treatment

Spinal pain treatment – move more often

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Back and neck pain treatment

NU Moves Physio leads the way in evidence based treatment. We are constantly looking to the latest evidence to help our clients move better and feel well. Being located at The University of Newcastle means a lot of our clients are academics, students and staff. A few areas we commonly treat are back and neck pain, which many people attribute to postural or sitting loads at work or while studying.

The scientific understanding of this problem has definitely evolved over the last few decades and has now changed significantly from the old adage of ‘sit up straight and don’t slouch’ to the ‘move more often’ advice. Move more means varying your postures and positions rather than having to sit up straight all the time. It might be that you need slouch a little if you have been upright for a while or sit back in your chair and use your backrest to sit up tall if you have been slouching. Stand desks are great to get you out of your chair but not for standing all day. A mixture of sitting and standing changes your posture which is best.

This is notably advice based on research for lower back pain. A common mistake leading to neck pain is reaching too far whilst at a computer.  Neck pain is often also related to the stress and tension that we carry in our shoulders. Again the best advice is often to get up and move more – go for a walk or do some exercise for 30 mins aiming for a daily basis. If you are too busy to walk that is often the problem that needs to be managed.

Professor Peter O’Sullivan leads the way in back pain research and advises ‘your best posture is your next posture’. Simple spinal pain treatment – move more often!

If you have neck pain or back pain at work or study, get moving and if pain holds you back then contact us on 0249216879 or admin@numovesphysiotherapy.com.au

Feel better through movement

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Manual physio newcastle

The Uni Physio Clinic on Callaghan campus is located within The Forum Sports Centre. NU Moves has been helping staff and students for more than a decade now, specialising in manual therapy, exercise prescription, and rehabilitation. Our goal is to help you feel better in the short term and increase movement / exercise in the long term.

Are you currently:

  • Sitting most of the day?
  • Not exercising daily?
  • Stressed (workload, interactional, emotional)?
  • Have any neck / shoulder or back / hip pain?

If you answer yes to 3 or 4 of these questions then it’s time to reflect and make some changes to your daily habits now.

If you answer yes to the first 2 questions then consider how you can start to fit a walk or another exercise you enjoy into your day. The goal for long term health and feeling better now is 30 mins of activity per day. It can also help prevent muscular pain associated with excess sitting.

If you have neck & shoulder or back / hip pain, that is when we can help you the most. Physiotherapy has a range of treatment options from massage, spinal manual therapy or dry needling to reduce pain. There should always be advice on activity / exercise or we can design a full exercise program suited to your goals. Assessment of your computer ergonomic setup is essential and advice on simple changes often helps. Occasionally we utilise orthotic prescription but only if it helps you get active with less pain.

To book an appointment with NU Moves call 4921 6879 or email admin@numovesphysiotherapy.com.au

Groin and adductor pain in sport

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Newcastle physiotherapy for groin and adductor pain in footballThe NU Moves Physio team has recently completed a masterclass debating the best approach to manage and treat adductor pain and tendon problems with footballers. Journal articles were found and discussed relative to the NU Moves approach to diagnosis and treatment.

The following is a summary of the NU Moves masterclass. The current best approach to assist a footballer with pain in the groin or adductor region:

  • Diagnosis is essential: There are many different possible sources of pain into the groin / hip area. Identifying the likelihood of each of these (e.g. osteitis pubis, stress fractures, avulsion fractures, bursitis, tendon strain, hernia, arthritis, lower back referral) via a thorough assessment is essential. Subsequently investigations (Xray, CT scan, MRI, Ultrasound) to confirm or negate are considered. The timing of investigations depends on the risks of the problems and whether treatment is altered because of the investigation findings.
  • Treatment of adductor tendon pathology:
    • Note that this requires consideration and exclusion of all the other potential causes of hip pain.
    • Don’t stretch the adductor muscle area – the right type of strength and functional return to sport exercises will assist recovery of flexibility and stretching is more likely to irritate the problem.
    • Stability is essential – becoming core stable in the pelvis by focussing on strengthening the gluteal and abdominal muscles in sport specific positions (i.e. one leg stand) is the starting point and can often be done very quickly after injury occurs.
    • Strengthening the adductor tendons – when commenced at the correct time after the injury, adductor strength exercise is useful in improving long term outcomes of full pain free return to sport. This could be a ball squeeze between the ankles / knees in lying or a band or cable resistance exercise in standing (as long as the pelvic stability stage has been achieved).
    • Graded return to running: graded return to jogging then running then change of direction exercises is essential. Once the tendon can cope with it and the pelvic / core stability is adequate then a terrific way to strengthen the area for running is to start jogging. The problem is when you go too hard too soon and create a flare-up of pain that lasts several days. Flare-ups are a set back to the eventual goal of return to playing again.
    • Sport specific exercise: kicking / striking / passing the ball in football can all be done lightly and gradually increased in a comparable way to jogging and running. Similarly, once pelvic / core stability and sufficient local strength of adductors is achieved, these are a great way to strength load the area for sport. Again, be wary of flare-ups by progressing too quickly.

The adductor tendon strain is a frequent problem in sport and particularly in football. The best advice is to get an accurate diagnosis first then an active exercise program including 3 parts: the pelvic / core stability, the adductor tendons themselves, and a sport specific program. Getting the right level of loads on the area during each phase of recovery is essential to the process. That is where we help the best.

If you want the best diagnosis and treatment then call us at NU Moves if you have groin pain or a known adductor problem. If you have a friend or family member needing advice to get back to sport then recommend us.

MRI scans for low back pain

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MRI scans for low back pain – when are they useful.

Lower back pain is common with almost all of us suffering from it at some stage in our life. Most times it settles fairly quickly and other times it responds to treatment. Scans or investigations usually in the form of MRI or CT are recommended when it doesn’t settle in an acceptable timeframe or your physio and doctor indicate it is recommended earlier.

low back pain scans and diagnosis newcastle physiotherapy

The purpose of this blog is to reduce fear or concern if you have scans that show pathology. Although any pathology seen on imaging can be responsible for your pain, it doesn’t have to cause pain. The following table is from a systematic review in the American Journal of Neuroradiology. It looks at lots of research studies where they have scanned the lower back in people who don’t have any pain. The table below shows the % of people that when they had scans they found pathology BUT these people did not have any symptoms or low back pain. In other words pathology is a common finding in people who do not have lower back pain.

20yrs 30yrs 40yrs 50yrs 60yrs
Disc Degeneration 37% 52% 68% 80% 88%
Disc Bulge 30% 40% 50% 60% 69%
Disc Protrusion 29% 31% 33% 36% 38%
Disc Annular Fissure 19% 20% 22% 23% 25%
Facet joint Degeneration 4% 9% 18% 32% 50%
Brinjikji et al, 2015. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. Am J Neuroradiol 36:811–16 Apr

The highlights in the table show that 37% of those in their 20’s had some disc degeneration but no pain. In the 30s age group it had increased to 52% but again no pain. If a scan is likely to show normal pathology associated with age but doesn’t mean you will have pain and it’s also not going to change the treatment, then scans are not recommended. So if you do have lower back pain, scans are not usually recommended in the early stage.

If you have low back pain, firstly you should manage the pain with simple analgesics such as paracetamol; stay active as tolerated and occasionally use positions that offer short term relief. In acute low back pain, physio can help with the posture and movement means to reduce pain.

There are times when you do need to have scans straight away and your doctor or physio will identify those occasions. For example if your pain is severe, worsening or if you experience neurological symptoms such as weakness, tingling or numbness, then you need to be assessed by your physio or doctor.

If you have back pain and it is affecting your ability to be active then contact us for an appointment. We believe in an active approach to treating low back pain. Contact us on 4921 6879.