sciatica. Treatment of this may be by manual therapies or by injection therapies you will be able to discuss this with your doctor. A herniated disk often occurs with lifting, pulling, bending, or twisting movements.

Spondylolithesis occurs when changes from ageing and general wear and tear make it hard for your joints and ligaments to keep your spine in the proper position. The vertebrae move more than they should, and one vertebra can slide forward on top of another. If too much slippage occurs, the bones may begin to press on the spinal nerves or compress the small joints at the back of the spine (facet joints). This causes back pain which is made worse with extension (leaning backwards) and may lead to back spasms.

Degenerative disc disease - when the discs in your spinal cord gradually become worn down

Rheumatoid arthritis - an inflammatory condition in which your immune system causes inflammation of the lining of your joints and surrounding structures

Causes of Low Back Pain

Back pain is common and affects most people at some point in their life.

Back pain can be triggered by everyday activities at home and at work, or it can develop gradually over time.

backpainBack pain causes include:
• Bending awkwardly
• Lifting, carrying, pushing or pulling incorrectly or loads that are too heavy
• Slouching in chairs
• Standing or bending down for long periods
• Twisting / over-stretching
• Driving for long periods without taking a break
• Overuse of the muscles, usually due to sport or repetitive movements (e.g. from gardening or unusual activity)
• Wear and Tear (osteoarthritis)
• Trauma and sports injuries
• No mechanism- some people just wake up one morning with back pain and have no idea what has caused it.

Back pain can be made worse by:
• Other illnesses or disease
• Being overweight
• Poor core stability and posture
• Smoking
• Long term use of medication that is known to weaken bones, such as corticosteroids
• Low mood, depression and anxiety

Common causes of lower back pain - Click the links below for more information

 The exact underlying cause of lower back pain is often complex and multifaceted. There are lots of different structures in close proximity that are all capable of producing pain, including bones, ligaments, tendons, disks, muscle and nerves. It may be only one of these structures that is causing your pain, however, most chronic (long standing) lower back pain cases are most likely involve a mixture of different structures.

 Here at the Blackberry Clinic our Musculoskeletal Doctors, Physiotherapists, Osteopaths, and Chiropractors are all very highly trained and will use skilled assessment procedures to produce an accurate clinical diagnosis of the underlying cause of your lower back pain. They will decided if you need further investigations, such as X-ray or MRI scan and decide of the most appropriate treatment plan for your specific case. The Blackberry Clinic prides itself on having many types of practitioners under one roof, who will all work together with the common aim of reducing your pain as quickly as possible and preventing re-occurrence.

Other Rarer Causes of Lower Back Pain are:

  • Ankylosing spondylitis- A chronic inflamatory disease. There is no known cure, although treatments and medications are available to reduce symptoms and pain. See National Ankylosing Spondylitis Society for further details. www.nass.co.uk
  • Osteoporotic or fragility fracture- Osteoporosis is caused by low bone density. This is more common in women after the menopause or people who have used high dose steroids for long periods. Diseases such as hypothyroidism can put you more at risk. See National Osteoporosis Society for more details. www.nos.org.uk
  • Rheumatoid arthritis
  • Spondoylolisthesis

       

      Exercise

      back-pain-2Exercise has been proven to be beneficial in the management of back pain in many ways, from strengthening core muscles to releasing endorphins and improving mood.

      A typical response to experiencing back pain is to take it easy - either staying in bed or at least stopping any activity that is at all strenuous.

      While this approach is understandable and may even be recommended in the short term, when done for more than a day or two it can actually undermine healing. Instead, active forms of back exercises are almost always necessary to rehabilitate the spine and help alleviate back pain.

      When done in a controlled, gradual, and progressive manner, active back exercises distribute nutrients into the disc space and soft tissues in the back to keep the discs, muscles, ligaments and joints healthy. Consequently, a regular routine of low back exercises helps avoid stiffness and weakness, minimises the likelihood of recurrence and reduces the severity and duration of possible future episodes of low back pain.

      Depending upon the patient's specific diagnosis and level of pain, the back pain exercises and rehabilitation programme will be very different, so it is important for patients to see a specialist back pain doctor or therapist trained to diagnose the cause of the pain. The specialist will develop an individualised programme of rehabilitation that will include back exercises, with instructions on using the correct form and technique.

      At the Blackberry Clinic, the Doctors, Physiotherapists and Rehabilitation staff in the fully-equipped gym work together to manage your pain, mobilise your back and strengthen the underlying structures to prevent future recurrences.

      Chronic Pain Management Service

      With more than 23 years of experience in the management of musculoskeletal pain, the Blackberry Clinic is ideally equipped to offer a Pain Management Service to patients who have traditionally been treated by a pain clinic in secondary care.

      Chronic pain is a complex biopsychosocial problem. A single pathophsyiological explanation is not available for many chronic non-malignant pain states. Up to one-third of chronic pain patients will have no objective findings of organic disease, and conventional treatment solely aimed at relieving pain is unlikely to be appropriate for such patients.

      Not all patients need a multi-disciplinary approach, but at the Blackberry Clinic we have these approaches available should it be appropriate for the patient concerned. The Blackberry Pain Management Service is Consultant-led and is a fully integrated multi-disciplinary service providing a patient centred approach to chronic pain and disability. Each patient will receive a customised programme or a combination of approaches appropriate to their condition.

      Available treatments include:

      • Consultant anaesthetist/musculoskeletal physician consultations
      • Prescription medication
      • Spinal injection procedures, with fluoroscopic guidance, i.e. epidural/prolotherapy
      • Injections, nerve blocks, radiofrequency neurolysis, facet joint injections, sacroiliac injections, sympathectomy, etc.
      • Transcutaneous electrical nerve stimulation (TENS) and acupuncture
      • Physiotherapy and rehabilitation programmes with exercise orientated programmes based on Pilates and other exercise systems
      • Exercise referral programmes in a fully-equipped gymnasium for functional rehabilitation including general exercise and fitness programmes, as appropriate
      • Psychotherapy, with behavioural approaches such as cognitive behavioural therapy/stress counselling
      • Educational methods for patients and professional colleagues in prevention and early effective management of conditions which may lead to chronic pain
      • Occupational therapy
      • Complementary medicines

      It is a basic humanitarian right that pain requires treatment or management, regardless of the cause. At the Blackberry Clinic we believe that although back pain doesn't kill, it 'tortures' and consequently demands adequate service provision.

      There is good evidence that chronic pain services themselves are cost-effective - the use of fully integrated pain clinics results in direct savings to the NHS of twice their own cost - and the Blackberry Pain Management Service seeks to provide the highest possible level of care in this field.

      "In a Clinical Standards Advisory Group study 11 out of 12 NHS pain clinics could 'not' offer all of the recognised treatments for chronic pain"... but at the Blackberry Clinic, WE CAN!

      Lower Back Muscular Strain

      What is a Lower Back Muscular Strain?

      A lower back muscular strain is when muscle fibers in the big muscles are over strained or torn.

      What causes a Lower Back Muscular Strain?

      A lower back muscular strain can be caused by a sudden excessive movement, or a prolonged amount of time in a poor position. The pain may come on suddenly or it might start once you have stopped the aggravating activity. The pain will usually be one sided and can be quite severe. Your back may be sore upon touch and the pain will be associated with activities and relieved with rest. It can cause the muscles to go in to a protective spasm, which can leave you feeling stiff and fearful of movement.

      What can you do about a Lower Back Muscular Strain?

      If you think you have a lower back muscular strain stop the aggravating activity. Avoid doing activities that make the pain worse but keep moving as much as you can within pain free limits.Try to move as normally as possible as abnormal movement patterns, such as tensing up and bracing can make the problem worse. Use ice on the affected area for 10 minutes every hour for the first 48 hours (use a towel between the ice and your skin to prevent ice burn). Then you can use both heat and ice for 10 minutes per hour alternatively. Take some simple over the counter pain relief if needed. If the problem persists or you want help to speed up your rate of recovery the Blackberry Clinic may be able to help.

      How can the Blackberry Clinic help?

      The Blackberry Clinic has a wide range of therapists, Physiotherapists, Chiropractors, and Osteopaths who are skilled and experienced in diagnosing and treating Lower Back Muscular Strains. They will use a range of manual therapy techniques including, soft tissue (muscles, tendons, ligaments) mobilisation, massage, trigger point therapy (releasing of knotted / tight muscles), myofascial release (connective tissue release), deep tissue massage, acupuncture, stretching and many other techniques.

      Importantly they will also give you their expert advice on how to manage the condition and how to get back to your normal activities quickly and safely. They will then educate you on how to change your habits that have contributed to the strain, such as a safe lifting technique or better sitting posture. This will give you the knowledge to take control and stop re-occurrence of the injury, after all prevention is better than cure!