Back pain stopping you doing the things you enjoy?

Back pain is one of the most common reasons people come to see me.

Sometimes it starts suddenly — you bend down, twist or get out of bed and your back seems to lock or go into spasm.

Sometimes it's been grumbling away for weeks, months or even years.

And sometimes the pain itself isn't the biggest problem.

It's the fact that you've stopped playing golf, going to the gym, gardening, walking, running or doing something else that's important to you.

I'm Simon Palmer, a registered osteopath in Chichester, and I've been treating people with back problems for more than 35 years.

My first question isn't simply:

“Where does it hurt?”

I also want to know:

“What is your back pain stopping you doing?”

Why Does My Back Hurt?

There isn't one single cause of back pain.

Your back is a wonderfully strong but complicated structure involving joints, muscles, ligaments, discs, nerves and the surrounding areas of your body.

Pain can sometimes follow an obvious event — lifting something, twisting awkwardly, a sporting injury or doing rather too much in the garden.

At other times there isn't an obvious cause at all.

That's why I don't think it's particularly helpful to look at somebody's painful back and immediately decide:

“You've got a bad back.”

The more useful questions are:

What's irritated it?

How are you moving?

What makes it better or worse?

Is anything else contributing?

And what do we need to do to get you moving comfortably again?

What Happens When I Examine Your Back?

I'll start by asking about the problem: when it began, where you feel it, what aggravates it, what eases it and whether you've experienced anything similar before.

I'll also want to know about your general health and any symptoms that might suggest your back pain needs medical investigation rather than osteopathic treatment.

Then I'll look at how you're moving.

That may include your lower back, but I'll often also examine areas such as your hips, pelvis and upper back because they all contribute to how your body moves.

I'll explain what I think is happening and whether I think osteopathic treatment is appropriate.

If I don't think it is, I'll tell you.

[WATCH: WHAT HAPPENS WHEN YOU VISIT AN OSTEOPATH?]

How Might I Treat Back Pain?

There isn't a standard “back treatment” that I give everybody.

Depending on what I find, how painful you are and what you're comfortable with, treatment may include:

• Soft tissue techniques

• Gentle mobilisation

• Stretching

• Muscle energy techniques

• Manipulation where appropriate

• Functional or other osteopathic techniques

• Advice about movement and activity

Sometimes somebody arrives expecting me to “click their back”.

Manipulation can be useful in appropriate circumstances, but it's only one of the techniques available to me.

You don't have to be clicked.

The treatment should fit the patient — not the other way around.

Should I Rest or Keep Moving?

This is one of the questions I've probably been asked thousands of times.

If your back is acutely painful and almost every movement hurts, a short period of rest may be perfectly sensible.

But once that severe phase begins to settle, I generally want to encourage gentle, comfortable movement.

Start small.

Walk around the room. Then perhaps down the garden. Then along the road.

Build gradually rather than trying to prove that you're better by immediately doing everything you normally do.

One phrase you'll hear me use a lot is:

Movement is medicine.

That doesn't mean ignoring pain.

It means finding the amount and type of movement your body can comfortably tolerate and building from there.

[#SIMONSAYS: SHOULD I REST WITH BACK PAIN?]

Is Walking Good for Back Pain?

For many people, yes.

Walking gives your body a gentle, rhythmic movement involving your legs, pelvis, spine, shoulders and arms.

It's simple, free and something most of us can adjust easily according to how we're feeling.

You don't have to walk five miles.

If five minutes feels comfortable, start there.

[#SIMONSAYS: IS WALKING GOOD FOR BACK PAIN?]

Why Does My Back Go Into Spasm?

A back spasm can be alarming because the muscles can suddenly tighten and make ordinary movements feel almost impossible.

I often describe this as the body becoming protective around an irritated or sensitive area.

That's why aggressively fighting against a spasm isn't necessarily helpful.

Gentle movement and gradually encouraging the area to relax can often be more sensible than trying to force your body into a position it clearly doesn't want to adopt.

[#SIMONSAYS: WHY DOES MY BACK GO INTO SPASM?]

Gardening and Back Pain

Gardening isn't bad for your back.

Spending an hour bent over a flowerbed without moving very much might be.

We often become absorbed in what we're doing and stay kneeling, bending, reaching or twisting for much longer than we realise.

Try varying the job, changing position and getting up regularly to move around.

And hedge trimming?

Reaching, twisting and holding a heavy object at arm's length while possibly standing on a ladder...

Your back may have a few opinions about that.

[#SIMONSAYS: WHY DOES GARDENING AGGRAVATE MY BACK PAIN?]

Should I Stretch My Back?

Gentle stretching can be useful, particularly if you're feeling stiff.

But more isn't necessarily better.

If muscles are tightening protectively around a painful area, aggressively forcing a stretch can sometimes make them fight back rather than relax.

Stretch comfortably rather than competitively.

If you're not sure which stretches are appropriate for your particular problem, ask.

[#SIMONSAYS: SHOULD I BE STRETCHING MY NECK OR BACK?]

Hot or Cold for Back Pain?

Both can feel helpful, and different people respond differently.

For a recent painful flare-up, I often suggest trying a cold pack for a short period to see whether it makes the area feel more comfortable.

Heat can feel soothing where stiffness and muscle tension are prominent.

The simplest rule?

If something makes you feel noticeably worse, stop doing it.

Neither heat nor cold tells us why your back hurts, though. They're ways of helping manage symptoms while the problem settles.

[#SIMONSAYS: SHOULD I USE HOT OR COLD FOR BACK PAIN?]

When Should Back Pain Be Investigated?

Most back pain isn't caused by something serious.

But not every painful back should simply be treated.

There are occasions when symptoms or your medical history suggest that further investigation or medical assessment is appropriate.

That's one reason an appointment starts with a proper case history rather than immediately putting you on the treatment table.

If I hear or find something that concerns me, I'll explain why and refer you to your GP or another appropriate healthcare professional rather than treating you unnecessarily.

35+ Years Treating Back Pain

I've been practising as an osteopath for more than 35 years and have carried out over 30,000 treatments.

And if there's one thing that experience teaches you, it's that backs — and the people attached to them — aren't all the same.

Two people can arrive pointing to exactly the same spot and have quite different problems.

That's why I don't believe in a one-size-fits-all approach.

I'll listen, examine you, explain what I think is happening and adapt treatment to you.

The aim isn't simply to make your back feel better on the treatment table.

It's to get you back to doing what matters to you.

#SimonSays: Back Pain

Want to understand your back a little better?

I've created a collection of short #SimonSays videos answering some of the questions patients regularly ask me:

• Why does my back go into spasm?

• Should I rest with back pain?

• Is walking good for back pain?

• Why does gardening aggravate my back?

• Should I stretch my back?

• Should I use hot or cold?

Straightforward answers based on more than three decades of treating people with back problems.

[WATCH ALL #SIMONSAYS BACK PAIN VIDEOS]

Back Pain Osteopath in Chichester

If back pain is getting between you and your work, sport or everyday life, come and see me.

You don't need to know what's wrong before you arrive.

We'll start by working that out.

Then we'll decide what to do about it.

Simon Palmer
Registered Osteopath
Fishbourne, Chichester, West Sussex
35+ years' experience | 30,000+ treatments

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