If you don’t sleep well, don’t put up with it - do whatever you can to put it right.

Here is an excellent site detailing a basic sleep hygiene ‘checklist’ …

http://www.umm.edu/sleep/sleep_hyg.htm

There are a lot of reasons why, at ANY age, making sure you have enough muscle is very important indeed. 

And they are not just the obvious reasons (e.g. helping the spine and joints cope better, coping with stress and so on).

But you don't need to look like the guy above.

A recent study shows how having enough actual muscle may help our health - in particular, may make it a lot less likely you will develop type 2 diabetes.

See the following article ...

http://www.sciencedaily.com/releases/2011/07/110728082601.htm

http://www.nutri-online1.co.uk/Default.aspx?tabid=1637

and there is this excellent resource from the National Institutes of Health …

http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Osteopathy is ideally suited to identify exactly where things have gone wrong, and then fixing them so that your body goes back to what it was before the accident.

Don't listen to people who tell you that you will always have a problem, or that you need to wait for 6-12 months to get any improvement!

Checkout this video for a simple demonstration of what happens to the neck in a rear-end-shunt.

A 'normal' knee is a delicately balanced and quite odd system of joints. Any change in the orientation and functioning of the knee stemming from the lumbar spine (for example, a joint has become stiff at the base of the spine) will alter the normal movement of one or both knees.

Now the knee may well be able to cope with this, and you may not notice any symptoms. And there may be no symptoms from the stiffer low back either.

Often though, the knee begins to grumble when you take up some new activity (e.g. running), or gain weight, or get less fit.

So bear in mind that a knee that begins to niggle for no reason may have its origin away from the knee, and the low back is a common source of this.

A common question - and surprisingly difficult to answer. To start with, it's a question of realising that each has two quite different effects.

Both cold and warmth (or even moderate heat) act as pain 'blockers' - in other words, rather like rubbing a stubbed toe, they 'distract' the brain from feeling the usual pain or ache. But both do something else too ...

Cold can seep through the skin, and serve to slow down inflammatory activity and blood flow in a painful area. This will work when there actually is inflammation causing the bulk of the pain, which is mainly only in the first few days of a new injury. A good example of an injury like this is where you have stretched a joint too far; the joint then 'seeps' inflammation (which causes pain and can cause a 'hot' feeling) over the following few days.

Warmth can relax the muscles and allow blood to flow through better. This is especially useful when muscle tension itself is causing the ache or pain, and there is no inflammation.

A neat way of remembering all this is to think: warmth is good for me when movement makes me feel better, and cold is good for me when I'd rather not move because of the pain!

Summary : both cold and warmth (or moderate heat) have different and similar effects!

This question is asked a lot by those people with low back pain, especially those who do manual work. In some times of back pain the entire muscle group of the low back goes into a kind of protective and panicky spasm.

It is true that for these kinds of patients the sense of compressive support that they get from the back support device does seem to 'calm' the muscles and, as a result, they feel less uncomfortable and often able to move around more.

The problem occurs when the back support device is used too much. Beyond a certain point the benefits get outweighed by the growing penalty of the muscles getting more and more lazy and confused.

Its a difficult balance to strike; use them - but not too much.

Clearly, high heels place more strain on the feet, ankles, knees, and low back than do flat shoes. But the body, when it works well, can tolerate a great deal of 'imbalance'.

But there are some particular issues worth bearing in mind for those of you with a spinal problem who want to wear heels.

The easiest way to explain it is to say that heels cause a tilting back of the lumbar spine (low back) and the neck. It therefore stands to reason that if your problem - even when wearing no shoes - is that you find bending backwards in the low back or neck causes pain or stiffness, then high heels are likely to aggravate this problem.

But if you find that you are quite ok bending backwards, but it's other movements that cause you problems, then you may well get away with heels.

A question we are asked a lot!

When spinal joints are manipulated they produce a characteristic pop or click sound. Neck joints, especially, sound loud because they are quite close to the ears!

To start with, the pop sound is NOT the sound of bones breaking ... actually, the joint itself (which is where two bones meet) produces the sound when the stretching of the joint reduces pressure enough for dissolved gases in the joint fluid to bubble out and produce the pop.

It's a bit like opening the top of a coke bottle (reducing the pressure) and seeing the bubbles form.

So the pop sound is a naturally occurring sound made when a joint is stretched.

Any so-called 'synovial' joint can make a pop - the art is in making stiff restricted joints move better through precise manipulation.

A common mistake is to overdo the heat.

Tired aching muscles certainly like warmth - it helps the blood flow through the muscle delivering fresh oxygen and nutrients, and disposing of accumulated waste products.

But, if you use too hot a heat source, the receptors in the skin detect it as pain ... in which case the muscle 'tenses up'!

Too much heat can also mottle the skin.

Don't overdo the heat ... muscles prefer warmth.

Is your low back aching a lot while you sit at work?

A common misunderstanding is that you should sit bolt upright when you sit in your office chair - rather like the lady in the above picture.

Perhaps you've been asked to do this to stop you slouching or slumping in your chair as you use keyboard or mouse, and stare at the computer monitor.

Well, sitting upright can be just as bad, as it still places quite high compressive forces at the base of the spine.

Try 'reclining' in your chair, with legs out in front, and your bottom slid nearer the front of the seat.

If your back problem is a disc type of problem, this can keep the 'strain vector' off the injured part of your disc and thus reduce pain.

Reclining in your chair may well help in some cases, but like all sitting related problems with back pain, you need to take regular breaks.

You must be careful when having your hair washed with your head and neck leaning backwards over the basin if any of the following apply to you ...

• You have a history of pain in the neck, or dizziness, vertigo, sickness or even blackouts, when you do activities involving looking up e.g. changing a light bulb, looking up at a plane, getting something off a high shelf and so on.
• Having your hair washed while leaning backwards over a basin makes you feel unwell or causes pain in the neck or head, while you are having your hair washed, or even afterwards when you have left the salon.

The reason for all this is that having your neck leaning backwards (what we call extension of the neck) compresses various structures such as joints and blood vessels, and this can cause symptoms (some transient, and sometimes serious). When your neck is healthy and mobile, extension is not a problem. When it isn't, extension can cause problems, especially prolonged extension.

So if you have any concerns over this, ask to have your hair washed while leaning forward over the basin!

When your back is hurting, it often hurts to bend forward, or backwards, or sometimes even both!

But I'm often asked by patients, 'what's most important when my back is not hurting - a good range of movement when bending forward or when bending backwards?'.

Well, both are important for different reasons, but if I had to choose, I would plump for having a good, or at least adequate, range of movement bending backwards - especially in the lumbar and thoracic areas.

The reason is to do with walking. Do this: while standing up, place one leg in front of you as though you are taking a longish stride. Observe how your lumbar spine has had to bend backwards to allow this (if it can't then you fall forward!). The longer the stride, the more the lumbar spine has to bend backwards properly to allow it.

Now, imaging what would happen if you lost the ability to bend backwards well.This stops you taking long strides. Gradually you shorten your gait to adapt. This places more strain on hips and knees. You can't run or even jog properly anymore.

Sooner or later you end up with a more short stride and stooping gait.

Avoid this by making sure your lumbar area can bend backwards well, either through treatment by your practitioner, or via exercise - or both.

Yes and no … it depends!

If you think you may be pregnant, but are not sure, and still need to see your osteopath, then do mention your possibility of pregnancy when you see him or her.

If you know you are pregnant, but are still under 16 weeks or so, then unless you have a serious problem needing osteopathic treatment, the general consensus is that it may be better for you to leave things as they are till 16 weeks or more, when the pregnancy will be well established.

If you are above 16 weeks, and have no significant complications or previously ‘difficult’ pregnancies, then treatment will be both safe for you and the baby, and just as effective as if you were not pregnant;

• you may have a previous problem that is still bothering you and you want sorting out before you get a lot heavier!
• you may find that the changes your body goes through in pregnancy expose for the first time a ‘weakness’ in your spinal functioning - a good example is where the extra weight at the front starts to overload a stiff mid back with resultant aches and pains
• you might find that - and this is especially true in later 3rd trimester pregnancy - that the body just starts to groan with the extra weight on increasingly lax ligaments and muscles

If you have had previously complicated pregnancies, then osteopathy may still be able to help, but for obvious reasons the osteopath will proceed a lot more carefully.

The short answer to this is "perhaps".

Some people don't need follow up treatments; for example, someone in good physical condition (who has a well working spine) has some kind of trauma which causes spinal dysfunction, which is then properly resolved by osteopathy - they then go back to 'normal'. Another example; there are some people who have very loose ligaments and connective tissue; they need excellent muscle tone to keep their system working properly, and treatment like osteopathy can't have much of a preventative type of benefit for people like this (although it can help to settle things down quickly if something does go wrong).

But for various types of people and problems, there is a case for occasional follow up visits, possibly over a long period of time, even if the original (painful) problem - from the perspective of the patient - has been resolved. A few examples of this are are;

• Someone who has had a long history of spinal problems; here there is a case for nipping things in the bud before bad patterns can return to cause pains and aches.
• Someone who does not have the time to keep up with physical exercise, and has either a very sedentary job (e.g. a computer worker) or an excessively active job (e.g. a bricklayer).
• Someone who competes in a certain sport and requires good functioning at all times; for people like this there is no point in waiting for things to go wrong - they need to be more proactive and have things checked out regularly.

Generally speaking, if you do need regular follow up treatments, then the number you will have in any given year will probably not be a lot more than the number you would have if you let things build up and cause a painful episode! Over a longer period of time, regular follow up sessions (even 2-3 per year) can stop the development of spinal stiffness patterns, that otherwise can become significant problems in your 60's and 70's.

Invest in your spinal health - it's worth it, and the benefits accumulate through the decades.

This is a VERY common question. There are a lot of myths. For example, “it’s because you are too tall!” (no, there is no evidence or reasonable explanation for this). Another example, “our spines aren’t designed to walk well on two legs …” (no evidence for this, either - quite a few quadrupeds get problems with their spines … ask any vet).

By the way, pain itself is caused either by what we call tissue damage such as a torn ligament (in which case inflammation occurs, and pain fibres communicate this to the brain), or by unusual behaviour of the spine being broadcast as pain by the spinal cord (even where there is no actual tissue damage).

But this article is not about the pain itself, but about what - in general - can go wrong with a spine and cause problems through life.

There are probably three to four decent explanations for spinal pain and problems - any of which on their own can cause problems (but don’t forget that some people may have more than one).

First, you may be born with a weakness (the great majority of people are not) that your spine is just going to have problems coping with, either when you are young, or which will come through during youth or even middle age. Examples of this are badly formed vertebrae at birth, or spines that twist as they grow (we call this scoliosis), or ligaments (that hold bones together) being too soft and stretchy.

Secondly, you can have a trauma; for example - falling down hard onto the ground, where joints and muscles are bruised and sore for a while. It’s a common myth that if the spine is bashed (e.g. in a car accident, or a child falling off a trampoline) then the spine must have gone back to normal functioning when the pain has gone. WRONG! Sometimes the spine CAN go back to normal on its own - but often (more often than not) it can’t. All that happens is that the spine figures out how to adapt to the new (worse) way of working following a trauma. So the pain has gone, but the spine does not work as well as it did. This may never cause pain in the future (in other words, the spine can successfully adapt to the problem) but it might well do so, and often as we get older and less fit, or as we take up new activities, the less good way of working can come back to haunt us. And of course, we can accumulate a series of traumas through our lifetime - they all add up! TIP for PARENTS: if your child or teenager has a trauma that causes pain for two days plus, but which then goes after a while, or just becomes a low grade ‘grumble’, then don’t assume their spine is working normally - get it checked out.

Thirdly, we may have a good and well developed spine, and we may never have had any significant trauma, but we just get less fit and less strong and less flexible as we get into middle age. So the healthy spine just doesn’t have enough energy or muscle power to maintain normal function - aches and pains then develop. Often treatment is NOT needed to help this - just an exercise program! TIP for PARENTS: do try to help your children reach adulthood as fit and strong as they can be … this will delay as long as possible the development of these middle aged aches and pains that inevitably happens to all of us if life and work get in the way of keeping fit and strong.

Lastly, ageing. We all get older, and however fit we keep ourselves, our ‘engines’ can mis-behave more easily and develop faults. Most people call these faults degeneration or ‘osteo-arthritis’. This explains why as we get older, we need to exercise (paradoxically perhaps) MORE frequently (though not as intensely) as we do in earlier decades of life, and also explains why we need more spinal treatment as we get older. Older generations of people thought it natural to get less active as they got older - now the newer ‘older’ generations are beginning to learn that daily exercise activity is essential as you enter your 60’s.

Indeed, a well-enough patient in his/her eighties needs to be doing some form of exercise EVERY day so as to keep moving properly.

It's easy to understand that a weak muscle will start to ache fastest when it is working very hard. It's also fairly obvious that a tired and sore muscle (not necessarily the same thing as a weak muscle) will also 'groan' when asked to work hard.

So when are your low back muscles working hardest? Here's a good rule of thumb- grading the work of the muscle LOW, MED and HIGH ..

1. When you are lying down - LOW

2. When you are standing - MED

3. When you are walking - LOW to MED

4. When you are fully bent forward (i.e. fingertips nearest floor) - LOW

5. When you are half bent forward - HIGH

The diagram above shows number 5. quite clearly. This is the classic washing up, cleaning your teeth, leaning over a cot, or washing the car type position. Lumbar spine muscles, even in a healthy spine, can only sustain this position for so long before aching.

If you have a back problem, this is a risky position to maintain - so take care.

That's why wearing a back support belt can help in this case, as the workload of holding you in this position is partly shifted from back muscles to the front and to the bony pelvis.

(Note that if you are holding onto something, such as when mowing the lawn, the position is not quite so bad for your back muscles as they are supported to some extent by your arms).

Over the years osteopathy has perhaps become synonymous with the treatment of spinal pain - after all, low back pain is common and it affects daily life dramatically.

But in reality osteopathy also helps pain and dysfunction in other parts of the body (e.g. ankles, knees, elbows, ribs etc.), as well as helping the functioning of important areas such as the thorax, abdomen and pelvis.

It is important to realise that an osteopath is a 'generalist' and not a specialist. We don't specialise in treating one thing because that would be completely at odds with the way that an osteopath sees human beings and the way that their system functions as an integrated whole.