Do you think your back pain gets worse in winter?

Did you know… Those who suffer with chronic back pain might notice it gets worse during autumn and winter.

In fact… Although there’s not much scientific evidence that shows a link between chronic pain and humidity, temperature changes and wind speed, weather changes can affect those, who suffer with joint pain conditions, especially arthritis and osteoarthritis.

Did you know… The most commonly accepted reasoning is that with colder temperatures comes lower air pressure, that can cause joint tissues to expand—further worsening joints already prone to swelling and tenderness

If cold weather worsens your pain, you can prevent it yourself and combat it with these three simple steps:

1.    Heat therapy

Including heat therapy in your daily routine can help to reduce stiffness and boost healing through increased blood circulation. Try applying a warm towel or a heating pad to your painful area for about 20 minutes for temporary pain relief. You can also go for over-the-counter heat wraps

2.    Water Therapy

If you like swimming, try to visit heated indoor pool with hot baths, Jacuzzis and saunas a few times a week for almost instant relief from your pain

3.    Stay active

As tempting as it is to just stay on the sofa during winter evenings, it is crucial to keep your spine mobile and stay active. If your pain is too severe to go to the gym, try long walks with hiking poles or Pilates at home

Here at The Whitchurch Clinic, we do see an increasing amount of patients with back, neck and shoulder pain during the festive period.  

The most common reason for this is due to carry large heavy bags and poor posture when sitting for long periods of time.  These both add extra strain on the joints, ligaments and muscles in your back and shoulder which can lead to an episode of pain.

We have put together some tips in order to avoid back and shoulder pain this Christmas:

• Wear sensible shoes - to avoid any abnormal stresses through the lower back.
• Avoid carrying heavy bags, including a hand bag - check your hand bag before leaving and only carry the essential items required.  Spread your shopping into different bags to lessen the weight, and try to have an even amount on each side.
• Park Nearby - try to park as close as possible to the shops, to limit the amount of time that you are carrying bags.  Also try to make regular trips back and for of the car to reduce the amount of bags carried at one time.
• Take your time and plan your journey - allow your self plenty of time and make a list of the places you need to visit. This will not only reduce the amount of time that you spend shopping, but will help to reduce down your stress levels.
• Take regular breaks - if shopping on foot, try to take regular breaks on benches etc to give the body a rest and to ease the loads.  If shopping online, take regular breaks every 20-30 minutes away from the computer.  Try to stretch out tired and sore muscles to encourage activation and loosen up the area. 
• Be conscious of your posture - take time to look at your posture when walking or sitting.  If walking try to maintain a neutral pelvis and stand tall.  If you sitting for long periods ensure that you back is fully supported and you are not leaning to one side.  Make sure that you are not slouching or dropping the shoulders forward.
• Breaking it up into stages - avoid doing anything in one go such as shopping, putting up the decorations or cleaning the house.  Try to break them up in stages and get help with heavy items.  Carrying these out in one go can cause the muscles to fatigue and taking awkward movements which can result in you straining the muscles, ligaments or joints and hen resulting in pain.  
• Keep active - Christmas is about of time of relaxing, however keep yourself moving about often.  Try to do 30 minutes of light exercise every day to keep your body supple.

If however the above advice is too late or you are currently in a pain episode, we at The Whitchurch Clinic are here to help.

Our Chiropractors, Andrea and Sarah can help by:

• Soft tissue massage
• Trigger point therapy
• Acupuncture/dry needling
• Spinal manipulation/mobilisation
• Home exercises/stretches
• Ergonomic and postural advice

Other treatments that may be benefit and are available at TWC:

• Hypnotherapy for stress management and help reduce tension
• Deep tissue massage to help release trigger points or provide relaxation
• Diet advice 

As with any new symptoms it is always important to visit your GP or chiropractor to rule out any other disorders before reaching a diagnosis yourself.

A question that frequently comes up in clinic: What mattress do you recommend? Now the British Chiropractic Association have released this video as a guide to help patients on their way to finding a good mattress and sleeping positions.

These illustrations demonstrate how an incorrectly placed pillow can stress the neck.

On your back you need fewer pillows than on your side so if you change from on position to another bare this in mind. We are also all different shapes so the amount of support we need varies from person to person.

If you're a back sleeper I recommend using one pillow, thickness depends on the depth of your natural curves, and pull the lower corners around your lower neck so the pillow is no lower than your shoulders.

For side sleepers, or those who tend to end up in this position, you need plenty of support so try two pillows, again the depth required depends on the width of your shoulders. Ensure you are not at the edge of the pillow and the lower front corner is pulled down to your shoulder and around the cheek. This will prevent you head dropping or rotating which can irritate the neck or lead people to sleep on their front.

Sarah Beer from The Whitchurch Clinic and member of the BCA comments on the findings:

“I think many of us will agree that the increasing numbers of people experiencing back or neck pain each week are concerning, especially given how simple it can be to protect ourselves from some of the most commons triggers".

“Our lifestyles are becoming increasingly sedentary both at home and at work – with many of us spending more time sitting than ever before, contributing to people in the region experiencing pain more frequently.For the 65% of adults in Wales who are experiencing back or neck pain on a monthly basis, I would urge you to consider incorporating more exercise and general movement into your routine where you can to help combat the effects of sitting still.”

Notes to editors:

This consumer research in 2018 was carried out on behalf of the British Chiropractic Association on between 28/02/18 and 07/03/18 on a sample of 2,066 adults in the UK.

The consumer research in 2013 was carried out on behalf of the British Chiropractic Association between 01/03/2013 and 15/03/2013 on a sample of 2,044 adults in the UK.

Chiropractors are specialists in spine care and chiropractic is a primary contact health profession that specialises in the diagnosis, treatment, prevention and management of many conditions that are due to problems with bones, joints, muscles and nerves, particularly those of the spine.

The BCA is the largest and longest established association for chiropractors in the UK. Chiropractic is a statutorily regulated healthcare profession, regulated by the General Chiropractic Council (GCC). Members of the BCA must abide by the GCC’s Code of Conduct and Standard of Proficiency. The association only accepts from an internationally recognised college of chiropractic education.  Chiropractic care offers hands on pain management and focuses on muscles, joints and nerves.  Chiropractic is suitable for all ages and can help with a wide range of problems.

This time of year is a great opportunity to get away, whether for day trips, the weekend, or the start of a longer break.

Unfortunately, many others have the same idea too! If you are facing a long or potentially delayed journey, keep our car travel tips in mind.

• Finally roll your shoulders back and down so they are relaxed against the seat

Make adjustments

• If you share a car, make sure the seat position is adjusted to suit you each time you get in. 
• The back of the seat should be set slightly backwards, so that it feels natural and your elbows should be at a comfortable and relaxed angle for driving.

Steering wheel

• Once you have adjusted your seat correctly, your hands should fall naturally on the steering wheel, with just a slight bend in the arms.
• If the wheel is too high and far away, tension will build up in your shoulders and upper back. If it is too low and close to you, the wheel may be touching your legs, which will reduce your ability to turn it freely, putting strain on the wrists and the muscles of the upper back.

Mirrors

• Your reactions must be quick, so you should not need to move your head a lot. The mirror positions should allow you to see all around the car with the movement of your eyes with minimal head movement.
• Set your mirror positions to suit you before you drive off. 

Seatbelts

• Your seatbelt should always lie across the top of your shoulder and never rub against your neck or fall onto the top of your arm. 
• Depending on your height, you may need to adjust the position at which the seat belt emerges from the body of the car. (If the adjustments available are insufficient, it is possible to purchase clips that help you adjust your seat belt height without impairing safety.)

Footwear

• Once you have adjusted your seat correctly, your feet should fall naturally onto the pedals. You should be able to press the pedals to the floor by mainly moving your ankle and only using your leg a little. 
• Avoid wearing wear high heels, or very thick-soled shoes, as you will have to over-extend the ankle in order to put pressure on the pedals. As well as making it much harder to deal with an emergency stop, this position will raise your thigh from the seat (reducing support to your leg) and create tension (and possibly cramp) in the calf. This, in turn, will impair the blood flow on a long journey.

Relax

• A relaxed driving position reduces stress on the spine, allowing your seat to take your weight.
• Take regular breaks - stop and stretch your legs (and arms!) at least every two hours, more often if possible. You should certainly stop more frequently if you are feeling any discomfort.
• Clench your cheeks - If you are stuck in traffic, exercise in your seat. Try buttock clenches, side bends, seat braces (pushing your hands into the steering wheel and your back into the seat – tensing and relaxing) as well as shoulder shrugs and circles.
• Leave the tight clothes at home - They will restrict your movement.
• It’s all in the timing - Allow plenty of time for journeys to avoid stress.

If I haven't answered all your questions feel free to ask on your next visit! 

With the change of seasons, we find ourselves tackling our gardens ready for summer time.  

Even though gardening is not considered as a sport it is very physical and time consuming, resulting in the body being in the same position for long periods of time. 

Gardening involves a lot of forwarding bending and at times can result in us twisting ourselves into awkward positions.  

These can result in spinal and surrounding structures to be strained and therefore resulting in back pain.

We have put together some helpful tips for you to incorporate into your gardening regime in order to prevent or manage any low back pain you may experience due to gardening. 

Warm up First 

It is a good idea to warm the muscles up first prior to gardening, as you would with any other type of work out.  This could be a brisk 5 minute walk with or without some gentle stretching. Below is a few stretches that will help to loosen the low back ready for gardening. 

If you already suffer with low back pain we would advise that you speak with your Chiropractor or healthcare practitioner in order for them to advise you on what stretches would be most appropriate for you.

Use support aids

Try to use support aids to make you feel more comfortable such as chairs or cushions.  Getting up and down from positions esp up from the ground can be a difficult task so use aids to help you alter your height.  

Ask for help

Do not be afraid to ask family, friends, neighbors etc for help.  If a task is is too much for one person or you are suffering with any discomfort as someone to help or take over.  It is important to understand your own limitations.

Chiropractors specialise in assessing, diagnosing and managing conditions of the spine. They are highly trained in finding the cause of pain in the spine. In the UK they undergo a minimum of four years’ full-time training. Importantly, chiropractors are regulated by law and must work within strict professional and ethical boundaries.

Before starting treatment, a chiropractor will do a full assessment. This will involve taking details about your condition, current health and medical history, and performing a physical examination. Sometimes it may be necessary to refer you for other tests, such as X-rays, MRI scans or blood tests. It is important for your chiropractor to gather as much information about your back pain as possible so that the most precise diagnosis can be made.

Your chiropractor will then explain what is wrong, what can be done and what you can expect from chiropractic treatment.

Chiropractors are best known for manual treatments such as spinal manipulation, where they use their hands to free stiff or restricted joints, or mobilisation, which is the gradual moving of joints.

But they may also use other recommended treatments such as certain types of acupuncture, electrotherapy, stretching exercises and rehabilitation, all of which form part of a chiropractor’s package of care. Your chiropractor may also offer lifestyle advice to help recovery and to prevent repeated episodes of back pain.

If your chiropractor does not think you can be helped by chiropractic treatment, you may be referred back to your GP or to another health professional. Chiropractors do not prescribe medication, so if this is needed, you may be referred back to your GP. As chiropractors support a joined-up approach to care, they may ask if they can send a brief report to your GP.

Many people who suffer long-term back pain benefit from regular, supportive chiropractic care to reduce the risk of recurrent episodes.

The research, which was carried out by the British Chiropractic Association, found that for sufferers in Wales, the top triggers for this pain were;

• Lifting or carrying heavy objects (53%)

• Sitting for long periods of time (46%)

• Sleeping/mattress/pillow (37%)

Notably, incidences of neck and back pain among younger people are also on the rise with 28% of people in Wales experiencing neck or back pain by the age of 20.

Sarah’s top tips to help local residents to prevent and manage neck and back pain are:

·       Take a break: When sitting for long periods of time, ensure you stand up and move around every 30 minutes. When at work, also make sure your desk is set up to support a comfortable position. This is different for everyone so if you don’t feel comfortable in your current set up, try altering the height of your chair or screen.

•  Keep on moving: Physical activity can be beneficial for managing back pain, however it’s important that if this is of a moderate to high intensity that you warm up and down properly to get your body ready to move! If a previous injury is causing you pain, adapt your exercise or seek some advice. Activities such as swimming, walking or yoga can be less demanding on your body while keeping you mobile! 

Other things which you can bear in mind are:

•  Lifting and carrying: Remember to bend from the knees, not the waist when lifting heavy items. Face in the direction of movement, and take your time. Hold the object as close to your body as possible, and where you can avoid carrying objects which are too heavy to manage alone, ask for help or use the necessary equipment.

• Sleep comfortably: The Sleep Council recommends buying a new mattress at least every 7 years. Mattresses lose their support over time, so if you can feel the springs through your mattress, or the mattress is no longer level, your mattress is no longer providing the support you need. Everyone has different support requirements, so when purchasing your mattress ensure it is supportive for you. If you share a bed and require different mattress types, consider two single mattresses which are designed to be joined together, to ensure you both get the support you need.

• Straighten Up!: The BCA has created a programme of 3-minute exercises, Straighten Up UK, which can be slotted in to your daily schedule to help prevent back pain by promoting movement, balance, strength and flexibility in the spine

We recommend that, if you are experiencing pain for more than a few days you should seek professional help, for example from a chiropractor, who can assess you and help you to get moving again without pain. You can book an appointment with any of our Chiropractors by calling 02920 617700

Notes to editors:

1)     This consumer research in 2018 was carried out on behalf of the British Chiropractic Association on between 28/02/18 and 07/03/18 on a sample of 101 adults in Wales.

2)     Chiropractors are specialists in spine care and chiropractic is a primary contact health profession that specialises in the diagnosis, treatment, prevention and management of many conditions that are due to problems with bones, joints, muscles and nerves, particularly those of the spine.

3)     The BCA is the largest and longest established association for chiropractors in the UK. Chiropractic is a statutorily regulated healthcare profession, regulated by the General Chiropractic Council (GCC). Members of the BCA must abide by the GCC’s Code of Conduct and Standard of Proficiency. The association only accepts from an internationally recognised college of chiropractic education.  Chiropractic care offers hands on pain management and focuses on muscles, joints and nerves.  Chiropractic is suitable for all ages and can help with a wide range of problems

Chiropractic, as practised in the UK, is not a treatment but a statutorily-regulated healthcare profession. Chiropractors offer a wide range of interventions including; but not limited to; manual therapy (soft-tissue techniques, mobilisation and spinal manipulation); exercise rehabilitation and self-management advice; and utilise psychologically-informed programmes of care. Chiropractic, like other healthcare professions, is informed by the evidence base and develops accordingly. 

The Royal College of Chiropractors (RCC) is an independent, apolitical body which was incorporated by Royal Charter in 2012 to promote quality, safety and professionalism in terms of postgraduate education, practice and research, in the public interest.

There are also four representative bodies for chiropractors in the UK: the British Chiropractic Association (BCA), the McTimoney Chiropractic Association (MCA), the Scottish Chiropractic Association (SCA) and the United Chiropractic Association (UCA).  

Royal College of Chiropractors webiste: www.rcc-uk.org

British Chiropractic Association website: www.chiropractic-uk.co.uk

McTimoney Chiropractic Association website: www.mctimoney-chiropractic.org/home.aspx

Scottish Chiropractic Association webiste: www.sca-chiropractic.org

United Chiropractic Association website: www.united-chiropractic.org/

Prospective students must apply through UCAS for access to a chiropractic undergraduate programme. Chiropractic undergraduates train for either 4 or 5 years to gain a GCC-accredited, university-validated MChiro or MSc degree, which enables them to apply to join the Chiropractic Register. Many chiropractors further their studies at Masters level in areas of special interest, such as sport and exercise, and some undertake professional doctorate or PhD studies.  

The evidence base for the care chiropractors provide is common to that provided by physiotherapists in respect of musculoskeletal (MSK) conditions. Thus, like physiotherapists and osteopaths, chiropractors can treat a wide range of MSK problems, as determined by the UK Advertising Standards Authority (ASA).

Chiropractors are most closely associated with management of low back pain, and the NICE Low Back Pain and Sciatica Guideline ‘NG59’ provides clear recommendations for managing low back pain with or without sciatica, which always includes exercise and may include manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) as part of a treatment package, with or without psychological therapy. Note that NG59 does not specify chiropractic care, physiotherapy care nor osteopathy care for the non-invasive management of low back pain, but explains that: ‘mobilisation and soft tissue techniques are performed by a wide variety of practitioners; whereas spinal manipulation is usually performed by chiropractors or osteopaths, and by doctors or physiotherapists who have undergone additional training in manipulation’ (See NICE NG59, p806). The Manipulative Association of Chartered Physiotherapists (MACP), recently renamed the Musculoskeletal Association of Chartered Physiotherapists, is recognised as the UK’s specialist manipulative therapy group by the International Federation of Orthopaedic Manipulative Physical Therapists, and has approximately 1100 members. The UK statutory Osteopathic Register lists approximately 5300 osteopaths. Thus, collectively, there are approximately twice as many osteopaths and manipulating physiotherapists as there are chiropractors currently practising spinal manipulation in the UK.  

Studies have shown various forms of manual therapy to be effective in the treatment of musculoskeletal pain (Clar et al, 2014), but while the mechanisms through which manual therapy exerts its effects are likely to be biomechanical and/or neurophysiological in nature, they are not well understood (Bialosky et al, 2009). Such is the case for many forms of therapy, including numerous examples in medicine and surgery. Note that the audible release sometimes associated with joint manipulation is characterised by rapid separation of joint surfaces with subsequent cavity formation or ‘cavitation’. Any particular therapeutic benefit of audible release is not fully established (Kawchuck et al, 2015).

Experiencing mild or moderate adverse effects after manual therapy, such as soreness or stiffness, is relatively common, affecting up to 50% of patients. However, such ‘benign effects’ are a normal outcome and are not unique to chiropractic care. Cases of serious adverse events, including spinal or neurological problems and strokes caused by damage to arteries in the neck, have been associated with spinal manipulation. Such events are rare with estimates ranging from 1 per 2 million manipulations to 13 per 10,000 patients; furthermore, due to the nature of the underlying evidence in relation to such events (case reports, retrospective surveys and case-control studies), it is very difficult to confirm causation (Swait and Finch, 2017). For example, while an association between stroke caused by vertebral artery damage or ‘dissection’ (VAD) and chiropractor visits has been reported in a few case-control studies, the risk of stoke has been found to be similar after seeing a primary care physician (medical doctor). Because patients with VAD commonly present with neck pain, it is possible they seek therapy for this symptom from a range of practitioners, including chiropractors, and that the VAD has occurred spontaneously, or from some other cause, beforehand (Biller et al, 2014). This highlights the importance of ensuring careful screening for known neck artery stroke risk factors, or signs or symptoms that there is an ongoing problem, is performed prior to manual treatment of patients (Swait and Finch, 2017). Chiropractors are well trained to do this on a routine basis, and to urgently refer patients if necessary. 

The above information has been cited from The Royal College of Chiropractors: https://rcc-uk.org/wp-content/uploads/2017/12/Chiropractic_the-facts_071217.pdf

About the Royal College of Chiropractors Granted a Royal Charter in 2012, The Royal College of Chiropractors or ‘RCC’ (formerly The College of Chiropractors) is an academic membership organisation with the following objectives:

• to promote the art, science and practice of chiropractic;

• to improve and maintain standards in the practice of chiropractic for the benefit of the public;

• to promote awareness and understanding of chiropractic amongst medical practitioners and other healthcare professionals and the public;

• to educate and train practitioners in the art, science and practice of chiropractic;

• to advance the study of and research in chiropractic.

www.rcc-uk.org

As the festivities are left behind, we begin to make our plans and resolutions for the year ahead.

Through January there is a surge of gym membership with people looking to become fitter and healthier.  

However taking on an exercise regime that your body is not use to can have its toll on the body and thus can lead to injury and pain.

Therefore we advise that you prepare yourself prior to embarking on any new programmes or activities.

According to research by the British Chiropractic Association:

"Exercise is the trigger for 30% of those experiencing back or neck pain.  For people embarking on an exercise regime, especially one that is new, the risk of suffering neck or back pain can be higher so it is important to be well prepared". 

https://chiropractic-uk.co.uk/new-years-resolutions/

•    Seek professional advice to check that there are no medical reasons why you should not exercise, particularly if you are not normally physically active.

•    Remember to warm up and warm down before and after any activity. Start with less strenuous activity like walking or jogging and finish with some light stretches at the end of an exercise session – this may help minimise muscle stiffness and reduce the chance of muscle strain.

•    Keep well hydrated by drinking plenty of fluids before, during and after exercise – this will help your muscles work more efficiently and will reduce aches and pains after exercise.

•    Make sure you wear the right attire for your chosen activity.  Wearing tight clothes when exercising could constrict your movement and lead to injury.

•    Wear appropriate footwear for the type of exercise you are doing – most specialist sportswear retailers will be able to advise you on this.

•    If you are enrolling in a gym, make sure you receive training on any equipment and if you are signing up to a programme, try and make sure you get proper training, advice and ongoing supervision.

The above information is for guidance only and is not exclusive.  It is important to ensure you are prepared, and have the right guidance into carrying out a new regime/exercise to avoid any repercussions.

Staying committed to maintaining a healthy back is a life long commitment. 

Here at the Whitchurch Clinic we are there to help with each step by offering a range of therapies:

• Chiropractic care
• One to one personal training
• Hypnotherapy
• Sports Massage
• Diet Advice

If you require any further information on any of the above please do not hesitate to contact our clinic on 02920 617700 for an informal discussion.