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Great advice on Sleeping and Beds from the BCA

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Research carried out on behalf of Premier Inn suggests that you can tell a lot about someone’s personality by the position they sleep in. Your bed can also be the cause of back pain and the British Chiropractic Association has some great advice for sleep posture and how to choose your bed and pillow.

Choosing the right bed can minimise those factors that may lead to, or aggravate back pain. Research by the British Chiropractic Association in 2011 showed that of those experiencing back pain, 41% of women and 36% of men said that their pain could be brought on by a night’s so-called ‘rest’.
We come in different weights, shapes and sizes, but have one thing in common; we spend more than a third of our lives in bed, so should choose our beds carefully.
Which is better, a hard or soft mattress? – The best mattress is a ’supportive one‘. A 16 stone person sleeping on a mattress may not get the same support as a 10 stone person sleeping on the same mattress.

How do I know which is the right mattress for me? – If you are lying on your side, your spine should be parallel to the mattress and your spine should not sag (bed too soft) or bow (bed too hard). The longer you can spend lying on a mattress before you buy it, the more accurate this feeling will be. – Your pillow should be an extension of this i.e. your neck should be a continuation of the straight spine and not too high or too low.
What about my partner? –   Always shop with your partner as your respective ideal mattress tensions could be very different.  If this is the case, buy beds from a range that allow two single mattresses to be zipped together, so that you both get the support you need.

How do I know if my current bed/mattress needs replacing? –  Are you and your partner getting comfortable nights sleep? If the answer is no, your bed may be the problem. -Can you feel the springs through the mattress? If the answer is yes, it is definitely time to buy a new one. –  Is the bed more that 10 years old? If the answer is yes, consider purchasing a new one – beds wear out and may sag or lose support with time.

What things can I do to help prevent back problems even with my new mattress? – Try and adopt a sleeping position which creates less physical stress on the back. For example, lying on your side is better than lying on your front with your neck twisted to one side. –  Keep moving and avoid being in any one position for too long.

No matter how comfy the position may initially feel, the longer you stay in one position, the more this will ‘load joints’. If your partner moves around a lot at night, try separate beds for a while as your partner’s movement could aggravate YOUR back condition! –  Drink water. Keep well hydrated; dehydration can make muscles ache. –   Don’t leap out of bed first thing in the morning. After you have woken up wake up, try some gentle stretches. –   Wake up your body. Once up, avoid bending or doing anything sudden or strenuous until you back wakes up!

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Sacro-Iliac, also known as SI, Joint pain

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The Sacro-Iliac joint is a common cause of lower back pain due to the large amount of force it has to cope with, patients often get this joint confused with the hip as it is quite low and slightly to the side of the spine (wider in women).


This joint connects the spine to the pelvis and takes on a lot of force during motions involving the legs and torso. The joint essentially is a wedge of bone (The Sacrum) at the base of the spine fitting into wedge shaped region (between the ‘Ilia’, pleural of the ilium which is one of three parts of the pelvis) at the pelvis hence the name Sacro-iliac. Because this joint takes on so much force it requires a lot of stabilising, hence there are many ligaments connecting the sacrum to the surrounding structures. These ligaments are prone to injury, if the muscles around the joint, above or below are not working efficiently to support the spine then the S.I joint’s ligaments and cartilage are prone to increased forces and therefore damage.

Front view:

Rear view:

Pain that originally starts in this region often spreads across the whole of the lower back, this is because inflammation is a very clever but also very crude system. When the inflammatory process starts, it essentially dumps inflammatory chemicals on a region. What it often does however is go a bit too far, this can actually damage healthy cells, giving the feeling of pain in a general region. The S.I. joint can also refer pain to various other regions, this is because where the pain fibers from the S.I joint enter the spine, fibers often cross with fibers that innervate other regions of skin of the body, therefore producing pain at the region also. When this occurs, it is known as an S.I. joint Syndrome as all three components of pain, restriction and pain referral are involved to make up the ‘syndrome’.
Purely using an Ice pack regularly for 10-15 minutes every 2 hours for a week will make a massive difference and should localise the pain back to the joint where it originated. To clear out the rest and to prevent recurrence, a Chiropractor may be needed to get the joints moving properly and the muscles loosened and functioning correctly once more. There is only around 2-4 millimeters of movement at the joint therefore a Chiropractor will help regain as much movement as possible. This will get rid of the pain completely and with the correct assessment and treatment of your bio-mechanics and function it will prevent the problem from recurring in the future.

There are more serious conditions that can affect this joint such as various arthropathies, (there are many types of arthritis) though a well trained Chiropractor should be able to determine the exact cause of the pain from your history and assessment.

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Tips To Improve Your Posture

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1. Stretch regularly – Yoga and Pilates are brilliant to improve your posture, the better you move, the better your posture and the less problems you will experience. If you feel tight in one particular area or are not sure where you are moving incorrectly then your teacher (yoga/pilates) or manual therapist (e.g. Chiropractor) can help you.

2. Correct your ergonomics at work, if you sit at a desk for long periods at work for example then make sure you ergonomics are perfect. A lot of companies will assess this for you, however make sure it is kept up to date as it is very important for your posture and to prevent injury.

3. Take regular short breaks, if you have to stay in one place for a long period of time (e.g. sitting down) make sure you take a break and move about for at least 5 minutes every half hour. This will allow  the structures within your body to recover from a prolonged period of stress in one position which can lead to poor posture.

4. Drink lots of water – staying hydrated keeps your muscles and joints supple and strong preventing your body from getting lazy and adapting a poor posture.

5. Feel free to fidget! Fidgeting is your body telling you that you need to move to get comfortable, listen to your body. If your body needs to move to be comfortable then let it be comfortable, just don’t let it be comfortable in one position for too long ;-) .

Always remember, keep moving and stay loose, keep your back straight when bending and use your knees!

If your company would like us to pay you a visit to conduct free postural assessments please get in touch!

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Chiropractor Danny Explains Why You Should Get Back and Neck Pain Treated Sooner Rather Than Later

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Within this post I’ll explain why seeking treatment for your back pain earlier will potentially save you a lot of money.

Take a quick look at these well researched statistics:

 

 

  1. 80% of the population will experience back pain at some time
  2. 40% of the population are affected by back pain currently (16 million)
  3. 2.5 million people have back pain every day of the year
  4. 119 million working days are lost
  5. 1.2 million people are affected by musculo-skeletal pain and 500.000 by work related stress

The Hard Working Citizen

The sooner a person with back pain sees a well trained therapist such as a Chiropractor, the sooner they will get better, simple. Recently I and my colleagues have noticed how patients are presenting with incredibly chronic (>3weeks) back pain. People seem to be putting up with pain without seeking help for longer than ever before, we think this may be due to the recent recession (or double dip recession as it is for us Brits). People are really feeling the pinch, but if you think you are saving money by not getting your back pain treated now, you are very mistaken. In fact, it’s not cost effective at all! Its actually uneconomical! I’ll explain why.

Scary but (potentially) true

I’m going to use a common lower back problem as an example, a lower back disc bulge, a disc bulge usually occurs because the underlying supportive back structures are working incorrectly. The forces within the lower back are therefore repeatedly falling upon structures that cannot cope with the increase in load (the discs, among other things). This leads to failure, if the bulge is not correctly managed and the forces continue to be incurred in a region that has already failed then its ability to heal is diminished. It may take months or years to get better with a very high chance that it will recur in the future due to the mechanism of micro tearing in the outer layers which heals incredibly slowly, if at all (Read more here on disc bulges). Disc bulges can progress and in a lot of cases may even lead to surgery, the likelihood of this increases if you do not seek effective advice and treatment. The earlier you seek treatment, the quicker your disc bulge will resolve itself and with the correct prevention strategy provided you will have a lower back that will be less susceptible to having disc bulges in the future.

“And financially this affects me how?”

The financial implications of this are simple, by letting your back pain progress and possibly worsen it may end with you requiring surgery and months off work with no guarantee it won’t recur. Due to the reasons above you may even require multiple surgeries in the future. Therefore, costing you even more in lost wages with time off work and possibly even your job! This is all theoretical of course and I’m not trying to scare you well, maybe a little lol… as more than likely if it is your first episode of back pain it may be nothing serious but for the price of a consultation fee it’s still best to get it checked out now to be better safe than sorry. The best way to treat the problem and find out the cause is to seek help from a well trained manual therapist such as a Chiropractor. A good therapist will offer you a variety of treatment and prevention options (or referral if required) and an insight into how your problem could progress if left untreated. So what I would recommend is to save yourself money and seek help now rather than later, trust me, your future pain free self will be thanking me in the long run.

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Sciatica…

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…It can be such a pain in the bum… literally! ‘Sciatica’ is the term used to describe any pain that is originating from irritation of the Sciatic Nerve. This pain can be felt anywhere down a leg, from the bottom to the feet.

The Sciatic Nerve is the longest and thickest nerve in the human body, running from your lower back all the way in to your foot, with its thickest part being around 2cm in width! As you can imagine, a lot can happen to that nerve along its route and exactly what can happen is the subject of this post. The Sciatic Nerve originates as individual spinal nerves known as L4,L5,S1,S2 and S3, these nerves exit the spine individually but then converge to create the Sciatic Nerve. Bear this in mind when we discuss problems that can occur to the Sciatic nerve that lead to what we all know as ‘Sciatica’.

Disc Bulges

The most common cause of Sciatica is what is known as a Disc Bulge (Click here for a complete description of what a disc bulge is). A disc bulge between the vertebrae of L4 and L5 or between the vertebrae of L5 and S1 can lead to ‘Sciatica’.

A disc bulge essentially only affects the nerve at which level the bulge is occurring, this therefore would affect the path of the Sciatic Nerve but particularly at the points at which the original nerve supplies the body. For example, a backwards and to the side (postero-lateral) Disc Bulge at L5/S1 usually causes pain/tingling/numbness/pins and needles at the sole and outside edge of the foot on the same side as the bulge. This is because the nerve exiting between the spinal segments of L5 and S1 is what is known as the S1 nerve root (like a tree a nerve has a root, another word for where it starts). The S1 nerve supplies both muscles (a Myotome) and skin sensation (a Dermatome). So as you can see the S1 nerve supplies sensation to the sole and outer edge of the foot which is why pain is felt here. This applies to all nerves exiting the spine. If one level has a bulge then the skin it supplies may have a change in sensation. The muscles that each affected nerve innervates may also not work correctly or may even begin to decrease in size and become flaccid, seen in severe cases. For example, The S1 nerve supplies lots of muscles in the lower leg and foot so it would be quite clear if there was something affecting its innervation severely as all these signs would be present. Chiropractors treat disc bulges all the time, worst case scenario is surgery for a disc but your Chiropractor or manual therapist will let you know if this is necessary.

Foraminal Stenosis

The word ‘Foramen’ basically means ‘a hole’, where the L4, L5, S1, S2, S3 nerves leave the spine between each vertebral segment is a hole called the ‘Intervertebral Foramen’. If anything decreases space at this Foramen then Sciatica can occur, problems such as bony spurs, inflammation, a Spondylolisthesis or a Tumor can all cause a decrease in space here and irritate the nerve as it exits. This can therefore be one of the causes that lead to irritation of the Sciatic nerve and the symptoms associated to it.

Piriformis Syndrome

In a nutshell ‘Piriformis Syndrome’ occurs as a result of the Sciatic nerve being irritated by the Piriformis Muscle. Though it’s not always simple to treat for the following reasons:

The Sciatic nerve’s relationship with the Piriformis Muscle in the general population differs from person to person. As you can see, most commonly it passes beneath the Piriformis Muscle, however in the minority of the population the Sciatic Nerve can actually pass through the Piriformis Muscle entirely, or even stay split around it and connect after.

The Piriformis is an external rotator of the the leg, if it gets too tight (common in a lot of people) it can become irritated, this leads to inflammation at the muscle and surrounding tissues, which in some cases includes the Sciatic Nerve. This irritation can cause symptoms down the leg that are often misdiagnosed as disc bulges due to their similar presentation.

If you have further questions or would like to know more about this topic please ring us on 01452309372 or email contact@longlevenschiro.com

 

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Posture Advice from Massage Therapist Kate West

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It’s rare to that you find someone with the ‘perfect’ posture, but the idea is that it is aspired to. Below is a diagram of what we should all be aiming for.

 

There tends to be 3 types of ‘bad’ posture that practitioners see most often:
Sway back posture:

• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage The Upper chest collapses, flattening out the chest wall. Chest also moves back and in.
• Upper Back has an increased bend forward (Kyphosis).
• Lower Back flattens out
• Pelvis tilting under (Posterior tilt) and pushing forward.
• Knees locked
Flat back posture:

• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage falling forward
• Upper Back Straightening out as you move down the spine
• Lower Back flattens out
• Pelvis tilting or tucking under (Posterior tilt)
• Knees locked

Hollow back posture:

• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage collapsing
• Upper Back is rounding (Kyphosis)
• Lower Back has an increased curve (Lordosis)
• Pelvis tilting forward (anterior tilt)
Knees locked

Poor posture can effect the body massively. It can mean some muscles shorten and so cannot perform normally and therefore others lengthen which decreases strength. It can also effect blood flow through muscles which can lead to pain spasms.

Poor posture can be the cause of much discomfort and injuries due to the short/tight muscles or the lengthened muscles that allow too much movement possibly leading to injury.

Posture is something that everyone should be very aware of and be trying to correct every minute of every day.

References:

Kendall, 1993
NLSSM – North London School of Sports Massage

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Why Do I Need to Use Ice?

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Its amazing… amazing how many times I have asked patients during our first meeting and consultation if they have iced their injury before coming in to see me. The answer 90% of the time is, “I haven’t” or “I have been using heat but not ice”. In mine and a lot of others opinions, Icing is by far and away the best thing you can do to get yourself back on the road to recovery as fast as possible in the early stages of a muscle or joint injury. Here in this post I explain why…

Probably your whole life you have been told if you have burned or bruised yourself that “you need to put ice or ice cold water on it to stop the swelling”. Well the same rule applies for your muscles and skeleton, this includes your spine by the way!, they all respond to ice in the same way as if you bruise your arm. Let’s take back pain for example, a similar thing is occurring with an episode of back pain that occurs with a bruise. Something in your back has been damaged as a result of weakness or poor function and the body is reacting by trying to protect itself using inflammation. The same as if you had bumped and subsequently bruised yourself.

Inflammation has 5 components; pain, heat, redness, swelling and loss of function. All five are reduced as a result of icing. Ok, now think about what I have just told you and consider this: If you just bruised your arm, would you put heat on it to try to make it better while it is still sore and hurting? (oh dear god, please say no…) Remember the 5 components of inflammation??, that’s right, heat was one of them!, therefore you would be encouraging inflammation if you used it, not good. This again also applies to your back, if your back is in pain it is usually due to inflammation, so don’t use heat!. The only time I recommend the use of heat is during a warm up before performing strenuous exercise and certainly not for someone in pain. Once a person is out of pain and functioning correctly I only encourage heat in the form of giving your muscles a good rub to make them more pliable if you know they are noticeably tight.

Right, now I want you to apply what I have just told you to your day-to-day life. If you had just suffered an episode of back pain, would you now consider it a good idea to have a hot bath?? or a hot shower??, or go in the hot jacuzzi down at you leisure club??. I hope you can see what I am saying here (and no, I am not saying don’t wash, that wouldn’t help any of us!). What I am trying to say is that you may be applying heat to your back pain without realising it, by performing day-to-day activities like those I just mentioned. What I would like you to consider when in an episode of back pain is turning down the temperature. When you have a shower or bath, reduce the temperature a bit (not too much!) and make sure you ice your back straight after for 10-15 minutes or find a cooler alternative to cleaning yourself, like using wash towels.

To conclude, wrap up some ice cubes in a damp cloth or wrap an ice pack in damp paper towels or a cloth and apply to the problem area. Perform 10-15 minutes of icing every 2 hours, five times a day or as close to that as possible. This is the perfect routine to help get yourself through the early stages of injury. I would also recommend seeing your Chiropractor or other manual therapist as there are some instances where the pain may in fact not be coming from the parts of the body you suspect. In which case your Chiropractor or other manual therapist will help you identify the correct place to apply your ice pack whilst also providing treatment, information, advice and guidance to aid the healing process and help prevent it happening again!.

When to use ice: Acute sprains and strains, Acute inflammatory processes: arthritis, bursitis, tendonitis myositis, and neuritis, Acute trauma, Acute and chronic muscle spasm.

When not to use ice: Cold hypersensitivity (test a small non-painful area first if worried), a vasospastic disorder (Vasospastic disorders are conditions in which the vessels of the extremities do not dilate properly.), Systemic complications, Raynaud’s Phenomenon or Certain malignancies (seek advice). Do not apply if you are a weakened individual; Old age, Infancy, Cachexic. Or if you have severe varicose veins, myocardial weakness or high blood pressure.

I hope this has helped you understand a bit more about your body and Chiropractic, If you have any questions on this topic send me an e-mail at danny@longlevenschiro.com

If you live in Gloucester or surrounding areas and are interested my Chiropractic services and what I can do to help you, then book an appointment to see Danny at the Longlevens Chiropractic and Sports Injury Clinic on 01452 309372

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