Blog post written by Jason Dodd who is the Clinic Manager at Bodylogics. The views and advice are the words of Andrew Terry who is the lead Osteopath at Bodylogics and supported by Jason Dodd.
Let’s start by answering this main headed question first. An Osteopath is very similar to a Physiotherapist or Chiropractor or Sports Therapist, they are trained to treat musculo-skeletal system which as its name says, are things related to either the muscle system or the skeletal system of the human body. Osteopaths, like Physiotherapists, Chiropractors and Sports Therapists, etc…. aim to find out the cause of your issue and not just the problem itself. For example, a client may come to us with what seems like shoulder pain and presents as pain in and around the shoulder area but once investigated, the cause of the pain may actually be coming from an issue with the neck. An Osteopath would examine and treat the neck area with the anticipation that this would have a direct link on the shoulder pain and how it presents.
What do Osteopaths treat?
An Osteopath treats a wide range of pathology and injuries. An Osteopath is commonly associated with the treatment of back pain but they are not limited to this alone. Osteopath’s are trained and skilled to treat all areas of the body and the Osteopath Team at Bodylogics are no different. In the next section we will look at a variety of different scenario’s that our Osteopath Team have dealt with in their time here;
A client presents with lower back pain
This is one of the most common presenting conditions here at Bodylogics and we would assume in most Osteopath Clinic’s around the country. On any consultation, and follow up, a thorough Q&A would be carried out to gain an insight into the history of your pain and how it presents, when it comes on, how long you have had it for, etc….. We would carry out a series of assessments but the things we would be looking for are as follows;
- Sacro-Illiac Joint – this is the area at the back of the hip, right next to the spine and is an important stabiliser in any movement of the body that stems from the hip (which is most movements). In this area the pain is likely to be referral pain from ligament tissues which are highly crucial for the overall stability of this key joint area.
- Gluteal muscles – the lower back pain you are experiencing could be as a result of a weakness in the glutes. Muscles that are weak and inhibited sometimes present in a painful/tight way and this can then send referral pain up into the lower back. The inhibition too can sometimes mean the lower back does more than what it should do on a day to day basis and this can result in it becoming overworked and tired/stiff. This is where a Sports Massage may benefit you in order to release some of the tightness/restrictions in the area.
- Sciatica – we hear this a lot but what does it actually mean? Well your sciatica nerve is the main nerve supply to the lower leg. Sometimes the facets of the spine can become mis-aligned and this then can pinch on the sciatica nerve which is why you can get pain, pins and needles and numbness in the lower back area. Some simple manipulations of the spine can help manage this but does not always provide a cure.
- Big wallet syndrome – one of our most favourite sayings. Those that sit with their wallet in their front pocket can sometimes create a pinch on the nerve known as the lateral cutaneous nerve and this can cause pins and needles which refers pain to the lower back area.
- Stenosis – this is where the disc/discs of the back have worn away and are now causing friction pain when movement occurs.
A client presents with pain in the Hip area
Again, our initial job is to carry out a thorough Q&A. We would also identify if it were to be referral from the lower back area which in some cases it may be. We would then carry out an objective assessment. This type of assessment is usually more focused on special tests which enable us to rule in or eliminate certain conditions. This is an important stage of the assessment as it will then guide our treatment plan.
- FAI – One of the first things we would look to rule out is Femoral Acetablum Impingement syndrome (or FAI). This is restrictive condition that can have a huge impact on overall life quality as patients can experience pain and discomfort for large parts of the day with this condition. This diagnosis is not common but it worth paying attention to as if left too long it can manifest and become much more difficult to treat.
- Pubis Synthesis – If we are able to eliminate this then we would look for things such as pubis synthesis which can originate from the front of the hip, near to the groin area. Again this is not common but when it occurs the pain can be high and patients find it hard to manage simple tasks like sitting for prolonged periods and taking part in exercise. This can then lead to added stress in people’s lives and stress has been proven to exacerbate pain in certain conditions.
- Gluteal tendinopathy/femoral bursitis – If the pain is radiating from the lateral (outside) side of the hip then it could be a case of Gluteal tendinopathy or femoral bursitis. Both of these diagnosis can be treated and managed effectively using conservative management and do not require scans or surgery as some people often fear.
A client presents with pain in the shoulder area
It is important here to understand the onset of pain. Did it come from a traumatic event, such as a fall? Or has it come from an insidious onset, which is where it has come on for no apparent reason. One of a client’s biggest fear is the sudden onset of frozen shoulder. This is a hard to manage condition and it is vital that the patient has patience and resilience with their rehab programme as it can take some time to reduce the issues that they may be suffering with. We look at some of the possible causes of shoulder pain here;
- Heart conditions – pain in the shoulder can sometimes be a referral pain from the heart. Although this is rare, it is worth getting it checked out if the pain seems to come on during exercise (can be as little as walking or going up flights of stairs).
- Neck conditions – one of the first things that would happen in any assessment of the shoulder is an assessment of the neck. We would look to see if you symptoms change when we change the position of the neck. If they do they the likelihood is that the issue lies in the neck and not the shoulder.
- SLAP tears – SLAP stands for Superior Labral Anterior Posterior and is the main fibrous tissue that holds the head of the humerus in place at the shoulder. When this labrum is damaged it can cause pain on movement. A positive sign of this is usually if upon injury the client heard a pop or snapping noise. Usually, the gold standard of care for this is surgery but some people are able to complete conservative management with positive outcomes.
- Rotator cuff tear – this is a tear of one of four muscles that are responsible for supporting the shoulder joint. They are often an underutilised set of muscles and very quickly develop weakness which makes them prone to injury/tears.
- Sub-acromial impingement/Bursitis – these conditions are commonly treated under the same care plan as it has been proven to be near impossible to accurately identify the exact cause of shoulder pain when going into side abduction (taking your arm out to the side) because to do this movement requires many different anatomical features to be is use at any given time and therefore identifying the exact cause roves near impossible. The good news is that conservative management approaches have proved highly successful in these conditions and a suitable programme can be developed for individuals.
Osteopathy is more than ‘just clicking necks and backs into place’. Osteopaths do specialise in particular areas but their focus is more on the long term solution to your pain and issues. Anyone can go out and find quick fixes, but the issue will continue to grumble on and will ultimately get worse over time unless you identify the cause of your symptoms. This is how Osteopaths can benefit the individual and regular appointments can help you to stay injury free and at the peak of your game!