Back Pain

Physiotherapy can be beneficial in managing pain, but the main focus is on strengthening exercises to help stabilise the affected joints. Back pain is a common problem, in fact nearly all of us will experience it as some point in our lives. Whilst the pain can be distressing and affect our ability to do the things that are important to us, in most people the structure of the spine is often normal.

Back & Neck pain

One of the most common injuries and source of pain that we treat is the back and neck. Our team of highly skilled physiotherapists have vast experience in helping you to restore full painfree movement, function and normality.

Back pain happens to many of us in our lifetime and can be frightening and debilitating, often causing time off work. It can be caused by an awkward lift, DIY or repetitive movements, gardening or sport. Often it can seem to start with a relatively simple movement – picking up a towel from the floor, a pen, turning round to speak to somebody. Back and neck pain is often the result of many hours of prolonged sitting, in car or at the computer, gradually overstretching some groups of muscles and ligaments, while shortening others, and putting pressure on the vertebral discs between each joint.

There is usually an underlying reason for the pain whether mechanical dysfunction due to overuse or weakness, muscle tightness from over-protection, or degenerative changes. Normally there is a combination of causes, and it is always best to get to the root of the problem to stop it happening again.

The spine is a very intricate, yet strong, structure with many small joints, ligaments, muscles and the discs. It is well designed for movement but not for prolonged stresses or sudden forces. In many cases it is the muscles, ligaments and connective tissue that cause mechanical problems and result in pain, it is often not the disc at all.

The discs are really tough structures, well attached to each vertebra. Occasionally the fluid centre (nucleus) can ooze out of a small tear in the fibrous outer structure of the disc. This can cause symptoms of pain and stiffness if it irritates the nerve or muscle, until the fibrous disc heals and the

The nerves that supply the entire body leave the spinal cord between each vertebral level of the back. So you can feel pain, pins and needles or numbness referring to your head, arms or legs. Wherever the nerves supply you can get symptoms.This means that sciatic pain, for example, does not have to be due to a disc problem. It can also be caused by irritation from a shortened muscle or ligament.

Pain can be caused or increased by fear. The brain will often read messages sent from the injured area as more of a danger than they actually are, and create all sorts or warning symptoms as a result whether severe pain, or pins and needles, to get you to move and get out of trouble. So often the ache you get from staying in one position day or night is the brain asking you to move and get the circulation going again.

At Radius our physiotherapists will assess your symptoms, including looking at any past history. We aim to give you a clear diagnosis and design an individual treatment plan to address the areas that need help.

Your treatment may include manipulation, mobilisation of the soft tissues and joints, and possibly electrotherapy. It will always include advice on your activities and posture and how best to function whilst you are getting better and for the future when you’re painfree again. You will be given specific exercises to help restore your muscle function and dynamic control of the spine (sometimes referred to as core stability).

We also aim to address any underlying problems and will usually recommend continuing exercise that suits you and your lifestyle, whether pilates, yoga, walking or swimming aiming for self help and management.

Download the back pain information and exercise sheet

Download the neck pain information and exercise sheet

This is provided as general information only and is not intended to be relied upon as medical advice.

Whiplash

Whiplash has been defined as:

 “Whiplash is an acceleration–deceleration mechanism of energy transfer to the neck. It may result from rear- end or side-impact motor vehicle collisions, but can also occur during diving or other mishaps. The impact may result in bony or soft-tissue injuries (whiplash injury), which in turn may lead to a variety of clinical manifestations (WAD)” (Quebec Task Force, 1995)

In essence it is a moderate-to-severe strain affecting the bones, discs, muscles, nerves and tendons of the neck. The unexpected force in whiplash can affect all these structures which can all produce pain.

Although symptoms of whiplash can appear right away it is more common for them to develop hours, days, or weeks after the injury occurs. Symptoms of whiplash can include: tenderness, pain or stiffness in the neck, jaw, shoulders or arms. Sometimes people experience dizziness, headache, loss of feeling in an arm or hand, nausea and vomiting.

It is important to keep moving and try to return to normal function as soon as possible. Our physiotherapists will assess your symptoms and advise you on the best treatment plan. This will often involve hands on treatment and an exercise regime specific to you to help to restore full painfree function.

This is provided as general information only and is not intended to be relied upon as medical advice.

T4 syndrome

Upper Thoracic Spine Syndrome

The symptoms of T4 syndrome usually include pain and stiffness of the upper thoracic spine between the shoulder blades. There can be a variety of other symptoms including diffuse upper arm pain, headaches, neck pain, and a glove like distribution of hand or forearm pain or pins and needles. These symptoms can often be worse at night due to reduced blood and oxygen flow to the area when inactive.

These symptoms can be referred from or around the 4th thoracic vertebra and the spinal muscles at this level. They tend to occur when there is increased stiffness  in the upper thoracic spine. This leads to irritation of the nerves at this level by either mechanical pressure (for example joint stiffness) or chemical irritation (inflammation). The symptoms tend to arise from irritation of the sensory nervous system so they can be quite unusual and diffuse, for example feeling like gushing water or creepy crawly sensations.

It is often caused by sustained periods of sitting or bending with the arms in front of you (laptops/driving/knitting/electricians). Sometimes a new or increased activity that involves a lot of bending or stooping and being kept in that position can set off the symptoms. The lack of movement tightens the muscles and stiffens the joints. It also slows the blood supply to the area and so reduces the amount of oxygen getting to the nerves, muscles and joints.

A thorough assessment will differentiate the symptoms and determine whether it is the thoracic spine that is cause. If so treatment will usually involve mobilisation of the myofascia (muscles and connective tissue) and joints in that area can help, along with nerve mobilisation techniques, postural changes, stretches and strengthening exercises.

Regular exercise and movement or classes such as yoga or pilates can help prevent the symptoms from recurring.

This is provided as general information only and is not intended to be relied upon as medical advice.