Osteopathy for Neck Pain

Did you know that approximately 1 in 3 adults experience neck pain at least once a year? It’s not surprising that it is a common reason that our patients come into Holistic Hands Osteopathy seeking osteopathic treatment. Research shows that neck pain is more persistent in people who have experienced back pain. As osteos who regularly treat patients with neck and back pain, we’ll share some simple steps to follow to reduce the risk of strain in your daily life. Read on to find out about the types of neck pain, and how osteopathic treatment could help.

Function of the neck

The neck, or cervical spine, contains the smallest vertebrae in the spinal column. It has several very important functions: to support the head and its range of motion, to allow blood to flow to the brain, and to protect the spinal cord.

What are the common symptoms of neck pain?

Neck pain is usually acute, which means it resolves within a few days or weeks. If it persists for longer than 3 months, it is considered chronic.

The common symptoms of neck pain include:

●     Muscle tightness, stiffness, and a decreased range of motion

●     Persistent aching

●     Pain that worsens when moving

●     Stabbing or sharp pain

●     Pain that radiates to the head, shoulders, and arms

●     Headaches

What are the common causes of neck pain?

Neck aches can be caused by something minor like sleeping in an awkward position or sitting at your desk for too long.

Some common causes of neck pain include:

●     Poor posture

●     Overuse and strain from sitting for long periods at the computer, or straining while holding your smartphone

●     Slouching forward, or straining while driving

●     Tension/stress

●     Osteoarthritis

●     Awkward sleeping position

●     Whiplash caused by vehicle accidents

●     Sports injuries

Less commonly, neck pain can be caused by serious illness or infection. If you have severe pain accompanied by fever, or numbness in your arms or legs, or you have injured your neck in a fall or accident, be sure to seek medical treatment from a doctor promptly.

How to prevent neck pain?

While it can’t always be avoided, there are some simple steps to reduce your risk of experiencing a strain, including:

●     Practice good posture when sitting and standing, especially for prolonged periods of time. If you need help to resolve postural issues, come and see us!

●     Reduce stress/tension by stretching, practicing yoga or meditating regularly.

●     Use a backpack instead of a shoulder bag when carrying a heavier load to distribute the weight evenly.

●     Check the ergonomic setup of your workstation - adjust your chair or screen to make sure the top of your monitor is at eye level. Keep your head straight, and your shoulders tracking directly above your hips.

●     Check your pillow - is it too soft or too firm? When was the last time you replaced it? You may need to try different pillows to find the right fit.

How to treat neck pain at home

You can manage some mild neck aches at home. Some of the treatments we like include:

●     Heat or ice therapy.

●     Modifying activities that aggravate or cause discomfort.

●     Gentle movement and stretching to prevent the area from tightening further.

How can osteopathic treatment help?

As osteos, we commonly treat neck and back aches in the clinic. Whether your symptoms are acute or chronic, osteopathic treatment could help get to the bottom of them. When a patient comes into the clinic with neck pain or discomfort, we will use a range of soft tissue techniques, including massage therapy, joint manipulation, and stretching which may help to increase blood flow to the area, reduce tightness, and restore your range of motion.

If you need help to manage your symptoms, come and see us. We will assess your symptoms and come up with a treatment plan to get you back to your best.

Injury blog: Spondylolisthesis

Hello readers! Our blog this month focuses on a spinal condition that in the sports world most commonly affects cricketers and gymnasts, but in reality, can affect anyone! The condition is known as spondylolisthesis (pronounced ‘spon-di-lo-lice-thee-sis’) and most commonly affects the lowest segments of the lower spine region.

What is spondylolisthesis? 

Spondylolisthesis is the slipping forward of one vertebra on another. This most commonly occurs at the L5 segment (the lowest vertebrae in the lumbar spine), which slips forward on the S1 segment of the sacral bone. The runner up? L4, which is also a commonly affected area.

There are a few different causes of this condition, and so it has been classified into different types. There are five categories of spondylolisthesis. These are:

1.     Degenerative: Occurs due to degenerative changes to the spinal facet joints and discs

2.     Isthmic: Occurs due to a bone defect in a part of the vertebrae known as the ‘pars interarticularis’

3.     Traumatic: Occurs following a trauma that results in a fracture of either the spinal facet joints or pars interarticularis

4.     Dysplastic: Occurs due to a developmental defect of the vertebrae which alters the direction of the spinal facet joints, leaving the segment(s) open to slippage in the area where they are partially held in place by the facet joints.

5.     Pathologic: Occurs secondary to a medical problem such as infection or cancer

In theory, any process that leads to the weakening of the supportive structures of the spinal segments (i.e. the bones, ligaments, discs, muscles) can lead to abnormal movement of the spine.

Grades of spondylolisthesis

Spondylolisthesis is further classified based on the amount of slippage that has occurred:

•           Grade 1: Between 0-25% of the vertebral body has slipped forward on the vertebrae below

•           Grade 2: Between 25-50% has slipped forward

•           Grade 3: Between 50-75% has slipped forward

•           Grade 4: Over 75% of the vertebral body has slipped forward

The most commonly reported grade of this condition is grade one, accounting for approximately 75% of all cases.

Signs and symptoms

These vary depending on the cause, but can include any or all of the following:

•           Low back pain, including pain in the buttocks

•           Pain along the back of the thigh which rarely goes lower than the knee

•           Tight hamstring muscles

•           Changes in walking pattern

•           Pins and needles and/or numbness down the legs

•           Bowel and bladder dysfunction (in more severe cases)

If you come to us with low back and/or leg pain, we are trained to work out exactly what is going on based on your symptoms and medical history. We will ask you lots of questions to begin with to dwindle our list of potential diagnoses to just one or two. Then we’ll get you to move and through a thorough movement assessment, will be able to come to a specific diagnosis that we will work with you to treat.

Sometimes we may require the help of imaging to rule in or out spondylolisthesis, depending on the severity of symptoms and how much it is impacting your life. In these cases, we will send you off for an x-ray which can detect this issue.

Treatment

Most cases of spondylolisthesis can be managed conservatively, meaning non-surgical options are chosen over a surgical one. When this injury occurs, the instability of the particular spinal segment can lead to many of the signs and symptoms mentioned above. One of the main goals of treatment is to increase stability around the affected area and offload the forces that are acting on the injured area.

We will spend time educating you on the mechanics of the spine. If you understand what is happening to your spine, you will know how to protect it, without adding unnecessary stress to the area. We will also advise on appropriate footwear, as well as standing, seated and sleeping postures. Being obese or overweight is also a risk factor for developing, as well as maintaining this problem. If you need to lose weight, we can help you formulate a plan to get there.

Exercise to increase core stability, as well as flexibility of tight muscles is a very important part of therapy as this will reduce the need for external supports such as braces in the long term. And of course, not forgetting our wonderful hands which will get to work on your muscles and joints to reduce tension and tightness, while increasing range of motion.

All of the above treatments will help you to manage pain, increase function and get you back to work or sport or gardening… Whatever your goal is! Call us today on 0439379847 if you have low back pain, or even if you already have a diagnosis of spondylolisthesis, and we can help you formulate a recovery plan to get you on the road to better health.

Fractures Let’s ‘break’ it down

Have you ever broken a bone? We hope you haven't, but it’s a common injury that happens to people every day! Any break in the structure of a bone is known as a ‘fracture’. We’ve written a quick guide to understanding all the lingo relating to fractures below. Let’s check it out!

Causes

Fractures are usually caused in one of three ways:

•           Excessive force: This can be through either a direct force to a body part (i.e. a high tackle in football which breaks the shin-bone) or an indirect force (i.e. having your foot planted and twisting your leg which leads to a fracture of the shin-bone).

•           Repetitive stress: These result from repetitive, strenuous activities like running or jumping.

•           Other disease: These are fractures secondary to another disease process in the body which leaves the bone more prone to breaking. This may be a hereditary disease like Osteogenesis Imperfecta (aka Brittle bone disease) or as a result of cancer or infection.

Types of fracture: General description

Fractures are broadly classified into two main types:

•           Closed: The bone fractures and the overlying skin remains intact.

•           Open: The bone fractures and protrudes through the skin exposing the bone and other tissues to the elements. These types of fractures are prone to becoming infected, which complicates everything.

We can also classify fractures on whether they are:

•           Complete: A clean break of a bone into two or more pieces

•           Incomplete: The bone is not completely broken with some of the outer structure of the bone remaining intact.

Types of fracture: Now let’s REALLY break it down!

Each fracture can also be given a more specific description based on where exactly the bone is broken and in what way it has broken:

•           Transverse: A horizontal break across the shaft of a bone.

•           Linear / fissure: A vertical break along the shaft of a bone.

•           Oblique / spiral: A diagonal, or as the name suggests, spiral type fracture around the shaft of a bone.

•           Greenstick: One side of a bone has broken but the other side remains intact. This is common in children where bones are much more flexible than adult bones.

•           Comminuted: The bone is broken into more than two pieces, possibly into several fragments

•           Impacted: Two parts of a bone fracture are forced into one another

•           Crush: Usually seen in the spine caused by vertical and forward bending forces down through the vertebrae

•           Hairline: A tiny crack in the bone — these are so small that they are commonly missed on an x-ray!

•           Avulsion: A piece of bone is ripped away from the main bone by way of tendon or ligament injury. (Remember tendon attaches muscle to bone and ligament attaches bone to bone).

Which type of fracture have you had in the past? We hope this guide will help you work it out. Next time you come across a fracture (fingers crossed you don’t) you’ll know exactly what the doctors are talking about!

Stay safe!

Injury blog: Winging of the shoulder blades

Hey everyone! We hope you are keeping well. We’re carrying on with life as close to normal as possible, so here is your monthly reading material. Perfect time for a tea or coffee we say! This month we’re taking a close look at the shoulder, specifically a condition that affects the shoulder blade. Do you have, or have you ever seen someone whose shoulder blades stick out on their back and look a little bit like wings? This condition is aptly named ‘winging’ of the shoulder blades.

Anatomy

Osteopaths love a bit of anatomy! The shoulder blade or ‘scapula’ is a largely flat bone that sits on the back of the rib cage and is an important ingredient in what makes up the various joints of the shoulder. As well as the larger flat part, a few extra lumps and bumps makes for a very odd shaped bone when looked at in isolation. One of the bony protrusions actually makes up the ‘socket’ part of the ball and socket joint in the shoulder. The ‘ball’ part being made from the head of the upper arm bone (aka the ‘humerus’).

Interesting fact… There are 18 muscle attachments on the shoulder blade. It is through fine balancing of these muscles which keeps the shoulder blade stabilised and flush to the back of rib cage, and allows us to move our shoulders through an extremely large range of motion. As you can imagine, keeping all of these muscles in full working order takes a bit of co-ordination. And with so many players involved, there is room for dysfunction to creep in and movement to become affected. Sometimes the dysfunction is great enough to cause the shoulder blade to flip outwards from the rib cage, and this is what we refer to as ‘winging’.

Causes of winging

The causes of shoulder blade winging can be broadly broken down into:

•           Muscular: As we previously mentioned, lots of muscles are responsible for controlling the position and movement of the shoulder blade. Injury to these muscles, or an imbalance in the strength, length and function of the muscles over a prolonged period may lead to this issue. The main muscles involved here are the Serratus Anterior (a muscle which attaches to the ribs and the underside of the shoulder blade), and the Trapezius (a kite shaped muscle which covers the back of the neck, shoulders and upper back… Aka ‘traps’). It’s more complex and there are more muscles involved, but these are the key players when it comes to winging.

•           Neurological: Muscles require a nerve supply in order to move, so if any of the nerves that supply the key players (i.e. Serratus and Traps) are injured, this can stop the muscles from being able to perform their job. Nerves can be injured through entrapment, where something presses on a nerve as it travels from the spine down to the muscle it supplies. Other causes may be from acute traumas as seen with car or sporting accidents where the shoulder takes a direct blow while the arm or neck are suddenly pulled.

Other ways these injuries may come about include prolonged wearing of a heavy backpack, complications following surgery, or as a result of a viral infection that affects the nerve.

Signs and Symptoms

The main sign is a shoulder blade that doesn’t sit snug to the rib cage, particularly when trying to move the arm upwards in front of the body or out to the side. Many people with scapula winging feel no pain whatsoever, but this can be a very painful condition if the cause is from a severe nerve injury. Another key sign is the inability of a person to lift their arm above their head.

Treatment

The treatment of shoulder blade winging very much depends on the cause. If the shoulder blades are winging because of a muscular imbalance, these are a little easier and faster to rehab. After careful assessment of your shoulder, neck and other spinal movements, we will aim to restore full functioning of the muscles that control the position and movement of the shoulder blades. This might include techniques which aim to lengthen short or tight muscles which are pulling the shoulder blade out of position. If there is a weakness to a particular muscle or group of muscles, we will also prescribe you strengthening and movement re-training exercises which aim to return the shoulder blade to its functional position.

Winging caused from nerve entrapment or injury is notoriously harder to treat. If entrapment of the nerve is caused by muscular tension in another part of the body, or because you’ve been carrying a heavy backpack for too long, then we will work on the relevant muscles and nerves to release the entrapment and pressure. We might also need to adjust how you wear your backpack and how much weight is inside while we focus on improving your physical impairments. Nerve-related injuries can take much longer to resolve. Winging caused by paralysis of the nerve which supplies the Serratus Anterior muscle has been known to take up to two years to resolve. The good news is, most people will make a full recovery in this time with surgical procedures saved only for more complex or unresolved cases. Which if you ask any Osteo, is always the goal!

If you notice winging of the shoulder blades, or difficulty with achieving full shoulder range of motion, then get in touch today on 0439379847 and get you on the road to recovery as soon as possible.

Bracing: when it is helpful and when it isn’t

A very common question we get asked at Holistic Hands Osteopathy is “Do I need to wear a brace to help with my injury?” Well this is very much a ‘depends’ sort of answer. It depends on the injury, where along the injury process you are and your personal circumstances.

Let’s first outline the advantages of wearing a brace and give some examples of when you might need to wear one.

Braces are items we place on a body part, usually over and around a joint, to provide extra stability to that area. They come in different forms but are generally quite flexible and elastic to ensure they move with the body, whilst being strong enough to protect the joint simultaneously.  Some braces are quite movable whilst others can lock a joint in a particular position.

When is it helpful?

The advantages of bracing include:

•           Providing stability to an injured body part to aid with treatment, rehabilitation and return to sport or work scenarios

•           Allowing faster healing by limiting movement at an injured body part

•           Reducing pain by de-loading injured structures

•           Can be easily put on and removed for any given situation

•           Are widely available and affordable

A common injury where you may need to use a brace is in the early stages of a moderate to severe medial collateral ligament (MCL) sprain of the knee. Imagine your knee has been forced inward whilst your foot is planted on the ground. If the force is great enough, the ligament stretches, tears and the stability of the knee is compromised. In this case, a brace is helpful to stop the knee from falling inwards again, which would interrupt the healing of the ligament. As healing progresses, the brace can be used less frequently or removed altogether to allow for more movement and activity. Other examples where a brace may be required include:

•           Wrist and ankle sprains

•           Tennis or golfer’s elbow

•           Knee cruciate ligament sprains

•           Pelvic instability (these are particularly helpful during pregnancy)

•           For stabilisation and re-training of scoliosis cases (i.e. abnormal spinal curves)

When isn’t it helpful?

One of the most common negative effects of bracing that we see is over-reliance. When someone has injured their ankle playing netball, part of the rehab process to get them back on the court quickly may be to wear a brace to provide them with the confidence to play to their full potential without fear of re-injury. This is all well and good as long as they wean off using the brace as rehab progresses. Many people end up wearing the brace as a safety net for 6 months, a year, or even longer because they are scared of re-injury. If you rely on a brace for support, it means the body part that was injured won’t have the necessary forces placed through it to ensure a full recovery to a pre-injury state. This could affect many factors including muscle strength, ligament stability and the body’s ability to know where the joint is in space (a.k.a ‘proprioception’). In order to return to that state, it's necessary to move and exercise completely unaided.

Other disadvantages include:

•           Failure to achieve full joint range of motion post-injury

•           Possible muscle wasting

•           Increased loads placed on other body parts, which can risk another injury elsewhere

Our best advice to you is to never see a brace as a replacement for good movement and rehab. Always follow the advice of your practitioner as to when you should and shouldn’t wear a brace. If you have any doubts or questions, please call us on 0439379847 to discuss.

Injury blog: Student’s elbow

G’day readers, it’s blog o’clock! This month's blog is about a common elbow injury. Ever heard of student’s elbow? “But I’m not a student!” we hear you say. Well you don’t have to be to fall victim to this condition. Students elbow, or ‘Olecranon Bursitis’ is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the ‘olecranon’ and the small sack which sits between the bone and the skin is called a ‘bursa’. The ‘itis’ part of bursitis simply refers to inflammation of that bursa.

What are the causes?

The most common way to develop student’s elbow is repetitive trauma to the tip of the elbow which slowly irritates the bursa and causes inflammation over time. Think of a student who sits for hours, day after day writing at a desk with their elbow resting on the table. The constant pressure on the tip of the elbow could be enough to kick things off. Anyone whose elbows are subject to repetitive pressure could develop this problem; plumbers and office workers are other good examples.

Other causes include:

•           A single blunt force trauma or fall onto the tip of the elbow

•           Infection

•           Having an olecranon spur (an extra small bony growth which rubs against the bursa)

•           Having an extra pointy olecranon (some peoples skeletons are just a bit different)

This condition may also develop as part of having another medical condition, such as Diabetes Mellitus, Gout, Rheumatoid Arthritis, HIV or alcoholism.

Signs and symptoms

So, what does student’s elbow look like? Signs and symptoms include:

•           A painful or (often) non-painful swelling on the end of your elbow

•           Pain with leaning on your elbow

•           Painful elbow movement

•           Restricted elbow movement (although this is often unaffected)

•           Redness, warmth and a fever (if associated with infection)

Will I need to have any tests done?

Possibly. As with all lumps on the body, your practitioner will want to rule out anything serious going on first. We ask lots of questions so we can paint a picture of what’s going on in our clinical head. Depending on your signs and symptoms, if you have a history of cancer or if infection is suspected, you may be directed to your GP for tests. This is to make sure you are receiving the best treatment in the best time frame. Your doctor may need to take a sample of the fluid inside the swelling to be sent off for lab testing. This will be able to tell us if infection is playing a part or not.

Treatment

The treatment of bursitis is very much dependent on the cause. If the cause is infection, then your GP will start you on a course of antibiotics and anti-inflammatories to fight it off and control the pain. Other treatment may include the use of ice or contrasting hot/cold bathing to help reduce the swelling. In severe cases, your elbow may need to be splinted or elevated in a sling. Elbow pads and changes to your general activities may also help to protect the elbow from further injury. Your GP may offer to drain the swelling (this is called ‘aspiration’ and requires a needle to remove the fluid), and this can help to provide relief by reducing pressure around the elbow.

Once clear of infection, or if you have a non-infective bursitis, then your superhero osteo can step in and work their magic. Abracadabra!

During the inflammatory process, swelling and pain may have affected how you use your arm. With pain, people often stop using that part of the body and swelling can affect the joint's ability to move smoothly through its range of motion. This can have a knock-on effect on the muscles and other tissues which surround the elbow joint. Many muscles which cross the elbow and are involved in elbow movement also cross the shoulder and wrist to aid in their function. So, you can see how a problem at the elbow could affect the whole limb (and beyond).

Here at Holistic Hands Osteopathy we will get to work at restoring full function to the shoulder, elbow and wrist. We will look at your spinal movements too to see if they have been affected. You can expect to be mobilised and massaged and we may also perform some lymphatic drainage techniques to help restore fluid movement through the limb (which may have stagnated during the injury process). Your biceps, triceps and other arm/forearm muscles may have shortened over time so we may perform some stretching techniques and will give you some exercises to do at home to back up what they do in the clinic room. If necessary, strengthening exercises may be given to reduce the risk of future episodes.

If your bursitis doesn’t resolve with the above treatments or keeps coming back, a decision may need to be made on whether the bursa should be removed surgically. This is called a ‘bursectomy’ and is usually a last resort. Extra pointy olecranons or spurs can also be treated surgically if needed.

Back to school… And work!

Now that the festive season is over, the kids will be back to school and the parents back to work. Normality resumes. Keep an eye on those elbows people! If you think you are developing an elbow problem (or any body part for that matter) then please call us on 0439379847 and we’ll get working on it straight away.

Injury blog: Shoulder impingement

Suffering from shoulder pain? Lucky for you that our December blog is all about shoulder pain… We’re good like that! As osteopaths, shoulder pain is up there as one of the most common complaints we treat, after lower back and neck pain. Office workers, gym goers and overhead sports people, such as basketballers and netballers are all regular victims of shoulder pain.

A common shoulder complaint that we see is shoulder impingement, otherwise known as subacromial impingement. Say ‘shoulder’ and most people think of a ball and socket joint. This joint does indeed make up a large part of the shoulder, but there is much more to it than that. Over the top of the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone (aka the clavicle), shoulder blade (specifically the ‘acromion’ part of the shoulder blade) and a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub = underneath).

It is within this space that the abovementioned impingement occurs and if present, may cause pain when moving the arm.

Why does impingement occur?

Well, there are quite a few soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles, a ligament and a fluid-filled sac called a ‘bursa’. Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated, overhead arm use in throwing sports, or chronic poor positioning of the shoulder and posture in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could lead to increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, so a person may end up with an inflamed bursa too.

 

Signs and symptoms

When someone has shoulder impingement, they may experience any or all of the following:

•           Pain when moving the arm (e.g. our cricketer above may feel pain when throwing)

•           Decreased range of motion in the shoulder

•           Weakness when using the arm on the affected side

•           Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child

Get to the osteo quick sharp!

If you want to get on top of your shoulder pain quickly, then we recommend a trip to see us here at Holistic Hands Osteopathy. After some thorough questioning and assessment, we will work out what lifestyle or movement factors are responsible for your pain. We’ll get to work with our hands straight away. Using a combination of soft tissue massage, joint mobilising, and many other techniques, we will aim to reduce your pain and get you moving better. Someone with a shoulder problem nearly always has an issue related to neck or back movement, so don’t be surprised if we go looking further afield on the body for answers to your problem.

If you are a thrower, we may ask you to demonstrate a throw so we can see how you are moving (don’t worry, we won’t ask you to do this if you are in acute pain). Likewise, if you are a desk worker, we may ask to look at your desk set up and sitting posture. Getting you to take a photo of yourself at your desk is often helpful for us to see if you need to make some changes that may be affecting your posture day-to-day. When it comes to any lifestyle advice, whether it’s the hobbies you have or the way you sleep, we’ve also got you covered!

We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quick as possible, always follow our advice between treatments, and please do your exercises! If you have weakness somewhere which is leading to your pain, a few treatments are not going to resolve this. Weakness and instability need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day. It’s a team effort. We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!

If you have shoulder pain, then don’t stand on ceremony, book an appointment today by contacting our clinic on 0439379847/www.holistichandsosteopathy.com.au. We’ll have you back throwing balls from the boundary quicker than you can say howzat! And if you have no idea what howzat means, then we suggest you ask the audience or phone a friend! ;-)

Let’s talk TMJ dysfunction

Hello and welcome to our November blog! The end of 2019 is fast approaching which means soon there will be an influx of social gatherings, work Christmas parties and family get togethers coming our way. What do we do at these gatherings? We talk, eat, drink… And maybe have a good catchup or two! Therefore, it’s very important that you have a good functioning jaw right?! Do you get jaw pain or clicking? Do you also suffer from headaches or neck pain? This month we’re focusing on our jaw joints - what we use them for, how these joints can cause issues and what we can do to help.

 

A bit of anatomy…

The jawbone (or mandible) is the bone which hangs from your skull, creating the lower part of your head. It houses the lower teeth and attaches either side of the head just in front of the ears. Put your fingers just in front your ears in line with the ear holes, gently open and close your mouth and you will be able to feel movement at these joints. These joints are called the temporo-mandibular joints, or TMJ. Movement at these joints occur when we open and close our mouth during activities such as eating and talking. As well as opening and closing our jaw, we can move it side to side and forwards and backwards!

Movements of the jaw, such as chewing, are controlled by various muscles. Three main muscles close our mouth, and one main muscle aids with opening it. This makes sense when you think about gravity's effect on the body. We need a bit more help to close our mouth and bite into our food than we do to open it and let it hang.

Problems with the TMJ

A common jaw condition us osteo’s treat is TMJ dysfunction. This is a relatively broad term we use to describe an issue with this specific joint which affects women twice as much as men. Problems can arise from many structures in and around the joint, including the muscles, joint surfaces and a small disc which sits inside. Muscle imbalances are common and can lead to stiffness or pain (or both) when opening and closing our mouth. Tightness in the surrounding muscles could be a result of trauma to the jaw (like with being punched or hitting your chin after a fall), clenching when sleeping (known as ‘Bruxism’), a neck dysfunction/restriction, or from dental problems such as having an uneven bite. People who are highly stressed will often clench their jaw in their sleep, which may lead to waking up with a sore jaw or headaches.

Inside the joint itself is a small disc which slides and moves during jaw movements. Sometimes this disc can become ‘displaced’ and may not slide and move as smoothly as it should. This may often lead to a jaw that clicks or cracks when opening the mouth. For the most part, the click is painless, however some people may experience pain alongside a click. In some severe cases the jaw may temporarily lock, which as you can imagine would be quite distressing to experience. Pain from the jaw joints can sometimes also present as ear pain.

Osteopathic treatment for TMJ dysfunction

Treatment for TMJ dysfunction will greatly depend on the cause of the dysfunction. A simple muscle imbalance may be corrected by soft tissue release of the jaw muscles, joint mobilisation, and corrective mobility and strengthening exercises. It is rarely that simple though. More often than not, a TMJ dysfunction will come hand in hand with a problem in the neck and shoulders, be it restriction of movement or poor stability and strength in the region.

An osteopathic approach to treating TMJ dysfunction will include a thorough assessment of the head, jaw, neck, shoulders and mid-back (and quite possibly further afield than that!). Because of the proximity of the jaw and neck, you rarely get dysfunction in one without the other. Your osteo will question you about your occupation, sleeping habits, hobbies, and current stress levels - all of which may be playing a part in your condition. If your osteo believes your TMJ issues stem from a dental issue, they may advise a visit to the dentist for a check-up as sometimes problems can be resolved with input from both professions. If clenching is an issue, you may find it useful to wear a gum shield or mouth guard to bed to alleviate pressure on the jaw and teeth. We appreciate it’s not the best look in the world, but it can be a game changer! Stress management including breathing, relaxation and mindfulness techniques can also be a great way to beat that stress in your life. Don’t worry, your osteo will have some tricks up their sleeve for this too. Always let them know if you feel like you need help with this aspect of your life.

If you think you might have a jaw problem, then don’t keep it tight-lipped. Open up that mouth and reach out to us (by talking we mean!). We’ll have you ready for copious amounts of food, drink (we say copious, but we mean in moderation, of course) and chin-wagging in the upcoming festive season before you can say ‘temporo-mandibular joint dysfunction’… Don’t worry, we struggle with that one too :) #tonguetwister

Safety at work

The great thing about Osteopathy is that it’s not just about ridding people of their pain. It is a way of life. Yes, people come to see us to get rid of pain, but once they are in our caring hands, our work doesn't stop there. We are huge advocates of ‘prevention is better than cure’. So, we will delve deep into your life - your diet, sleep patterns, hobbies, job and more. We look at you and your life as a complete package and will help you work out what areas need adjustments so you can live a long and healthy life (which is as pain-free as possible!).

Work is a big part of most people’s lives and is often a significant contributing factor to their pain. This month we’re giving advice on two key areas to ensure you are looking after yourself at work, so you can avoid injury and keep food on the table. All in the name of ‘National Safe Work Month’! Read on to ensure you are giving yourself the best possible chance of staying injury-free at work.

Lifting posture

We see lots of people coming in for treatment because they have hurt their back, neck or shoulders in a lifting-related incident. Our advice for you…

1.     Plan ahead to make sure you have a clear path from A to B for the object you are carrying. Make sure the object is stable and is not going to topple over whilst you are carrying it.

2.     Get close to the object and with your feet hip-width apart, and whilst keeping a straight back, bend at the hips and knees to get low to the ground (key words here – “STRAIGHT BACK”!).

3.     Ensure you have a firm grip of the object and whilst keeping your back straight (there it is again!), lift from your hips and knees until you reach an upright position.

4.     Always move using your feet rather than twisting or leaning through your back.

5.     Always keep the object close to your body. Never try to hold it out in front of you with your arms, as this places a great deal of stress on your shoulders, neck and back.

6.     Always get help from another person(s) if the object is too heavy for you alone. It is NEVER worth the risk of injury by tackling a task that may be slightly beyond your physical capabilities.

Desk set-up

Postural strain from a seated desk job is another common work-related injury we treat. To ensure you are sitting pretty, our advice to you is…

1.     Ensure the top of the screen is level with or just below the level of your eyes, and centred in front of you.

2.     Sit with relaxed shoulders, elbows bent at 90 degrees and avoid cocking the wrists back when typing (adjust your desk height to suit this if possible).

3.     Adjust the tilt of your chair to allow the hips to sit at an open angle of 100-110 degrees.

4.     Adjust the backrest of the chair to ensure you are supported in an upright position whilst seated.

5.     Avoid slouching back on to your tailbone. Instead, gently roll your pelvis forward to sit on your sitting bones and bring the curve of your low back into its natural position.

6.     Take regular breaks from sitting. Get up out of your chair every 30-45 minutes to allow your body to move and stretch.

So there you have it. Our skills are much more than just our hands. We’re full of good advice! No matter what job you do, we’ll help you break it down to make sure you are getting the most out of it and not putting yourself at risk of a workplace injury. Here’s to a happy workday, every day!

Osteoarthritis: aging and your body

Hello readers and welcome to October’s blog post! This month we are turning our focus to the elderly - an ever-growing population. Did you know that there are approximately 700 million people in the world aged 60 and over? And did you know that it is estimated that by 2050, there will be around 2 billion people on the planet that fall into this age bracket? That’s just over 30 years away! That’s quite difficult to comprehend, but with people beginning to work and live longer, it’s important that the elderly population get the attention and care they need to stay healthy and active; so they can enjoy the quality of life they deserve.

You might think that as people get older, they become less active and therefore are less likely to injure themselves. This may be true to a degree, especially once reaching retirement age, but the elderly population are generally an active population and are just as much at risk of injury as the next person. A 60-year-old person might not play footy or run around the basketball court as much as a teenager might, but they have other things to contend with - an ageing body with years of gradual degenerative change and weakening that we all experience at some point as we go through life. One of the most common causes of injury in the elderly is falling. Unfortunately, as the body ages, it becomes more prone to falls. This usually boils down to a combination of individual factors (i.e. having multiple diseases, poorer eyesight, or general weakening of the body) and environmental factors (e.g. trip hazards around the home setting). Some of the most commonly seen injuries sustained from falls include fractured hips, arms and forearms, cuts and lacerations, as well as head injuries.

In a clinical setting, us Osteos see our fair share of older patients. It’s less likely we’ll see someone in the acute setting immediately following a trauma like a cut, laceration or in many instances where a fracture is suspected, but it does happen. It is much more likely however, that we will see patients experiencing pain related to postural strain (think about the retiree who sits around a lot), or from degenerative changes in the body. A common degenerative condition affecting the elderly population is osteoarthritis (OA). This most commonly affects the joints in the hips, knees and spine - particularly those of the neck and lower back. It’s no coincidence that these are the main weight-bearing joints of the body.

So what is OA?

OA is a condition affecting the synovial joints in the body (the joints between two bones in the body that have a lubricating fluid between them). It is characterised by changes to the cartilage and underlying bone, as well as inflammation and irritation to the soft tissues that help to hold the joints together - known as the synovium - it’s the tissue that forms the lubricating fluid that sits between the joints.

Primary OA refers to changes in the joints that relate to the ageing process. It will often run in the family, so if your granny or dad has it, you may be more at risk to develop it. Secondary OA is arthritic change from any other cause. For example, following on from trauma, repetitive stress, poor posture, or from diseases such as gout.

Signs & symptoms

The main symptoms (things the person experiences) of OA include pain, stiffness, poor joint function and muscle weakness. Signs (things we look for in the clinical setting) that a joint is degenerated include popping and clicking, poor range of motion, bone and joint swelling, deformity and instability.

What to do if you have or think you have OA

First things first, book an appointment to see your local Osteo. After questions and assessment, we’ll get to work on your body and putting you on a pathway to moving better. There is a good chance your arthritic joint is paining you because you aren’t moving well, and the joint is being loaded incorrectly. The good news is, we know how you should be moving, and what needs to be done to get you there. We’ll aim to reduce your pain down by releasing tight and over-worked muscles and mobilising your stiff joints. Mobilising the joints helps to increase range of motion and will help promote production of the lubricating synovial fluid that sits between the joints to allow smooth fluid movement. You should get off the treatment table feeling less pain and moving better. There is a good chance you’ll need to do some form of strengthening to the surrounding weakened muscles, so the joint is more supported when you move it. More good news, we know which exercises will be beneficial to get you on the path to stronger muscles. Unfortunately, we cannot claim to cure your OA, but we can certainly get you moving with less pain or in an ideal situation, no pain at all.

What’s the outlook with OA?

More often than not, if caught early, significant changes can be made to stunt the progression of this degenerative condition. So, don’t ignore pain, it’s your body’s way of telling you something isn’t right. With early treatment, the best possible outcome will be achieved. If you pop into the clinic and we determine your issue is not OA-related, we can provide you with a sense of relief and get you on the right track for your situation (a positive outcome, either way!). In severe cases, you may require the opinion of a specialist orthopaedic surgeon. Sometimes people require joint replacements and can go on to live a very good quality of life with a new hip or knee for example. Always see your Osteo first though. Using our skills, we can possibly keep you from having to go under the knife a bit longer, and maybe even at all. Worth a shot don’t you think?!

Pain from within - Why pain isn’t always simply a strain or sprain

Did you know that you don’t always have to strain a muscle or sprain a ligament in order to feel pain? Deep inside your body are the cogs that keep your body ticking over… your organs. We have lots of organs inside us: The heart, lungs, stomach, intestines, liver, gallbladder, and more. Well, did you know that when something goes wrong with these organs, they can also give you pain? To add to this, sometimes that pain is felt in a completely different part of the body than where the organ is located! This can lure you in to thinking that something is wrong with that body part when really there isn’t. Sounds silly right? Let us explain further…

In scientific terms, we are referring to a phenomenon called viscero-somatic pain or a viscero-somatic reflex. ‘Viscero’ refers to ‘organ’ and ‘somatic’ refers to ‘body part’. So, by definition, viscero-somatic pain is pain that comes from an organ that is felt in a specific body part. And for each organ, there is a specific body part or parts that you will generally feel the pain in. It all comes down to how the body is wired in the nervous system. We’ll give you an example to make this a little clearer…

When someone has a heart attack, the classic symptom is chest pain (although not always). However, they will often experience other symptoms such as left-sided neck, jaw, shoulder and arm pain. The reason for this is when the heart muscle becomes devoid of oxygen from a blocked artery, a nerve signal is sent to the spinal cord and up towards the brain to alert the brain that something is wrong. At the same level of the spinal cord where those heart signals enter, there are also other nerves entering that relate directly to the muscles and skin from the neck, jaw, shoulder and arm. The theory is that the brain cannot distinguish where the problem is coming from, due to the close proximity of the nerves in the spinal cord, and therefore you may feel pain in both the chest and in these other areas. It’s pretty crazy right?!

A problem with the liver or gallbladder can give pain symptoms in the abdomen and also in the right shoulder. It’s for the same reason as above, but just a slightly different wiring for that organ.

As an Osteo, we will be looking for certain signs and symptoms if we suspect this might be happening with you. These might include:

•           Pain that is deep, diffuse and difficult to localise

•           Pain that is difficult to reproduce in the clinic room

•           Changes in the skin, such as sweating, dryness, redness or changes in sensation

•           Changes in the muscles, such as spasm or rigidity

•           Pain which is unaffected by activity or rest

We’ll also be very interested in your medical history and will ask you questions to see if you have a history of digestive, breathing or urinary issues (this depends of course on the organ we suspect may be the issue). There may be a few sensitive questions we need to ask, so please do not be offended if we dig deep. It’s all to ensure we get to the root cause of your issue. Some of our treatment may also be aimed at affecting the target organ itself. We’ll be sure to talk you through any treatment techniques before we perform them. Rest assured, if we feel you need to be seen by a GP or specialist, we’ll point you in the right direction to ensure you are in capable hands.

The Lymphatic System

Hello everyone and welcome to our September blog post. This month we’re going to introduce you to your lymphatic system. What it is, what it does, and why your Osteo loves it so much.

 

So, what is the lymphatic system?

One part of it is a collection of small tubes found right throughout the body, and you can think of these tubes as part of the circulatory system of the body. Say ‘circulatory’ and everyone thinks of blood, arteries and veins, but the buck doesn’t stop there. The lymphatic tubes are well and truly just as important as the tubes that carry blood around the body. The other part of the lymphatic system is a collection of larger tissues found in various areas of the body and you can think of these as part of the body’s defence system. So straight away, you can see it’s pretty darn important!

Let us take a look at these areas in a little more detail… A little recap for you on circulation: arteries take blood from the heart to the body, and veins take blood back to the heart from the body. Where does the lymphatic system fit in to all of this? Well, the tubes (or vessels) of the lymphatic system roughly follow the pathway of the veins of the body (so back towards the heart). The pump of the heart creates pressure, which drives blood through the arteries where it gets distributed around the body providing life-giving nourishment to all of the different tissues of the body (i.e. our skin, muscles, bones and organs). However, the pressure from the arteries causes some of the fluid and nutrients in blood to leak out into the surrounding areas. And this is where the lymphatic tubes kick in. They pick up the excess fluid and nutrients (mainly proteins) and send it all back towards the heart to be re-used by the body. This ensures every valuable bit of fluid and nutrition in the body is not wasted. Very efficient right?! The fluid that travels through lymph vessels is simply called ‘lymph’.

The lymph travels through the lymph vessels by a combination of muscle contractions in the vessel walls, and us moving our bodies (another reason why moving is so good for you!). Along the way back up to the heart, the fluid is passed through a filter station called a lymph node. Here, any of the nasty bacteria, viruses, or even cancer cells that are in the lymph are dealt with swiftly by our defence cells. The freshly cleaned lymph is then sent further along the chain until it reaches a vein close to the heart. It is here where the lymph re-enters the blood and the cycle continues. 

Before we forget (just kidding, we never forget!), in the small intestines there are some very specialised lymph vessels which help the body to absorb fats from the foods we eat. This is another important function of the lymphatic system!

Defence, defence, defence!

 

On the defensive front, there are various tissues located around the body (called lymphoid tissues) where the production of our defence cells occurs. The main tissues include the ‘thymus’ - which is found in the upper chest region, and the ‘spleen’ - found in the abdomen. If it wasn’t for these handy organs, we would be much more susceptible to infection and disease (and death). So, it’s these organs which help to populate our bodies with the lifesaving defence cells. We have a lot to be thankful for with this system!

Osteos love their lymphatic systems

So why are we so interested in this system? Well at the heart of Osteopathy lies the principle of maintaining fluid balance and equilibrium throughout the body. We’re all about keeping the flow going. But sometimes flow of fluid in the body can become compromised, maybe due to injury or disease, and then congestion in the tissues occurs and things start to stagnate. This can lead to a whole host of issues including reduction in movement, pain, and imbalance throughout the body. Regardless of your issue, our treatment will aim to remove any barriers to a functioning system to reinstate flow of fluid through the body. Sometimes a dysfunctional lymphatic system can lead to a type of swelling called lymphedema, which is essentially a backlog of lymph fluid. This often occurs in the hands, arms, feet and legs. Depending on the cause, this is something your trusty Osteo is skilled at dealing with, so always seek help if you notice swelling.

We hope this has been interesting and educational, and we hope you now have a newfound respect for the intricacies of the human body. After all, it is what keeps you alive, so look after it. Here’s to health!!

Why your Osteo wants you to sleep

Did you know that sleep is good for you? You might be thinking well that’s obvious isn’t it? However, you might be surprised to hear that nearly 10% of the Australian adult population (that’s over 1.5 million people) suffer from some form of sleep disorder and are living with consistent, insufficient levels of sleep.

Now when you’ve come in to see us, or next time you’re in for a bodily complaint, we may have asked, or ask you about your sleeping habits. This is because as Osteos we pride ourselves on being thorough and delving into a person’s life to see what lifestyle factors could be contributing to their issue, pain or injury - it’s what makes us such awesome practitioners!

Lack of sleep, or sleep deprivation is just one important factor we will consider when conducting your initial consultation. Sleep is relevant for all types of complaints and seeing as it is Sleep Awareness Week between the 5-11 August this year, we thought we would write a little blog outlining the reasons why we want you to improve your sleep habits. We’ll keep this short, after all, we don’t want you falling asleep on us!

The benefits of sleep are numerous, complex and as with a lot of things to do with our amazing bodies, not yet fully understood. Some of the important benefits include:

1.     It helps to achieve peak physical health.

After a busy day running around after the kids, being in the gym pumping iron, shooting hoops on the basketball court, or working long hours on a computer — your body needs time to recover and repair from the days strains and stresses. Sleep is when a lot of this recovery takes place. If you want all the hard yakka in the gym to pay off, then make sure you get regular, high-quality sleep. During a deep sleep period, your body releases hormones which help your muscles to recover, strengthen and build mass. This is similar when recovering from injury. You might be asleep, but your body is still busy working away trying to put things right and keep you functioning for when you rise the next morning. Inadequate sleep has also been linked to increased rates of obesity, cardiovascular disease (including high blood pressure and stroke), kidney disease and diabetes. Being sleep deprived may also affect your immune system’s ability to fight off common colds and flus (which are in surplus during the winter months!)

2.     It helps to maintain healthy brain function and mental well-being.

Did you know that being well rested improves your ability to learn? And after a day of learning, a long sleep helps you to consolidate and reinforce what you have learned during the day. So, you’ve been to see your Osteo and they have you performing some new stability exercises for your shoulder or body rotation mobility exercises to help improve your golf swing. You’ve been practicing and practicing between sessions, and because you are sleeping well, your body is more likely to adapt and remember those movement patterns better than someone who is sleep deprived. You can expect to be more focused, creative and have better problem-solving skills if you are getting the Zzz’s in. You are also less likely to experience depression, mood swings and lack of motivation. Win, win, win!

3.     It helps you to stay safe.

Between the years 2013-2017, more people were killed in car accidents relating to tiredness and fatigue than those relating to alcohol and drug intoxication. But it isn’t just those on the roads who are at risk. Think about all those working in healthcare, coal mines, air flight, factories and other mechanical-related industries - fatigue is a potential killer for anyone! Even us Osteos need sleep (yes, it’s true!), so that we can safely manage our patient loads and be alert to any possible health problems that come through our door. A decent sleep allows us to be the best possible practitioner for you.

So next time you’re battling with yourself on whether to binge-watch your favourite TV series long into the night or go to bed, bed might be your preferred option (maybe just watch one episode… Or two). Then? Lights out!

Lumbar disc prolapse: Symptoms and treatment

It’s moving day and you’ve been running around packing, unpacking, lifting boxes and awkward furniture all day. You can’t stop though because there’s still more to do. It’s onwards and upwards with another load in the back of the Ute. You bend down to pick up the umpteenth box of the day and bang and you’re hit with excruciating low back pain and a shooting pain down the back of your leg. It’s crippling and you’re struggling to catch your breath and stand up straight. It’s a scenario unfortunately a lot of us are familiar with, but what has caused this searing pain? One possible and relatively common cause for such pain is a lumbar disc prolapse. Sit back with a coffee and let us take you through the ins and outs.

What is a disc and what just happened when I bent down?

Your spine is made up of many vertebrae spanning from the neck all the way down to the tailbone. Between each vertebra sits an elastic-like structure called a disc. The disc is made up of a tough outer section called the 'annulus fibrosus’, and a gel-like inner section called the ‘nucleus pulposus’. The discs work to separate the vertebrae to allow movement, as well as provide shock absorption to forces acting on the spine during movement.

Common causes of disc prolapse include trauma and degeneration of the disc tissue as a result of poor posture (for example lots of slouching or slumping) and repetitive bending movements. When we bend forward, particularly when we bend forward under load (like with our house mover above who had been repetitively picking up and putting down heavy boxes), the forces acting on the discs, and especially the inner nucleus, increase drastically. Over time these repetitive movements may cause small micro-tears in the layers of the outer annulus, which weakens the overall structure of the disc. Slowly, the nucleus gets forced out and a small bulge may occur (there is often no pain at all at this stage). If these movements continue, or if you go to pick up that box which is just too heavy for you, the force is too much and the bulge can progress into a larger protrusion. Like with any injury, the initial response of the body is inflammation. The presence of inflammatory chemicals alone can cause irritation to the surrounding nerve tissue as it exits the spine, or you may get actual contact of the disc on to the nerve itself, causing impingement. This is when you feel pain and know that all is not well.

What should I expect to feel when this happens?

The signs and symptoms of a disc prolapse can vary greatly depending on the type and severity of the prolapse, and where the spine is affected. A prolapse may happen slightly out to one side of the disc affecting only the nerves on that side of the body (this is most common). Or it may occur in a backwards direction, potentially affecting nerves on both sides of the body. A small bulge may only yield mild symptoms, whereas a large prolapse may cause more severe symptoms. Interestingly, this is not always the case though.

Some of the symptoms you may experience include:

•   Low back pain

•   Pain running down the front, side or back of the leg

•   Pins and needles or tingling down the leg

•   Numbness down the leg

•   Muscle weakness (this may manifest as losing the ability to lift your foot)

The most common disc prolapse affects the L5/S1 disc (the lowest disc in the spine) and will give symptoms down the side and back of the leg. Your practitioner will ask you lots of questions and do lots of tests to determine exactly what area is being affected.

How do we treat disc prolapses?

Initially you may be in a lot of pain and simple movements may be very difficult to perform, like standing up straight, for example. This is because the body is trying to protect you from doing further damage. Once inflammation occurs, the body needs a few days to deal with what has happened. So, if you come to see your Osteo straight away, don’t expect to feel better after one visit. In fact, it is quite possible you will feel worse in the coming days before you start to feel better. The advantage of seeing your Osteo early on is that they can educate you on the do’s and don’ts, tell you what to look out for and inform you what to expect going forward. Often the unknown is scary, but your Osteo will be able to ease your mind, even if not the pain immediately. Us Osteos like inflammation. It’s the body’s way of protecting the injury and getting organised for repair. So, although it may be painful, it is good to see it through without intervening too much.

Early on, we’ll get you moving better. We will also give you breathing, relaxation and core activation exercises to help the body better cope with the pain. A disc will often prolapse because of poor core stability, so getting you on the path to rehabilitating your core is good early on. When it is possible, we will relax the tight muscles and reinstate movement to joints that may have seized up and become restricted following the injury. Our focus is to ensure the fluids of the body (i.e. blood, joint fluid, and lymphatic fluid) are moving freely around the body. When injury occurs, these fluids can become congested and a bit stuck around the area, and sometimes need a little help to get moving again. This will ensure a speedier recovery. The injury site will need lots of fresh blood to the area, while the lymphatic system will need to be flushed – ridding the area of all the bad stuff. Depending on the severity, discs generally take around 3-6 months to fully recover.

Your Osteo is trained to help you through the injury process, so you can rest assured you are in safe hands. We know when and how to treat and know what to look for to ensure you are seen by the right people if it’s required (this might include your GP or a specialist if necessary). If you think you have a disc prolapse or have previously been diagnosed with one and need help managing it, then look no further. Call us today to book your appointment.

Stiff and painful neck? Facet joint injury explained

Treating stiff and sore necks has to be up there as one of the most common areas of the body we Osteo’s see on a day-to-day basis. The causes for neck pain are numerous, with some of the common causes including muscle strain, joint restriction and degeneration, and disc-related injuries. Out of those, we regularly see injuries relating to the facet joints of the neck, which are small joints formed by two vertebrae in the spine.

What are facet joints there for?

In a nutshell, there is a facet joint on either side of the spine at each level. Depending on their position, they restrict and allow certain movements, based on how the joint surfaces are orientated. In the neck, the joints are orientated in such a way that allows for relatively large amounts of movement through forward and backward bending (flexion and extension), side-to-side bending (lateral flexion), and some twisting (rotation) too. If you move your head around, you will notice your neck is the most mobile part of your spine. This can leave it a little susceptible to injury.

How do these joints get injured?

It could be something as silly as a quick glance over the shoulder like checking your blind spot in the car, or spending an extended period looking up like when having to paint a ceiling in a house. There are usually some underlying movement issues that lead you to this point. For example, joint restrictions higher up in the neck or in the mid-back. That quick glance over the shoulder could be enough to sprain the soft tissue capsule of the joint that holds it together, or the long period spent looking up could over-compress the joint surfaces and lead them to become inflamed and lock up. Mums who spend hours looking down at their bubbas can also put these joints under strain and end up with a very stiff and painful neck.

 Can an Osteopath help?

Of course! We can help, and in many ways other than just using our hands. When you come into Holistic Hands Osteopathy we will take you through some questions to get an in-depth look into your life and the issue you’re currently experiencing. There are likely to be many things in your life that have led you to this stiff and painful neck and we want to make sure we tick off and address all of those risk factors. We’ll look into your personal and work life, hobbies and sports and even how you spend your time relaxing and sleeping. These are all areas that can play a part.

We will of course assess you physically. You may have a neck issue, but we will take a keen interest in what your shoulders, mid and low back are doing, as well as the pelvis and beyond into the legs. Once we can see how your body is working as a unit, we will discuss the treatment plan with you and get to work. Initially we will focus our attention on relieving your pain. We’ll use our hands to massage the muscles, mobilise the joints and we may use manipulation to achieve optimal joint motion and muscle relaxation. We’ll then give you some pointers on exercise and lifestyle advice so you can leave knowing how to manage the problem and continue to improve further at home.

A locked facet joint will typically take a few days to calm down following injury. Once the initial inflammation reduces, the pain decreases, movement improves and you should start to feel normal again. Within a few treatments, we’ll have you pain free and moving better than you have in a long time - this is where our work on the rest of the body comes in to play. It’s never JUST a neck issue!

Stiff neck anyone? Call us today and we’ll get you on the mend :)

Introducing chronic pain and how to treat it

Hello everyone, and welcome to our July blog! This month we are going to be talking about pain. We can’t believe it’s already halfway through the year. Time certainly does fly! But for the 3.24 million Australians living with chronic pain, it’s just more time spent battling the daily hurdles - getting out of bed, working, socialising, being a parent, everything really! Being in pain for a long time can be debilitating and have a huge impact on a person’s life.

Taking into account running healthcare costs, time and money lost at work, as well as decreased quality of life, the total cost of chronic pain in Australia in 2018 totaled $139.3 billion! It’s a growing problem with a prediction that over 5 million Australians will be affected by chronic pain by the year 2050. As Osteopaths, we work with and treat people who experience chronic pain day in and day out. It’s a complex topic, so we have devised a little introduction to break it down so you can understand more on chronic pain - all in the name of National Pain Week which is due to take place at the end of this month.

What exactly is pain?

Pain is an unpleasant experience. Ask 100 random people in the street if they like to experience pain, and there is a good chance 100% of those people will say “no”. However as unpleasant as it is, pain is an essential part of life. It is our protection mechanism. When we injure ourselves, we feel pain. Sometimes before we even get to the injury stage, we can feel pain… Pain will also stick around for a bit following an injury to remind us that healing needs to take place and that we need to protect the injured area from further damage. It’s a sophisticated alarm system and you have your brain to thank for all of this. Pretty cool huh?

Interestingly, there are people on this earth who cannot and have never felt any pain at all. These people may have a very rare condition called Congenital Insensitivity to Pain (CIP). They are basically born with the inability to feel pain. You might think this could be pretty beneficial - going your whole life without pain. How awesome would that be?! In reality, this is a very serious condition, and many who are born with it have a drastically shortened life. Mainly because injuries and illnesses can go unnoticed, potentially putting their life in danger. For example, cuts and burns will go missed, because they lack the important alarm system we were talking about above. Pain is a lifesaver.

Acute vs chronic pain

Pain can be very simply divided into two types, acute and chronic. Acute pain is the pain felt when we fall or cut ourselves, strain a muscle or sprain a ligament. When injury occurs, special sensors in the vicinity of the injury detect that something is wrong, send a message along nerves to the spinal cord and up into the brain. Your brain will process this information (very quickly) and will send a message back as a pain signal. You say “ouch”. Over the coming days and weeks, the injury heals and the pain disappears. During this process, your brain will have formed a memory of the event, and this helps you to steer clear of similar dangerous situations in the future. Protection at its best! For purposes of time, acute pain is pain that is felt for any time up to six weeks. Sub-acute pain (a sub-set of acute pain) is pain felt anywhere between six weeks and three months.

Chronic pain

Chronic pain, also known as persistent pain, is essentially pain that has lasted longer than three months and is a very different kettle of fish to acute pain. In many instances, it is pain that is felt way beyond tissue healing times and is extremely complex in nature due to the involvement of different body systems. And, most importantly, the persons belief about what pain is. The initial cause may be from a fall or car accident, just like with any acute injury. It may also be caused by diseases such as arthritis, cancer or migraines (as well as many others).

Why chronic pain develops is a complicated process. In a nutshell, generally tissues have healed, yet the brain is still perceiving a threat. This is due to changes in the nerves carrying signals to the spinal cord (the peripheral nerves) and changes in the spinal cord itself. Essentially, these nerve tissues become highly sensitised and end up sending faulty or misleading information to the brain. The brain perceives this information as still threatening, and the result is ongoing pain. It is much more complicated than that, but this gives you the gist of what is going on.

It is important to understand that when someone is in pain for long periods of time, they can start to become affected in other ways. Depression and anxiety regarding pain is commonplace. A person’s beliefs about pain will also begin to affect their behaviour. For example, they will start to avoid certain movements due to fear of injuring themselves further (which can cause other musculoskeletal issues). In psychological terms, this is known as exhibiting fear avoidance behaviours.

Treating chronic pain

The longer the cycle of chronic pain persists, the harder it is to treat. Unfortunately, treatment is not as simple as applying first aid principles like rest, ice and compression, followed by massage, mobilisation and rehabilitative exercise programs. It is still important to treat the person’s movement dysfunctions of course, but treating the depression and anxiety whilst educating the person on what is actually happening is just as important, if not more so. Until all facets of a person’s pain experience are dealt with in some way, it is unlikely the cycle will be broken. Therefore, treating chronic pain rarely comes down to just one profession. It requires what we call a multi-disciplinary approach to treatment. So yes, an Osteopath may well be part of the team, but it is likely a person will also require the services of a Psychologist and their GP too. It may be that pain medication will need to be prescribed (although the debate is still out on how effective strong pain medications are in the instances of chronic pain).

Your Osteopath will help to treat you by ensuring your body is moving in the best way possible, and that your tissues are at their optimum health. They may also advise you on how to improve your sleep patterns and diet, to ensure your body is getting the rest and nourishment it requires. They will advise you on the forms of exercise which may be beneficial and may even be able to give advice on relaxation and breathing techniques. Most importantly, they will spend time with you, educating you on what exactly is going on with your body so that you can begin to understand it yourself— and begin breaking the cycle of chronic pain. It will be a team effort, and they will be with you every step of the way!

We hope you found this blog interesting and educational. If you would like to know more about National Pain Week and further information on chronic pain, please visit http://www.nationalpainweek.org.au.

The most common headache

Did you know it is estimated that 50% of the global adult population have experienced a headache within the last year alone - that’s over 3.5 billion people! Unfortunately, there are too many types of headache to be able to cover them all in one blog, unless you fancy reading through about 50 pages of text… Yeah we thought not! We figured a good place to start would be the headache that is most commonly experienced throughout the general population. We introduce you to the ‘Tension-Type Headache’ (or TTH).

WHO DOES IT AFFECT?

It is estimated that around 7 million Australians experience TTH, affecting approximately 42% of women and 36% of men. A person will commonly begin to experience them during teenage years and may experience a peak in headaches around their 40’s, as headaches begin to tail-off after this period in life. People who experience TTH on less than 15 days per month are classified as having ‘Episodic TTH’. Those experiencing them for more than 15 days per month are classified as having ‘Chronic TTH’.

KNOWING YOUR HEADACHE

Different types of headache come with different signs and symptoms. For TTH, there are some common things to look out for. These include:

 

•   A tight band or ‘vice-like’ sensation of mild to moderate pain around the head

•   Pain across both sides of the head

•   Constant pain that may last anywhere from 30 minutes to several days

•   Scalp, neck and shoulder tenderness accompanying your headache

•   Difficulty concentrating or sleeping

•   Restricted neck movements

•   Depression and/or anxiety

Symptoms of TTH and migraine (another type of headache) may overlap slightly, but TTH are not usually described as throbbing, one-sided, or accompanied by visual disturbances, light sensitivity, nausea, vomiting, or worsening with activity; whereas migraines regularly are.

WHAT ARE THE CAUSES?

Despite the name, TTH are not always caused by tension or stress in a person’s life. TTH may be triggered by many things, including:

•   Excessive frowning

•   Teeth grinding or jaw-clenching (called ‘bruxism’)

•   Postural strain from work or driving

•   Exposure to bright lights or loud noise

•   Prolonged reading

•   Stress, anxiety and depression

•   Excessive tiredness or fatigue

•   Medication overuse

This last one is of particular importance, as the overuse of painkillers to treat TTH can ignite the onset of another type of headache known as ‘Chronic Daily Headaches’. These headaches are usually unaffected by pain medication and the person may also begin to experience migraines. Symptoms tend to be more severe than your average TTH.

CAN THEY BE TREATED?

Fortunately, there is a lot of help out there for such headaches. Usually the best course of action is to remove the trigger for your headache. This can be sometimes hard to work out, and we can help you identify what might be the root cause of your headaches. Your therapist can help to resolve those tight and sore muscles around the head, neck and shoulders by performing soft tissue massage, joint mobilisation and possibly manipulation techniques. They will also look at your posture when standing, sitting and lying down to try and highlight areas for improvement.

Other forms of treatment may include:

•   A visit to the dentist if you grind or clench excessively

•   Relaxation, breathing and stress-relieving techniques

•   Improving sleep patterns and cycles

•   Psychological therapy which may or may not include anti-depressant/anxiety medication

•   A visit to your GP to discuss medication use, if the cause of your headache has been highlighted as potentially relating to the amount of medication you are taking – remember those chronic daily headaches we mentioned earlier?

So, please do not suffer headaches in silence. Speak out (it’s good to talk after all) and book an appointment with your friendly Osteo to start your journey to beating headaches. You’ll feel the tension just melting away!

Fatigue - When to Worry?

Experiencing tiredness is not uncommon for a lot of us. Many of us have busy lives, juggling family, work and staying active. It’s hard and it’s tiring. Our bodies are pretty resilient, but there will always be a point where the body needs a break, giving you a sign to slow down and step back. This often results in the BEST night's sleep of your life and you wake up feeling refreshed and ready for it to all begin again.

But are you experiencing an extreme tiredness that no amount of sleep seems to remedy? If this is the case, then you are possibly suffering from fatigue relating to a medical condition. There is every chance you are experiencing some other symptoms too. Luckily, we are about to educate you on some of the common causes of fatigue, so you know what to look out for, and can nip it in the bud quick time…

1.     IRON DEFICIENCY ANAEMIA: A common condition where you tire very quickly, feel heavy in the muscles, have a sore tongue and may develop brittle nails. Women with heavy periods are especially prone to this condition.

2.     HYPOTHYROIDISM: Also known as an ‘Underactive Thyroid’. You may experience weight gain, constipation, dry skin and muscle weakness. This one is also more common in women.

3.     DEPRESSION: You don’t just feel low with this condition. Depression may keep you awake at night, or wake you early in the morning, disturbing your sleep cycle and leaving you feeling exhausted!

4.     ANXIETY: In extreme cases where anxiety disrupts daily life, fatigue is often experienced alongside those uncontrollable feelings of irritability and worry.

5.     CHRONIC FATIGUE SYNDROME: This is fatigue felt over extended periods of time (4-6 months +). You may also experience a general feeling of being unwell following exertion, headaches, muscle pain, sleep disturbance and loss of memory or concentration.

6.     GLANDULAR FEVER: A viral infection that can leave you feeling fatigued for months even after the infection has cleared. You may also experience a sore throat, swollen lymph nodes in the neck, swollen tonsils, headache, fever and rash. Antibiotics are usually unsuccessful in treating this infection.

7.     DIABETES MELLITUS: Fatigue is a common symptom of all types of diabetes. Other symptoms to look out for include increased thirst, hunger and urination. Weight loss is another common symptom.

8.     COELIAC DISEASE: An autoimmune disease where the body reacts to gluten in the diet, leading to fatigue, diarrhoea or constipation, as well as bloating, wind, nausea and vomiting, weight loss or gain, and anaemia.

9.     SLEEP APNOEA: Imagine being constantly disrupted while you’re trying to sleep because your throat narrows or closes, which interrupts your breathing… You can see how you’d be exhausted constantly. You may be told you snore loudly, experience morning headaches and frequently wake up with a dry mouth or sore throat.

10.  RESTLESS LEGS SYNDROME: This is the constant urge to move your legs at night, leading to poor quality sleep. Other symptoms include involuntary night time jerking, unpleasant crawling sensations and deep aching throughout the legs.

Now you know what to look out for, don’t put up with fatigue. Take notice of what your body is telling you and ultimately make sure you get your symptoms investigated through your GP. Luckily, your beloved osteo also trained to pick up on such things. We’ll make sure you get the correct referral you need if we suspect the reason for your sore muscles and joints is not just because you played a bit too hard on the weekend! Don’t worry, we have your back (no pun intended… Sort of)!

Women's Woes

Hello everyone! May is here, which means we get to celebrate those wonderful humans who brought us into the world - our Mums. And as it’s Mother’s day this month, we thought we’d dedicate a blog to common musculoskeletal conditions in women.

When it comes to musculoskeletal health, there are many conditions that females are more likely to develop. As you probably expect, this is mainly because of the differences in our bodies, both structurally and chemically. There are also certain sports and activities with higher female participation rates that leave them prone to sports-specific issues. And lastly, we need to consider that women are a lot better than men at seeking help for their health, and so we tend to know more information about what affects women (in a clinical setting). Men… Start speaking up please!

Below we concentrate on a few conditions, outline what they’re all about, and explain why women are more likely to develop them over their male counterparts. On your marks… Get set… Go!

KNEE CONDITIONS

In this example, we will focus on the patellofemoral joint, or PFJ (the joint between the kneecap and the thigh bone). The front thigh muscles (the quadriceps) run from the hip to just below the knee. The kneecap is held in place over the end of the thigh bone by the tendon of the quadriceps muscles. When all is happy and in place, this allows for smooth gliding across the joint as we bend and straighten our knees. As you walk, the joint bears about 50% of your bodyweight, but this can drastically increase to up to seven times your bodyweight when you run or squat. So it only takes something small for stress to increase at the joint and potential pain to develop. Pain associated with this joint is commonly caused by misalignment of the kneecap as it crosses the joint.

In women, common factors that may lead to this issue include:

•   A wider pelvis

•   Increased inward twisting of the thigh bone, and outward twisting of the shin bone

•   Inwards collapsing of the knees and feet

•   Increased laxity (looseness) of the ligaments around the knee

When we treat this issue, we aim to reduce pain and correct the alignment of the joint. We do this by strengthening the buttock, hip and thigh muscles, as well as stretching of the back chain of muscles down the leg. Temporary taping or bracing may help the patient to stay active doing what they love!

OSTEOPOROSIS

Osteoporosis is a condition that affects the density of our bones, weakening the internal structure, and ultimately leaving us prone to fractures. It commonly affects the elderly population, but may also affect younger people. Unfortunately for women, they are four times more likely to develop this condition than men. Not fair, right?! Blame menopause. This is when women stop producing Oestrogen - a hormone responsible for maintaining bone mineral density throughout life.

There are however, many other causes of Osteoporosis, including alcoholism, anorexia, kidney disease, and long-term steroid use. As a female, having your ovaries removed as part of a partial or full hysterectomy also leaves you prone to developing this condition.

Treatment usually consists of a combination of calcium and vitamin D supplementation, a structured exercise regime, and especially for the elderly, minimising risks of falls around the home by removing unnecessary furniture, carpets, rugs and mats. Some menopausal women opt for hormone replacement therapy (HRT), which helps to maintain bone mineral density following menopause. This has unfortunately been seen to increase risk of breast cancer and heart disease, so not all women choose this pathway.

SPINAL CONDITIONS

There are a few spinal conditions that active women in particular are prone to developing. Take your average dancer, gymnast or figure skater (all activities with a majority female participation rate) and what do you think of? Flexibility, right? These types of activities commonly involve movements to the extreme limits, such as over-arching through the back. People who constantly subject their spine to these types of loads and forces are more likely to develop a stress fracture in a small part of one of their vertebrae. This particular type of stress fracture is called ‘Spondylolysis’.

Spondylolysis is characterised by a dull ache, usually in the low back region, which is made worse by the same overarching movements of the spine. They can vary in severity from a partial stress fracture, through to a full thickness fracture, which can then develop further into a slippage of one vertebrae on another, called a ‘Spondylolisthesis’ (bit of a mouthful right!).

If suspected, your practitioner may refer you for imaging to confirm. Otherwise treatment consists of a combination of rest from the aggravating activity whilst undergoing a rigorous core stabilisation exercise programme. The good news is, most people can return to their chosen activity once they are pain free and feel strong again! Awesome!

So spare a thought for the women in your life - especially your mumma! More importantly though, if you are female and think you might have one of the above conditions, or are experiencing pain of any kind, please contact your local osteo and they will be able to chat it through, assess you thoroughly, and put you on the path to staying happy, healthy and active.

OK men… You are also allowed to contact us. SO PLEASE CALL US!!!!!! (We aren’t yelling… Much.)

Carpal Tunnel: Symptoms and treatment

It’s been a long day at the office, the kids are fed, bathed, and down for the night, and it’s time for my head to hit the pillow. Exhausted doesn’t cut it, but I still cannot sleep… What IS this tingling in my fingers and wrist pain I keep getting?! I felt it a bit at work earlier too, but why now? I’m nowhere near a desk or computer!

Sound familiar? Wrist pain is quite common, and one of the most common causes for pain over the palm side of the wrist and hand is Carpal Tunnel Syndrome (CTS). CTS presents when one of the larger nerves that travels from your shoulder down to the tip of your fingers (it’s called the Median nerve) gets compressed as it passes through the wrist. The ‘tunnel’ is a small space in the wrist, made up on one side by the wrist bones (the ‘carpals’), and a soft tissue covering on the other side. Alongside the nerve travels a group of tendons from the forearm, and once all of that has passed through the tunnel, there isn’t a lot of room for anything else. Throw in a heap of repetitive wrist movements over a prolonged period (for example typing at a desk day in, day out), and the structures running through the tunnel can become irritated and inflamed making an already small space even smaller. Once the nerve becomes compressed, symptoms start to creep in.

Signs and symptoms

CTS can be characterised by the following signs and symptoms:

•   Burning wrist pain (on the palm side of the wrist)

•   Numbness, pins & needles or tingling of the thumb, index, middle and inside part of the ring finger

•   Night time symptoms

•   Pain that radiates to the forearm, elbow or even the shoulder

•   Reproduction of symptoms when compressing or tapping over the palm side of the wrist

As well as repetitive motions of the wrist (seen commonly in desk-based workers, sports people, and even our very own manual therapists), CTS can be caused by some underlying conditions, such as Diabetes Mellitus, Thyroid disease, Rheumatoid Arthritis, high blood pressure, and from fluid retention associated with pregnancy or menopause. Trauma or fractures in the wrist may also lead to this condition. Unfortunately, if you are female, you are also three times more likely to experience this problem.

Treatment

If caught early, this problem can be managed conservatively with a combination of the following treatments:

•   Soft tissue release, joint mobilisation/manipulation (contact your local Osteo

•   Anti-inflammatory medication

•   Splinting of the wrist (particularly at night time)

More severe and persistent cases may require more invasive treatments including having a steroid injection, or possibly surgery to decompress the nerve.

If you have wrist pain, and you think it could be CTS, then our best advice is to visit your local Osteo where you can be assessed thoroughly, diagnosed accurately, and given the best advice and tools to manage your problem. We’ll get you waving goodbye (pain-free) to pain in no time!