The 2012 Back Pain Show

Posted on February 27, 2012 by Paul

Hi there everyone.

I just thought I’d write a quick blog about The Back Pain Show 2012, which took place this Friday & Saturday (24th & 25th Feb 2012) at London Olympia.

Firstly I would like to say a big thank you to all of the staff at F2F Events (Dave McAllister, Robbyn Snow et. al.) who did a stellar job organising the event, everything seemed to go incredibly well.

As for the event itself, well I’ll give you a personal view first and then move on to my perspective of what it may have been like for the visitors to the show…

My Take…

I really enjoyed the show. It is always good trying to help those who are unfortunately suffering with low back pain or sciatica. I also had a few people come over to me to say they had come specifically to speak to me and listen to my talk, which was nice; I hope you found it was worthwhile.

For those who had already bought my book and put in to practice my approach, thank you very much for all of your kind words, it’s great to hear you are doing so well.

I was also quite busy talking to people and offering my advice and opinions as to how they can help themselves ease the pain they are in. Once again, I hope my advice helped and you all know I am only an email away if you wish to ask any other questions. If I may hasten to add, I was not a ‘hard seller’ of my book or approach at all, and there were also occasions where I said to people that I did not think my approach would benefit them… my apologies to you if you were one of those, but I hope I was still able to offer you some sound advice for you to take away and follow up this week.

The Back Pain Show itself seemed busy, with a few peaks and troughs throughout the day re numbers present at any one time (especially on Friday). Although having said that, this was the first time I had exhibited at the back pain show and therefore I have nothing to compare it to…

As for my talk, I think it went well. It probably didn’t last as long as I thought it was going to, maybe I was rushing a bit… was I? In the same breath though, I didn’t want to bore people with just going and on :-) . I was also conscious of allowing plenty of time for people to ask any questions they may have had. Interestingly, especially on Saturday, not many questions were asked, but then I spent well over an hour at my stand afterwards answering questions to those who had listened to the talk. No problems, I know I am a bit like that myself and if I’m in an audience I would rather ask a question on a one to one basis as opposed to in front of everyone with a microphone in my hand!

One thing I did not do as much as I would have liked to have was to get around and talk to other exhibitors. I did manage to talk to a few though, and hello to those who I did meet, but what with it being my first show, I probably got a bit all consumed with my own stand and trying to help and talk to those people who were visiting the show (but I suppose that’s not a bad thing, as that is what the show is there for after all!).

Another thing that I did not get to do was to watch much of the Therapy and Exercise Zone, although I did have a small vantage point from where my stand was. This was an area where visitors to the show had the opportunity to participate in different classes, therapies and activities, all free of charge. It looked popular and sounded like fun. Without a doubt this was a fantastic idea and seemed to be something that everyone enjoyed. If this has encouraged or motivated just a few people to start exercising or joining a class, then that’s a huge plus point and the organisers should by highly commended for creating such an activity zone and those who run classes there should also be congratulated.

In hindsight, maybe I should have popped around a few times when it was a bit quite. Chatted to a few more exhibitors and also watched some of the exercises classes taking place, maybe joined in??? Anyway, to the many exhibitors I did not speak to, I hope you enjoyed the show as much as I did.

For Visitors…

OK, I was obviously not a visitor but I thought I would give my view of what I think it may have been like for one, as ultimately the show itself is for the visitors, without them there would be no show.

Firstly, there was obviously a wealth of information, knowledge and products available for people to ask questions about, look at and try out, which was great. I thought it was fantastic that everyone was genuinely interested in providing a service or treatment to benefit those suffering with low back pain or sciatica.

However, this wealth and variety was also a kind of Achilles Heel, as one word that definitely sprung to mind with regard to how those visiting the show may have felt was ‘frustrating’.

The majority of visitors to the show are ones who are in pain, and pain can make us desperate to do or try anything. I would imagine for those that were suffering with low back pain or sciatica, their head must have been spinning with all the different approaches and products available, all professing to help resolve or ease their pain. I had several people come up to me and ask what I thought of such and such a product on such and such a stand. Obviously I could not give any advice as I was not familiar enough with any of the products, I just advised them to ask as many questions as they could, visit other stands who were selling similar products, try the product and then make as best an informed decision as they could following this.

I felt kind of useless really, and deep down I may have had an opinion on certain products, but that is all it would have been, an opinion. The last thing I wanted to do was say ‘yep, that’s a good product’ and it provided no benefit at all, or alternatively, say ‘No, I do not think that product will help you’ and lo and behold, they miss out on something that would have helped!

As much as we all like to think our own product or approach is wonderful, one thing that is guaranteed is that it will not work for everyone (I wish my approach did, but I am not arrogant enough to think that it does … that is why I offer a 90 day money back guarantee with my book).

The chances are I am likely to have more insight into low back pain and sciatica than the majority of low back pain and sciatica sufferers who visited the show did. However, when looking at some of the products available, I was not sure as to what products would and would not benefit certain people, so how must it feel for those who are in pain? Some of these people are desperate for help and when they are then confronted with so many different options to try and ease their pain, I would imagine they do not know what to do.

As I mentioned above, I did not get around to look at as many exhibitors products as I would have liked, but I think one solution to this could be for everyone to offer some kind of money back guarantee. I certainly do and I know other exhibitors did as well, but I do not know whether everyone took that approach.

Anyway, I shall wrap up this blog now and definitely do not want it to look as if I am finishing on a negative note. The Back Pain Show is a fantastic event and I would just like to sign off by saying a MASSIVE WELL DONE to all those involved in the show (organises and exhibitors) from little old me :-)

As I previously mentioned, there was without doubt a fantastic wealth of knowledge, information and products available which could undoubtedly help those with low back pain and sciatica. There were also plenty of great people there offering fantastic advice to try and help those suffering in pain.

I believe that The Back Pain Show 2013 is scheduled for February 22nd & 23rd – let’s hope and all strive for an even better show then.

As always, I would really be grateful of your feedback, in particular if you were a visitor to the show. Therefore please feel free to comment by replying below to this blog, or even drop me an email.

Many thanks again and I hope you are all well.

Take Care & Good Luck,

Paul

Posted in Just Low Back Pain, Just Sciatica, Low Back Pain & Sciatica, The Back Pain Show Articles | Tagged , , , , , , | Leave a comment

Low Back Pain & Sciatica – ABC News Video

Posted on January 31, 2012 by Paul

I have come across this video of a “Dr Oz” from ABC News, and thought I’d share it with you all and give you my comments…

video platformvideo managementvideo solutionsvideo player

In general I pretty much agree with what he has to say. From the start it was fantastic to hear him mention that it is things we do in our every day life which lead to back pain - I couldn’t agree more with him on that point.

The clip of the disc bulge is quite a good one, and I like the fact he feels we do not have to go rushing to a doctor or seek treatment even if there is a disc bulge present. However, his view that instead we should just wait it out I do not agree with. If there is a disc bulge present (& it is responsible for your pain) then the likelihood is that there is a cause for this. It is almost certain that the cause of this is due to the things we are doing from day-to-day (Dr Oz states this himself at the beginning of the show) and therefore, rather than just wait it out we should instead immediately start addressing the problem. If it is a disc bulge, this would likely present as Flexion Dominated Pain (FDP) with my Personalised Treatment Approach and therefore a graded programme of extension based exercises would begin once any acute inflammation present had passed.

Low back pain & sciatica returning – a myth?

We would also need to address the cause of the problem. For example, if it was due to a sedentary lifestyle with poor posture, this would need to be changed. If we did not do this and instead just ‘waited it out’ the pain may well resolve itself, but it would undoubtedly return again at a later date (a common belief and complaint of low back pain and sciatica for exactly this reason – address the cause of the problem though, and this belief would become just a myth).

What about sitting?

With regard to every day things, this Doctor also mentions that we should avoid sitting for longer than about 20 minutes without getting up an moving around. WOW, he is defintely echoing my thoughts there!

I am going to ‘kind of’ agree with him in respect of how we should sit though. I take on board what he says with regard to sitting upright, it’s much better than sitting slumped, however, it is equally important that we sit relaxed and supported. Sitting just bolt upright, as Dr Oz appears to himself, is not really the best way for us all to sit. What can happen under these circumstances is that the postural muscles which help maintain this position will start to fatigue, and we will then bring in other larger muscle to compensate for this. This will mean our posture becomes more rigid and this itself can lead to aches and pains. Not only that, but this will almost certainly aggravate your pain if you are suffering with Extension Dominated Pain (EDP).

As I mentioned, I believe the best way to sit is to adopt a relaxed, upright and supported posture. Just push your bottom into the back of the chair, make sure there is good lumbar support and then sit back and relax. This position should be almost effortless, as long as your back is supported.

The driving comment I would also support, although it is always a difficult one as sitting for 90 minutes if you are currently suffering with low back pain or sciatica can be very difficult. Having said that, it is hardly practical to stop and get out every 20 mins!

Shoes and Wallets

I tend to agree with this also. Although, I do not necessarily think it is high heels which lead to foot pain which then results in low back pain or sciatica. Rather that wearing high heels tends to make you lean forward a little, which we then compensate for by leaning backwards. It is this leaning backwards repeatedly for long periods of time which places increased stresses upon the facet joints of the lower back and this in turn can result in low back pain and/or sciatica.

As for the wallet, this could be a cause of low back pain as it will create asymmetry as suggested and therefore potentially lead to pain.

Tiger Balm and Anti-inflammatories.

With regard to the former, my own personal opinion is that you may get some temporary relief from this type of stuff, but probably little more. The latter though I am an advocate of taking, although only as a means to an end. If you are suffering with an acute attack of low back pain or sciatica, anti-inflammatories can provide you with a very important part of your early treatment programme. I discuss this further with my blog “Low Back Pain and Sciatica – Should I take medication and if so what type?”

Finally, I will say I also agree with Dr Oz stating that 24 hours of rest is OK (depending upon the severity, a little longer may even be indicated). However, it is not just a case of then getting up and moving around, rather a case of slowly but surely getting moving again. This may mean at first just moving around in bed a little bit and then progressing to getting out of bed and then back in again. Also, just because resting for 24 hours is ‘OK’ it does not mean you have to. If you are able to move around before then, no matter how little, it is important to do so, progress this as and how you see fit. If 36-48 hours pass and you are still unable to move around at all or get out of bed, then it is best to call the doctor or be assessed by a health professional.

Well, that took a lot longer than I though it was going to! In short it was refreshing to hear a Doctor say the things he did, even though I did not necessarily agree with all of it. Nevertheless, if everyone listens to what he has to say (and me as well :-) ) then there would be lot less low back pain and sciatica around, which can only be a good thing.

Read my book for FREE

At the moment you can drop me an email and request to read the eBook version of Low Back Pain & Sciatica – A Personalised Treatment Approach for FREE. Just visit the page http://www.spinal-health-care.com/eBook-Preview/ and then send me an email to the given email address.

Many thanks as always for visiting my blog, I hope you have enjoyed it and found the information beneficial.

I am going to sign off with my usual request, feel free to comment upon my blog pages and if you have any topics you would like me to consider for future blogs, please let me know.

Take care as always and keep in touch.

Paul.

Posted in Just Low Back Pain, Just Sciatica, Low Back Pain & Sciatica | Leave a comment

Low Back Pain & Sciatica – Any questions…

Posted on December 21, 2011 by Paul

Hi there everyone and thanks for visiting my blog.

I am always asking if anyone has any questions with regards to low back pain & sciatica, so I thought I would start a blog on that matter.

Therefore, if you have any questions at all with regard to low back pain and sciatica, feel free to post them here, I’ll get back with a reply as soon as I can. If it’s a good topic, I’ll even give it it’s own blog.

Only a quick post for today, so I’ll say see you soon, and don’t forget to post some questions :-)

Thanks as always,

Paul.

Posted in Low Back Pain & Sciatica | Leave a comment

A tight piriformis muscle and sciatica

Posted on September 12, 2011 by Paul

The piriformis muscle (a fairly large muscle situated deep in the buttock region) is responsible for much low back pain and sciatica suffered by the general population, especially when it is tight. Therefore today I thought I would talk about how this muscle, when tight, can result in sciatica and also how you can begin stretching it to help alleviate any signs and symptoms you may be suffering with.

The piriformis muscle, as I mentioned above, is positioned deep in your buttock region, as shown in the image below. You will also see in that image how the sciatic nerve, which originates from the nerve roots of the lower back/sacrum, passes underneath the piriformis muscle (in some people it actually passes through the muscle belly itself). Therefore, if this muscle is tight, you can probably imagine how it may begin to aggravate the sciatic nerve and lead to sciatica.

 

The piriformis muscle with sciatic nerve

 

NB: Just a brief note on sciatica, it is important I state here that the term ‘sciatica’ is a descriptive one and not a diagnostic one. Basically, anything which aggravates the sciatic nerve and leads to pain (anywhere from the lower back down to the foot and toes) can be classed as ‘sciatica’ regardless of what causes it. Therefore there is no one treatment as such for sciatica, as it will all depend upon the cause. Consequently, one treatment or exercise which helps to ease one cause of sciatica may actually aggravate another person’s sciatica if it has a different cause. As mentioned at the top of this article, I will be talking about sciatica caused by a tight piriformis muscle.

If a tight Piriformis muscle is causing your sciatica, the pain will typically start in and around the buttock area and then radiate anywhere from your buttock, down the back of the leg and into your foot. This is because the sciatic nerve passes through the buttock (underneath or through the piriformis muscle) down the back of the leg towards the knee. Once it actually passes below the knee it is no longer the sciatic nerve, rather it divides into other peripheral nerves which have different names. However, it is widely accepted that the term sciatica can be given to pain which passes below the knee and as far as the foot/toes.

If the tightness in this piriformis muscle is severe enough, it may even begin to compromise the impulses which pass along the nerve, consequently, pins & needles/numbness may result or even weakness in any of the muscles that the sciatica nerve or its branches supply.

If you are presenting with signs and symptoms which you feel may be a result of a tight piriformis muscle, then beginning with a gentle course of piriformis stretching exercises will be a good way to start resolving your pain (as long as you take it easy to begin with and ease off if you feel they are aggravating any of your signs and symptoms at all).

I will now go on to describe one of the gentler stretches for the piriformis muscle…

 

Piriformis Stretch.

Lying on your back with both knees bent, gently place the ankle of the side to be stretched upon your opposite knee. Then place the hand of the same side to be stretched on your knee as shown and gently push your knee away from you.

 

Low Back Pain and Sciatica - Piriformis stretch in lying

Schedule:

Hold: 20 – 30 seconds

Reps: 2 – 3

Times per Day: 2 – 3

 

With this stretch, you should be looking for a stretching sensation in the region of your buttock, however you may find the stretch passes a little further down your leg or even into your lower back. As long as it is only a stretching sensation then this is no problem. You should feel no pain though.

NB. If you find it difficult to even place your ankle upon your opposite knee as shown above, this implies your piriformis muscle is likely to be extremely tight. Therefore there is even more reason for you to need to stretch this muscle, however you need to be careful as you may easily aggravate the pain you are suffering with. Therefore I would suggest you try straightening the opposite leg of the side being stretched a little further, as this will place less stress across the piriformis muscle.

The above stretch is just one of several you can try in order to loosen up your piriformis muscle. If it is tightness in this muscle which is causing your signs and symptoms, you will definitely need to consider stretching it. If you wish to try a slightly firmer stretch, take a look at the other piriformis stretch I have on this website here http://www.spinal-health-care.com/tips-a-advice/piriformis-stretch-2/

It is important I reinforce that which I said at the beginning of this article, sciatica has many causes and if it is not a tight piriformis muscle which is causing your pain but rather something else, then piriformis stretches could possibly aggravate your pain, so be careful with these exercises and if they do begin to aggravate any of your signs and symptoms, ease off or stop them altogether.

Also, although it may be a tight piriformis that is causing your pain, there may be another underlying reason as to why the piriformis muscle is tight in the first place (it may be compensating for weakness elsewhere for example) therefore other exercises may need to be incorporated into your exercise programme as well as a piriformis stretch.

However, the most important thing is that if the piriformis muscle is tight, it will need stretching and there are many occasions when simply stretching this muscle alone is suffice to ease or completely alleviate the signs and symptoms of sciatica. Therefore be careful, but give the above stretch a go. If you feel this is not really a ‘hard enough’ stretch, try to step it up a little with the another I have on this website http://www.spinal-health-care.com/tips-a-advice/piriformis-stretch-2/.

That’s about it for now. As always I hope you have enjoyed this blog and please feel free to comment on this blog below or provide suggestions for future blogs.

Many thanks again.

Take Care & Good Luck,

Paul.

Posted in Just Sciatica, The Back Pain Show Articles | 1 Comment

The Back Pain Show Article – Listen to your body…

Posted on August 10, 2011 by Paul

Listen to Your Body

Make no mistake about it, your body does not want to be in pain. If you are suffering in pain, it is nearly always because you are doing something that your body does not like and therefore it is giving you pain as its way of asking you to stop doing it.

The human body has an innate desire to heal itself of any injury it encounters 24 hours a day, 7 days per week. Whether you have a simple paper cut a broken bone or low back pain and sciatica, your body will always strive to repair itself.

So where does the body go wrong with low back pain and sciatica?

The truth is, it doesn’t go wrong, it is just we do not always give it the best conditions for it to work. I get very frustrated with the mystique often created with regard to low back pain or sciatica. Ultimately, it is the same as any other injury… if you provide your body with the correct conditions to heal itself, heal itself it will.

What are the correct conditions for our body to heal itself then?

Well, that’s an impossible question for me to answer on an individual basis, simply because your low back pain or sciatica will be different from the next person who is suffering with low back pain or sciatica. However, you can answer the question for yourself by quite simply listening to what your body is telling you.

If you are suffering with low back pain or sciatica and you perform a certain activity or get yourself in a specific posture which increases your level of pain, then you are doing something which your body does not like and therefore you are interfering with your body’s natural desire to heal itself. Alternatively, if you are performing a certain activity or in a specific posture and your levels of pain decrease or go completely, then without doubt your body likes what it is doing and therefore it is healing itself to the best of its ability.

Although I appreciate it is not always practical, adopting postures and performing activities which your body likes, along with avoiding or modifying those activities and posture that it does not like (those which increase your levels of low back pain and sciatica) is something that you should aim for 24 hours a day… I guarantee you it will go a long way to resolving your pain!

Isn’t that just like a Tommy cooper gag though?

I went to the doctor the other day, I said “Doctor, it hurts when I do this”. He said “well don’t do it then”

Funny, yes (well, for those older one’s like myself!) but also very true.

Believe me, your body does not want to give you pain just for the sake of it. If you are feeling pain, it is because you are creating inappropriate stresses across the structures responsible for your pain. In turn, these inappropriate stresses are interfering with your body’s desire to heal yourself of the low back pain or sciatica you are suffering with. Consequently, your pain is not going to get better, or at best, take longer to get better than it should do.

It’s like having a cut across your elbow, or any joint for that matter. Due to the natural movement that occurs at a joint you will keep on interfering with the healing trying to take place for that cut. Therefore it is highly likely, due to this interference, that this cut will take longer to heal than if it were just on your forearm say.

Anything you do which interferes with the healing process trying to take place for your low back pain or sciatica, I can almost guarantee you will increase your levels of pain, so why keep on doing it? Whereas if you are doing something which is not interfering with the healing process, your level of pain will at worst not increase, although more than likely it will decrease or go away.

Is that all I have to do then for my low back pain or sciatica to get better then?

I’m afraid not, although it is without doubt an integral part of resolving your pain. Ultimately, you need to address the cause of your low back pain or sciatica, which in my opinion is a combination of incorrect postures and movements, along with muscle imbalance (tight and/or weak muscles). However, if you do not stop aggravating your pain, it will not matter how much you do to address the cause of your problem, you will always be fighting a bit of a battle due to you interfering with your own body’s natural desire to heal itself. Therefore always try your best to…

avoid or modify the things which aggravate your pain and encourage those that ease it.

If you take this little saying onboard and put it into practice as much as often as you can throughout the day, you will be on the right road to begin healing your pain. As I mentioned above, more will be needed with regards to getting to the cause of your problem, but if I can offer one single piece of advice for you to put into practice, this would be it.

It’s only what the professional do anyway…

Just before I go, I know there may well be some people thinking that not doing things that increase your levels of pain is stating the obvious. Well firstly, you will be surprised at the number of people who do not listen to their body. For example, I have treated many people who know that sitting in a certain chair aggravates your pain and walking around a little eases their pain.

However, when I discuss this matter further with them, it transpires they still spend much of the evening sat in that same chair, not even thinking to get up and walk around a bit! The best they muster is to ‘fidget around’ in the chair, even though this only gives them temporary relief at best. They are then surprised that they find it difficult to get to sleep because their low back pain or sciatica is worse when they finally do get up to go to bed!

I would suggest for this type of problem (it may well be one you recognise) that the individual concerned only sits for about 15-20 minutes and then stands up and has a little walk around the living room for a minute or two. It is amazing the difference a small change like this can make, not just to the pain being suffered while sitting, but also to the pain that is preventing them from getting to sleep.

Another suggestion is obviously with regard to the chair, maybe a firmer one should be used, or at least a rolled up towel, or something similar, should be placed in the small of the back.

Anyway, I am really digressing now! Back on to my point with regard to those who think it is stating the obvious, or even just burying your head in the sand by avoiding things that aggravate your pain, have a think about what professional athletes do during the rehabilitation of an injury…

If there was a professional sprinter who tore his hamstring, do you think he would keep on trying to run on it? Of course he wouldn’t. Why not? Because he knows that if he were to do that, the tear would just get worse and therefore take longer to heal.

It is more likely the first thing he would do is rest it, maybe only walking but potentially using crutches if the tear was severe enough. As the body began healing itself, he may take up some brisk walking, but he would still avoid doing any more than that for fear of re-injury or simply it taking longer to heal. As time passed this athlete would begin gentle jogging (but no more at this stage) and then slowly but surely progress to full jogging, running and then finally sprinting.

This would all be a very gradual process though, where he would be constantly listening to what his body (his hamstrings in this case) was telling him. If at any stage while exercising pain was felt  from the site of injury, he would ease off straight away and not perform that exercise (at that intensity anyway) until enough healing had taken place to allow him to perform it pain free.

If we think about it, what this athlete is doing (and what any athlete does for that matter) is listening to his body and avoiding the activities that aggravate his injury while encouraging those he can do pain free… exactly the approach I would want you to take when suffering with low back pain or sciatica.  This approach, along with an appropriate exercise programme to address the cause of the problem, will soon see you free of the pain you are suffering with.

Many thanks for taking the time to read this article. Please accept my apologies for it being a bit of a lengthy one, but hopefully you have enjoyed it and gained a good insight into the best way of curing the pain you are currently suffering with.

As always, feel free to leave an comments, or suggestions for future blogs, below.


Posted in Just Low Back Pain, Just Sciatica, Low Back Pain & Sciatica, The Back Pain Show Articles | 7 Comments

Back Pain Show – Introduction

Posted on July 19, 2011 by Paul

Hi there all.

For those that do not know, I have recently joined up with The Back Pain Show to help promote good health for those suffering with low back pain and sciatica – by the way, if anyone wants free tickets to the The Back Pain Show, use this link here to obtain them:

http://www.backpainshow.co.uk/go/spinalhealth

This partnership involves a few different things, one of which is that I shall be writing regular articles for them. Each time I write an article (it will be in the region of every 4 weeks) I shall then publish the article on this blog.

The first article I have written is just a little introduction about myself and my plans with the articles. As I am sure you are aware, I am always encouraging people to post comments or suggestions with regards to my blog, so please continue.

Just before I post the first article, I shall provide you with the link to sign up to the Back Pain Show’s e-clinic, where you will also be able to obtain an over 50% discount on my book…

50% Discount on my book

If you want to sign up to The Back Show’s e-clinic you can use the following link:

http://www.backshowexpo.co.uk/e-clinic-subscription/

If you do sign up, not only will you receive access to my articles as soon as they are published, but for a LIMITED TIME PERIOD ONLY you will also be able to purchase my book Low Back Pain & Sciatica – A Personalised Treatment Approach with an over 50% discount. Therefore meaning you will pay only £13.97 instead of £27.99.

Anyway, now for my first article:

Hi there and thanks for joining me to read this first of many articles for low back pain and sciatica sufferers.

My name is Paul Boxcer, I am a qualified Physiotherapist (and have been for nearly 14 years now) and I have treated many, many people suffering with low back pain and sciatica. I wholeheartedly believe that far too many people suffer unnecessarily with either of these conditions. This is because the majority of low back pain and sciatica suffered by the population can be cured by the individual who is suffering with that pain.

It is this belief that was one of the main inspirations behind me writing my book “Low Back Pain & Sciatica – A Personalised Treatment Approach”. My book provides all of the information needed for the reader to understand why they are suffering with pain, self diagnose their pain and then self prescribe an appropriate treatment programme to cure themselves of that pain.

Can I just assure you now that the articles I shall be writing will not be about me selling my book. However this will be the one and only time I will say that if you follow the link at the bottom of this article, for a limited time you will be able to purchase my book with a 50% discount (there you go, I promise not to plug my book anymore!)

My aim in writing these articles for The Back Pain Show is to share a few things with you that I think are important for those suffering with low back pain and sciatica, along with a few tips and advice that may help out as well as some general information about things such as anatomy and old wives tales.

The one really important thing that I want to get across with these articles is that the majority of low back pain and sciatica suffered by the population is referred to as ‘non-specific’ i.e. there is no one specific cause or structure that can be truly identified as being the source of pain (even if investigations such as X-rays or MRI scans may indicate that a source of pain has been identified, a lot of the time these can turn out to be red-herrings)

I believe that this type of pain (non-specific) is nearly always a consequence of incorrect postures and movements patterns, along with muscle imbalance i.e. tight and/or weak muscles. Without doubt, as I mentioned above, I believe that the majority of people suffering with non-specific low back pain or sciatica can resolve the pain themselves, as long as they know what to do.

I know that at times it may seem you are never going to resolve the pain you are suffering, but never give up on the belief that you can. I am not going to promise you that absolutely every single person can resolve their pain themselves, that would not be true and anyone who claims to be able to do this (or has some kind of contraption that proposes to) I would not take too seriously. However, as I have already said, I do believe that the majority of people suffering with low back pain or sciatica can.

Anyway, that’s about it for now and I hope you enjoyed reading my little introduction. Just before I do go though, I would like to point you towards a blog a wrote with regards to a very important topic you must certainly read about if you are suffering with Low back Pain or Sciatica. That blog is on Red Flags and you can access it here:

http://spinal-health-care.com/blog/2011/05/30/red-flags-for-low-back-pain-sciatica/

This particular blog is important because there are rare occasions when the pain being suffered by those with low back pain and sciatica is not a consequence of joints, muscles, ligaments and the like causing the pain, but rather something which may need to be assessed and investigated further by a health professional… sometimes urgently. It is for this reason that I always encourage people to read about Red Flags http://spinal-health-care.com/blog/2011/05/30/red-flags-for-low-back-pain-sciatica/

Thanks once again for taking your time to read this article. To begin with I shall be posting an article approximately every four weeks. However, if there is any topic you are interested in and would like me to write about it, feel free to reply to this blog below and I will gladly write about it and also include it in a future article with The Back Pain Show.

Thanks once again for reading this introduction and I hope you have enjoyed this and will also enjoy the future ones as well. Feel free to post any comments below, but in the mean time…

Take Care & Good Luck,

Paul.

Paul Boxcer – Spinal Health Care

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Low Back Pain and Sciatica – Should I take medication and if so what type?

Posted on July 6, 2011 by Paul

Hi all and thanks for visiting my blog on low back pain and sciatica.

In a previous blog “The different types of pain associated with Low Back Pain & Sciatica (Part I of II – Inflammatory Pain)” I touched upon the issue of taking medication to help resolve any low back pain or sciatica you may be suffering with. As a rule of thumb, I am not a great believer in taking medication for the sake of it. Nevertheless, there are or will be times when either the pain you are suffering with is of a severe inflammatory nature, and therefore a short course of anti-inflammatories may be the way to go in order to settle this inflammation, or the pain is just that severe that you need to take some medication just to get by or function, in which case some pain killers may be the best thing to take.

I will now look to outline the principle difference between these two types of medication which can be used to decrease pain and then give you my opinion on when it is best to take (or not to take) them.

Let’s say you are suffering with low back pain or sciatica and have an inflammatory response taking place. Your body will  be producing inflammatory chemicals that themselves stimulate pain nerve fibres. It is these pain nerve fibres that send the pain messages to the brain and results in you feeling pain. The main difference between pain killers and anti-inflammatories lies in whereabouts in the body they have their effect on preventing you from feeling that pain.

Pain Killers:

With regard to pain killers, these simply prevent the pain messages from being perceived by your brain. If this message is stopped, you will feel no pain.

Anti-inflammatories:

These work differently by stopping or reducing the inflammatory response taking place. As a result of this there will be a decrease in the number of harsh chemicals present to stimulate the pain nerve fibres in the first place. If these pain nerve fibres are not being stimulated, they are unable to send pain messages to the brain and therefore there will be no pain felt.

In effect, the anti-inflammatories are addressing the main cause of the low back pain or sciatica i.e. the cause of the pain nerve fibres being stimulated, whereas when you use pain killers, the pain nerve fibres are still being stimulated, you just cannot feel the pain.

NB: Although I have said that the anti-inflammatories are addressing the cause of the pain (the inflammation which is irritating the pain nerve fibres), ultimately we need to find and address the cause of the inflammation itself i.e. the reason why you are suffering with low back pain or sciatica.

So when should you take Anti-inflammatories or Pain Killers?

The way I see it is that the best way to take pain killers is to take them in an ‘on demand’ manner, i.e. when you have pain. If, for whatever reason, your low back pain or sciatica is quite severe, then feel free to take some pain killers in order to reduce the pain. However, and this may seem like I am stating the obvious but you will be surprised at the number of people who do not take this approach, if you are not in pain or the pain ‘is not too bad’ then there is no need to take any pain killers.

Anti-inflammatories on the other hand I feel should be taken regularly/as prescribed if you are suffering with low back pain or sciatica as a result of inflammation. The reason I say this is because it is best to have the anti-inflammatory in your system twenty-four hours a day, consistently mopping up all of the inflammatory causing chemicals as they are produced. Even if your pain does not feel too bad, it is still important to continue taking the anti-inflammatories regularly until you are confident there is no or very little inflammation present.

It is important I stress here that you will not be taking the anti-inflammatories in order to mask the pain. I would never advocate that, you will be taking them as a means to an end. By taking the anti-inflammatories regularly, you will be constantly reducing the sensitivity of your pain, which itself will mean the pain is not as easily aggravated.

If your pain is not as easily aggravated, you will then be able to perform the appropriate exercises more readily in order to stretch and strengthen the structures concerned which are responsible for your low back pain or sciatica. Finally, as the structures concerned become more supple and stronger, the increased stresses present which were causing your pain will be steadily reducing and therefore the low back pain or sciatica you are suffering will also begin to reduce. It is at this stage that you should start to gradually ease off on the number of anti-inflammatories you are taking.

I hope this blog has helped shed some light with regards to the two most common types of medication which are used to treat low back pain and sciatica. Please remember though, whenever taking medication, always make sure that it is OK for you to take it and if you are unsure, always consult your GP first.

I’m going to finish with my usual plea! Please feel free to comment below on this blog (or comment on any of the other blogs I have posted on low back pain or sciatica) and also fell free to put forward other suggestions for blogs you would like me to post in the future about low back pain or sciatica.

Thanks for reading and have a good day :-)

Paul.

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The different types of pain associated with Low Back Pain & Sciatica (Part II of II – Mechanical Pain)

Posted on June 27, 2011 by Paul

Hi there everyone and thanks for joining me in Part II of this Blog, which is about the different types of pain you may encounter when suffering with low back pain or sciatica.

This Blog will be about Mechanical Pain, which typically presents as what I refer to as an ‘on/off ’ pain, i.e. if you put yourself in a certain position or perform a certain activity, you feel pain, yet if you remove yourself from that particular position or activity, the pain goes away. It is also the classic grumbling type of pain that has usually been around for some time, many months or even years.

This doesn’t tend to be as debilitating as the acute inflammatory pain, in that it doesn’t give you a constant, often vicious, striking pain which can take your breath away. It tends to be more of a pain about which people often say “I have got used to it” or “I’ve learned to live with it”.

In some respects this is like the acute pain, in that there may be a degree of inflammation present. However, I tend to refer to this as low grade inflammation i.e. not as intense and constant as the inflammatory response set up with acute pain where everything seems to hurt. Instead, the structures responsible for this pain are more sensitive than they should be and therefore when a mechanical stress is placed across them, rather than just accepting it as a part of our normal movement, the pain nerve fibres are stimulated (due to their decreased pain threshold levels) and therefore pain is perceived.

The reason why this mechanical pain often maintains itself for many months or even years, is because we naturally and subconsciously avoid the stressful postures and activities that will provoke the pain, so as not to increase the pain further. For example, we may avoid any gardening or housework or maybe simply modify how we put our underwear, shoes and socks on in the morning. However, it is all well and good temporarily avoiding certain activities in order to give the body a chance to heal itself (an approach I think is essential as part of a correct treatment regime and one I definitely advocate with my Personalised Treatment Approach), but this is only appropriate if we are doing this to settle the pain down in order to begin a specific treatment/exercise programme which targets and addresses the cause of the pain.

The problem arises when certain postures and activities are avoided/modified just because they hurt. If there is no thinking beyond this, then this is quite simply burying our head in the sand. Under these circumstances, although we may be preventing an acute flare up of the pain, the cause of the pain is not being addressed and therefore it will continue to aggravate the structures concerned and those same structures will continue to give pain. This ends up being the typical pain we “learn to live with” or “have got used to“. This is such a shame, as nearly always this type of pain can be addressed and resolved.

That is about it for mechanical pain, although I would just like to state that the distinction between inflammatory and mechanical pain is not black and white, but rather different shades of grey. There is no threshold point where the pain turns from primarily inflammatory to primarily mechanical or vice versa. Only you can judge which type of pain you are feeling. A good rule of thumb however is:

Acute/Inflammatory Pain: This tends to be constant and easily aggravated, i.e. you may carry out a quite simple activity/posture and you will feel a sharp and intense increase in pain. The constant pain/aching always present also increases and it is likely that this will now take some time to settle down.

Chronic/Mechanical Pain: This tends to be more like a pain you can turn on and off by changing your posture or activity.

Acute on Chronic Pain

I would just like to finish with a little piece on the type of pain referred to as ‘acute on chronic’ and this may well be a type of pain you recognise.

If you have had your low back pain or sciatica for some time, with it being primarily mechanical in nature, we often refer to it as being a ‘chronic’ pain problem. When we talk about an attack of pain as being ‘acute on chronic’ all we are referring to is that the individual concerned has been suffering with mechanical pain for some time, i.e. chronic pain, however, as a result of the cause of this mechanical pain not being addressed, the constant stresses being placed across the lower back will mean the potential for an acute attack of low back pain or sciatica is never too far away. Consequently, from time to time, an acute inflammatory episode of pain will occur in addition to the chronic pain the person concerned is already suffering with.

Initially, this may occur just once or twice a year and the individual suffering with this pain will not be too concerned, as they know that taking a few days from work or maybe just ‘taking it easy’ for a couple of days will soon sort it out and the pain will then drop back down to its ‘normal level’.

However, the issue is that this continuous aggravation by the cause of the problem is slowly but surely driving down the pain threshold levels of the low back pain/sciatica. Consequently, what was a problem just once or twice a year and only lasted for a few days, then becomes a problem two to three times a year and may last for a week or so. With the pain threshold level still being driven down further, this acute attack of low back pain or sciatica may then begin to happen four or five times a year and may last for a couple of weeks.

I am sure you can see where this is going. Eventually, the attacks of pain occur so frequently and last for that much longer, that in effect the ‘normal level of pain’ becomes a higher level to that what it used to be. This is because before any acute attack of pain has had a chance to settle down completely, another one occurs.

The obvious aim of treatment here is to discover which stresses upon our lower back are keeping the pain threshold levels at a constantly inappropriate low level. If we can discover these stresses and eliminate them accordingly, the pain will once again resolve itself as the body begins to heal itself. This can be quite readily achieved and is so with my Personalised Treatment Approach.

OK, that’s about it now for both inflammatory and mechanical pain, as well as acute on chronic pain. I hope you have found both of these Blogs interesting and informative, and as always I am going to finish by encouraging you to post your comments below. They are always much appreciated and I will always respond to them.

Free Preview of my Personalised Treatment Approach.

Don’t forget that if you want to have a free preview of my book, just email me on:

paulboxcer@spinal-health-care.com

or use the Contact Paul tab at the top of this page. I will then send you the login details to access my eBook.

Needless to say, my Personalised Treatment Approach covers all of the do’s and don’ts you need to know in order to resolve any inflammatory or chronic low back pain and sciatica you may be suffering with. Therefore drop me a line and I will send you the details of how to access the whole of my book for free.

Thank you as always for checking out my Blog. Please post any comments or opinions you may have on this Blog below (or on any other Blogs I have posted) and I also welcome any suggestions for future Blogs.

Many thanks once again.

Take Care & Good Luck,

Paul.

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The different types of pain associated with Low Back Pain & Sciatica (Part I of II – Inflammatory Pain)

Posted on June 24, 2011 by Paul

If you are suffering with Low Back Pain and/or Sciatica, you will obviously be in pain. However, when using my Personalised Treatment Approach it is important to distinguish between the two different types of pain you may be suffering with, namely acute inflammatory pain and mechanical pain, as this will influence how you begin treating, and then ultimately resolving, the pain you are suffering with.

In this Blog, I will go on to elaborate a little more about Acute Inflammatory Pain, I shall then post Part II on Monday where I will talk about Mechanical Pain.

Acutely Inflamed Pain/Inflammatory Pain:

You will definitely know if you are suffering with acutely inflamed pain, as it is the type pain which is unremitting and very easily aggravated. This, without doubt, can be the most debilitating of pains, where even the most innocuous of movements can trigger an unbearable increase in pain which will then hang around for some time, feeling almost impossible to shift.

What happens here is that the structure(s) responsible for the low back pain or sciatica you are suffering with have been traumatised such that an inflammatory response has been set up by the body. Consequently, the body produces chemicals which stimulate the pain nerve fibres, which themselves send messages to the brain screaming PAIN! This is your body’s way of trying to get you to stop aggravating these structures further while the body starts the healing process. As mentioned above though, this pain is likely to be constant and severe, with any kind of relief seeming a million miles away.

Beware of the vicious cycle

In addition to the intense pain which has to be endured when suffering with inflammatory pain, another problem which can arise is a painful vicious cycle. This is because not only do the inflammatory chemicals increase pain levels by stimulating the receptors of the pain nerve fibres, but they also decrease the body’s threshold level for pain as well i.e. the structures responsible for the pain are more sensitive. This makes these same structures more readily stimulated to send further pain messages to the brain and also to create more inflammation. The subsequent increased inflammation sensitises the structures again, resulting in the pain threshold levels decreasing further and therefore leading to more pain and the injury being easily aggravated and son on… I have captured this vicious cycle with the image below:

Low Back Pain and Sciatica - Negative Cycle
A vicious cycle which may be encountered when suffering with Low Back Pain or Sciatica of an inflammatory nature.

 

I often use the analogy here of hitting your thumb with a hammer. You only have to do this once, but you can bet your life for the next few days you only have to brush your thumb against something and it will start to throb and ache yet again, becoming even more sensitive for a while.

Without any doubt, the immediate aim for someone suffering with an acutely inflamed attack of low back pain or sciatica is to settle the inflammatory response that is taking place. This is because this type of pain, due to its very high sensitivity, can stop you from performing the exercises and activities you need to in order to begin resolving your pain.

Now I am not a great believer in taking medication for the sake of it, but this is the only time I would advocate a short course of anti-inflammatories

I will be posting a Blog soon about taking medication for low back pain and sciatica and the different options available, however, I must say here that it is always important to make sure you are able to take anti-inflammatories and there are no contra-indications for you doing so. If you are not sure, always speak to your doctor first.

The reason I say it can be appropriate to take anti-inflammatories at this stage is because the sooner you can eliminate the inflammatory response taking place, the sooner you will be able to diagnose your pain (it is always difficult to provide a diagnosis when the pain is so sensitive that anything and everything hurts). Once you have diagnosed your pain and the sensitivity is beginning to decrease, you will then be able to start a specifically tailored exercise programme for you to begin resolving the pain you are suffering with.

In summary, to be able to resolve any low back pain or sciatica which is a consequence of significant inflammation, the immediate aim is to settle that inflammation so that the problem becomes a mechanical type pain instead. Once this has been achieved, you will then be able to self diagnose and then self prescribe an appropriate exercise programme which eliminates the mechanical pain and therefore the pain altogether.

I think that is about it now for inflammatory pain. I hope this has helped shed some light on this nasty type of pain suffered by many people with low back pain and sciatica. Don’t forget to check in on Monday and read about mechanical pain.

Free Preview of my Personalised Treatment Approach.

Needless to say, my Personalised Treatment Approach covers all of the do’s and don’ts you need to know in order to resolve any inflammatory low back pain or sciatica you may be suffering with. If you want to preview the whole of my book for free, please do not hesitate to contact me by email on paulboxcer@spinal-health-care.com or use the Contact Paul tab at the top of this page. I will send you the login details for my eBook.

Thank you as always for checking out my Blog. Please post any comments or opinions you may have on this Blog below (or on any other Blogs I have posted) and I also welcome any suggestions for future Blogs.

Take Care, Good Luck and see you on Monday.

Paul.

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Is an accurate medical diagnosis necessary for Low Back Pain or Sciatica?

Posted on June 7, 2011 by Paul

With my Personalised Treatment Approach to treating low back pain and sciatica, I am a great believer in not getting too carried away with any specific medical diagnosis you may already have been given (if I may just hasten to add, that is not to say you should not go to see a health professional to have the low back pain or sciatica you are suffering with assessed, as this is important, especially if your signs and symptoms are getting no better). The reason I say this is because any medical diagnosis you are given may not actually be the cause of the low back pain or sciatica you are suffering with, as more often than not it may be just a normal sign of the ageing process we all go through as we, well… get older!

If I ever treat someone who tells me they have been given such a diagnosis, I often tell them (after I have carried out a full assessment obviously to make sure there is nothing else going on which may indicate further medical attention/investigations) to more or less ignore the diagnosis. The reason I say this, is because it is more than likely there are plenty of people walking around who would be given a similar diagnosis were that to have the appropriate investigations, yet they will be suffering with no low back pain or sciatica whatsoever. The most important diagnosis we need to concentrate on is what I refer to as the ‘functional diagnosis’ i.e. the diagnosis given after taking the history of the problem, listening to the individuals typical daily activities and assessing how they move and checking for any muscle imbalance which may be present.

A few classic examples of medical diagnosis which can be a bit mis-leading are:

Facet Joint degeneration (wear and tear of the joints in your back)

Degenerative disc disease (wear and tear of the discs in your back)

Facet Joint Arthropathy (basically, there is something wrong with the facet joints, normally wear and tear!)

Herniated Disc (this means there is a disc bulge present, and while this is not necessarily a sign of ageing/wear & tear, it is something that many people walking around with no pain at all would be diagnosed with were they to have the appropriate investigations)

Ideopathic Low Back Pain (it is not known why you are suffering with Low Back Pain. This could just as readily be called ‘I do not know low back pain’)

Lumbar Spondylosis (medical jargon for changes which are taking place, typically as a result of… wear and tear)

I am sure you can see where I am going with this, these diagnostic terms describe ‘problems’  identified following further investigations, such as an X-ray or MRI scan, which may well be picked up if someone who is suffering with no low back pain or sciatica at all were to undergo the same investigations!

When I explain this to a patient, it is sometimes met with a degree of scepticism. I fully understand this as I can relate to someone thinking that if, for example, an MRI scan shows they have a Herniated Disc and they are in pain, then it is thought that this must be the cause of their pain. However it is not always the case and can be a red herring.  Mind you, I may not be so understanding when a fellow health professional believes that just because an X-ray or MRI scan picks up something, that this is definitely the cause of the pain.

Anyway, I was having a little surf around the net, and it was reassuring to come across this article on the same kind of topic (http://www.spine-health.com/treatment/diagnostic-tests/getting-accurate-back-pain-diagnosis). It is from a website called Spine Health (nothing to do with me I can assure you, although I wish it was my website!) and although it does not explicitly state that which I have above, it does acknowledge that some terminology can be confusing and also that the most important thing is a ‘clinical diagnosis’ (the same as what I refer to it as a ‘functional diagnosis’).

I thought I would share this information with you to have a look at and, as always, feel free to give me your thoughts below. I have be no means looked at the whole site, but it appears to be a good website to browse if you are suffering with low back pain or sciatica, as it looks like there is a lot of valuable information there.

I hope you are all keeping well and don’t forget to leave a comment if you have anything to say.

Take care for now,

Paul.

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