A pain in the neck……

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The lower back is an intricate structure of interconnected and overlapping elements:

• Tendons and muscles and other soft tissues
• Highly sensitive nerves and nerve roots that travel from the lower back down into the legs and feet
• Small and complex joints
• Intervertebral discs with their gelatinous inner cores.

An irritation or problem with any of these structures can cause lower back pain and/or pain that radiates or is referred to other parts of the body. Pain from resultant lower back muscle spasms can be severe and feel disabling.

Classification systems can be useful in subgrouping and hence managing low back pain. Various systems have been developed over the years, most recently with chronic low back pain being classified into 2 groups:

1. Specific back pain disorders – this is where there is a true pathobiological origin such as those mentioned above – disc, ligament injury etc

2. Non-specific back pain disorders – this is where pain cannot be attributed to a single structural injury

The most specific way of diagnosing lower back pain is with an MRI, however the results should be interpreted with caution (have a look at my previous blog on the use of scans for more details!) as there have been studies that have shown people with no back pain to have changes on MRI, and conversely those with chronic and severe symptoms can have a clear MRI!

Due to the complex nature of lower back pain there is no universal method for managing or treating it. Of all the injuries seen, lower back pain must be taken on a case by case basis, with the treatment strategy put together for the exact symptoms on presentation. Treatments may include hot and cold, strengthening exercises, stretches and flexibility, massage, posture correction, lumbar mobilisation, acupuncture and…..manipulation. However, manipulation is not always the cure it can be sold as…..if it were, people would be clicking backs all the time and curing things very quickly and charging a lot for it! Because believe me, if I, or anyone else, could click someone’s lower back and make their pain resolve straight away, then we would all be doing it!!!!

If you are in any doubt however you should make sure you get your lower back checked out, either by us at 360-physio, your GP or another trusted healthcare professional

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At 360 the process is simple, a full detailed examination will be performed after you have described the problem in full. If its a problem we think we can help, we will do everything we can to try and get you back to where you want to be. If its something that we have no experience in, or feel someone else would be better placed to deal with we will make sure you end up in the right place to get the right treatment.

So give 360 a call and get yourself on the road to recovery!

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If in any doubt, please seek medical advice as each case is different, but remember, its the clinical picture, not the MRI picture that counts!

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Shoulder injuries are frequently caused by athletic activities that involve excessive, repetitive, overhead motion, such as swimming, tennis, pitching, and weightlifting. Injuries can also occur during everyday activities such washing walls, hanging curtains, and gardening, however injuries can also occur from trauma such as a fall or come on for no apparent reason.

Common shoulder injuries:

Shoulder instability

Shoulder instability occurs when the shoulder feels like it might slip out of place, with the shoulder becoming unstable when the muscles and ligaments that hold it together are stretched beyond their normal limits. If the ligaments that hold the shoulder muscles to bones tear and can’t hold the joint together, the shoulder may dislocate. A fall onto an outstretched hand, arm or the shoulder itself, or a violent twisting, can cause a shoulder dislocation. When the shoulder pops out of the socket repeatedly, the condition is called recurrent instability

Rotator cuff tear/Impingement

The rotator cuff is one of the most important components of the shoulder. It is comprised of a group of muscles and tendons that hold the bones of the shoulder joint together. The rotator cuff muscles provide individuals with the ability to lift their arm and reach overhead, they also help to give the shoulder some stability.

Trauma (such as a fall), heavy lifting or repetitive movements can cause to tendons to become inflamed or in severe cases torn. Often these injuries do not get better by themselves and it is best to try and seek some expert help, please contact us at 360-Physiotherapy if you are in doubt.

Frozen shoulder

Frozen shoulder is a condition that leads to pain and stiffness of the shoulder. It is also known as adhesive capsulitis or shoulder contracture.

The symptoms tend to gradually get worse over a number of months or years. You will typically experience shoulder pain for the first two to nine months, which can be severe, followed by increasing stiffness. The stiffness may affect your ability to carry out everyday activities and, in particularly severe cases, you may not be able to move your shoulder at all.

The condition may improve with time, but this can sometimes take several years

Overuse/strains

Sudden increases in activity can place extensive stress on the shoulders and lead to a decrease in flexibility. This is a common problem in middle age, or people who don’t exercise regularly but go out every now and then for an intense sport or due to a sudden change in the type of work being done (either recreational or vocational)

Although painful and inconvenient, these overuse problems can usually be treated quite successfully

Arthritis

Beginning as early as age 50, some people develop osteoarthritis, which causes painful movement. This occurs as the smooth surfaces of the cartilage that line the bones of the shoulder joint are worn away, and joints begin to wear out, sometimes known as ‘wear and tear’.

As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other, causing pain.

Although there is no cure for arthritis, the symptoms can often be fairly well managed without the need for repeated injections or surgical intervention, if you are I any doubt please contact 360-Physiotherapy for an appointment

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Ankle injuries are defined by the kind of tissue – bone, ligament, or tendon that’s damaged

A broken ankle is also known as an ankle “fracture.” This means that one or more of the bones that make up the ankle joint are broken .A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for a few months. Simply put, the more bones that are broken, the more unstable the ankle becomes. There may be ligaments damaged as well. The ligaments of the ankle hold the ankle bones and joint in position – if you suspect you may have broken your ankle it is vital you seek out expert medical advice.

One of the most common injuries is the sprained ankle, often occurring when you roll over on your ankle.  This is an injury to the lateral ligaments of the ankle.  There are 3 primary ligaments that can be injured and the severity of injury depends on whether you have simply sprained or stretched one of the ligaments, or torn one or more of them. A ligament sprain can range from many microscopic tears in the fibers that comprise the ligament to a complete tear or rupture which can be very serious and require intervention, and if you are in any doubt you should contact 360-Physiotherapy for an appointment

Physiotherapy is essential in accelerating a return to full fitness and will often involve use of the following treatments:

• Massage
• Joint mobilisation
• Proprioceptive re-training
• Electrotherapy
• Strength and conditioning training
• Taping

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Knee pain and knee injuries are extremely common, and there are many causes. It is important to make an accurate diagnosis of the cause of your knee pain or injury so that appropriate treatment can be directed at the cause. Your knee is a complex joint with many components, making it vulnerable to a variety of injuries including:

• soft tissue injuries e.g. ligament sprains (including ACL and MCL tears or ruptures) and muscle strains
• bone conditions e.g. knee arthritis, Osgood Schlatters
• Cartilage problems e.g meniscal tears
• biomechanical dysfunction eg Patellofemoral syndrome
• Overuse problems or repetitive strain injuries e.g. Patella tendonitis or patella tendinopathy
• Post surgery e.g ACL reconstruction, Menisectomy or total knee replacement

It may even be referred from your back in the form of sciatica! Knee pain has many causes and your knee treatment varies considerably depending on an accurate diagnosis.

Treatment can involve

• knee mobilisation techniques
• massage
• taping
• stretches
• strengthening exercises
• rehabilitation protocols for anything from knee reconstruction or knee replacement

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Neck and back pain is extremely common and most people will experience it in some form during their life time. The pain can range from a dull ache, to sharp shooting pains and can be short lived or constant in nature. Often there is no obvious cause for spinal pain, and it can occur seemingly for no reason or after an injury or accident.

There are also many names given to spinal pain including: * Prolapsed Disc * Sciatica * Lower Back Pain

• Osteoarthritis
• Back Stiffness * Spondylosis * Lumbar Spondylosis (Osteoarthritis of the spine ) * Lumbar Facet Joint Pain
• Disc Bulge
• Intervertebral Disc Prolapse
• Back Muscle Spasm
• Back Muscle Injury
• Back Ligament Injury
• Sacro-iliac Joint Pain
• Postural Low Back Pain
• Lumbago
• Wry neck
• Whiplash
• Neuropathic pain
• Acute/chronic

In the case of neck pain there may be symptoms into the shoulder and arm, or in lower back pain there may be symptoms into the legs. These symptoms are often called referred pain and can present as an ache, throbbing, pins and needles or numbness.

The majority of spinal pain is called mechanical or non-specific. This means that the source of the pain is probably due to damage to the muscle, ligaments, discs, or the vertebrae themselves. However, it is often very difficult to provide a precise location for the source of the pain – remember the spine is a complicated and intricate structure! If an irritation to one of these structures does occur it may result in localised and/or referred pain, potentially with muscle spasm – which can become very painful.

Nerve root pain means that a nerve coming out from the spinal cord (the root of the nerve) is irritated or pressed on. (Many people call this a trapped nerve.) You feel pain along the course of the nerve which may be cause pain into the arm or leg. Nerve pain is often caused by a bulging or prolapsed disc (slipped disc) – which puts pressure on the nerve and therefore causing the pain.

While lower back pain is extremely common, the symptoms and severity of lower back pain vary greatly. A simple lower back muscle strain might be excruciating enough to necessitate a hospital visit, while a degenerating disc might cause only mild, intermittent discomfort.

Identifying the symptoms, along with an accurate diagnosis of the underlying cause of the pain, is the first step in effectively managing your symptoms.

At 360-Physiotherapy there are many different methods used to treat your spinal pain which may include heat, massage, mobilisations, manipulations, acupuncture, core stability, pilates, stretches, neural mobility and many more.

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