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Low Back Pain - An Osteopathic Approach
It is unfortunate that most people, who consult an osteopath, only come when they are having a physical crisis. It is interesting, that whilst most of us have our cars serviced regularly, whether there is a fault or not, few seem to consider having our physical bodies treated or even checked out. A lumbar spine dysfunction i.e. low back stiffness is actually a lot easier to treat when not in pain or muscle spasm and even makes more economical sense to treat when less painful or without symptoms, as fewer treatments are usually needed. Although most of us seem to prefer to take the gamble and assume that, if there's no pain, there's no problem. 
An osteopath may use a variety of approaches for low back pain and dysfunction, including that of the well known 'click' of manipulation*. The 'click' is the releasing of the small 'facet' joints at the rear of the spine and is similar to clicking one's knuckles. This has the effect of directly improving the mobility of a stiff, 'locked' & often painful joint and, through a reflex reaction, relaxes the local muscles that were holding or 'locking' the joint. The muscles can then be stretched to reduce the likelihood of the tension/ muscle spasm returning and the person may be given stretching exercises to maintain mobility of the released joints.
If any joint has been stiff over a long period time, then muscles across the joint will have physically shorten. When you consider that the body does its' utmost to avoid wasting energy, then it's easy to see that a permanently contracted (tensed) muscle is a drain on the system, whilst a shorter more fibrous structure will do the job with less energy.
Irritation or 'locking' of these facet joints is by far the most common cause of neck & low back pain and not the infamous 'slipped disc' (to be the subject of a later article). E.g. The sensation of a 'pulled muscle' is usually due to a facet joint irritation and an actual 'pulled muscle' in the back is very rare, as is, the proverbial - 'bone out of place'. Spinal joints, with few exceptions, cannot go out of place. If you ever get the opportunity to study a real or model spine you could see that this is a mechanical impossibility, in the absence of a fracture and this is only likely to be present if there has been a severe physical trauma to the area or if there is osteoporosis (thinning of the bones) present.
Areas around the lesion are usually treated to breakdown the postural pattern that may have led to, or are as a result of the problem. For more ingrained patterns a Cranio-Sacral osteopathic approach maybe used. (N.B. Not all osteopaths use this approach, so please check if this approach is preferred.) This works with the inherent, very gentle, subtle movement patterns, that occur throughout the body.
Osteopathic treatment is not necessarily a quick fix, although treatment usually gives good immediate symptom relief. Quite often specific exercises are given to improve and maintain the greater mobility gained from treatment, improving the long term outcome. More general exercise may also be advised, such as, swimming, Hatha Yoga or Tai Chi. In short, the more regularly these are practised, the less frequently you will need treatment.
Posture and various other influences are also usually discussed and advised on, as appropriate.
* NB The type of manipulation referred to above is not the sort of manipulation that physiotherapists typically use. There are some physiotherpists that do use this type of manipulation, which they refer to as a Grade 5 manipulation, but physios have to do further postgraduate study to learn this. As such, those that do typically work privately.
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Last Updated (Monday, 20 December 2010 02:31)


