Many people are familiar with the term "bulging disc" in regards to lower back pain. It can feel like an intense, sharp, stabbing sensation that can often travel down your leg through your hips and bum, sometimes as far as your feet.
This is a common diagnosis when you start to develop back pain. You get a scan which shows changes in the disc, and the pain matches the effected nerve area. It can be a scary diagnosis.
But you may be surprised to know that a lot of people who don't have pain have also been found to have changes in their discs. I find this study to be really encouraging, because it shows that people who have significant changes to their disc structure can still live a painfree life. It suggests that the disc changes may have already been there for some time before any painful symptoms even began, and gives hope that even if the structure doesn't change, that the pain can change.
Lets have a look at this interesting literature review, particularly in regards to the findings around disc degeneration, disc bulges and disc protrusions.
This is a literature review of 33 separate studies that investigated the imaging of spinal degeneration in painfree people ranging from their 20's to their 80's. It was published in the American Journal of Neuroradiology in 2014.
In total, the review takes into account MRI and CT scan imaging on 3110 individuals with no painful symptoms.
As you would likely predict, the number of findings increased with the participants age group, showing age-related degeneration occurs even in people who aren't experiencing pain.
Lets have a look at the imaging results for the disc degeneration, bulge and protrusion categories:
Disc degeneration - changes to the disc and surrounding vertebrae that result in loss of cushioning and support, may include signs of osteoarthritis at the joint.
Disc degeneration in painfree participants was identified in:
Disc bulge - changes that alter the shape of the disc and can make portions of it "bulge" out of place, which can apply pressure to nearby nerves.
Disc bulge in painfree participants was identified in:
Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves.
Disc protrusion in painfree participants was identified in:
What does this mean for your bulging disc?
It means that theres a good chance that your structural changes were already present before your back became painful. The area may be irritated or flared up right now, but these findings are a good indication that even if your scans don't change, your back pain still can settle down.
It means that a scan showing disc changes doesn't have to be a life sentence of pain.
Does this mean bulging discs DON'T cause pain, then?
Don't get me wrong, bulging discs can be painful, and for some people it can be severe. This study just helps to show us that theres more to back pain that what shows up on MRI or CT scans. Structural changes are just one layer in the complex onion that is back pain.
We can help!
There are lots of ways we can change your experience of back pain through massage and myotherapy techniques like dry needling, taping and support, strengthening the surrounding muscles with exercises that are appropriate for you, and supporting your understanding of how your back functions.
Book a time to come see us to talk about your back pain and creating a treatment plan to reduce it.
If you have joint pain, chances are that hydrotherapy is going to be a huge help to you.
A hydrotherapy pool is a warm water pool for doing exercises. Its quite different from swimming laps, although a lot of people find that swimming can be helpful too, if its not painful to do it. Can’t swim? It doesn’t matter, a hydrotherapy pool is usually quite shallow, it usually doesn’t have a “deep end” where you can’t touch the bottom.
Our local hydrotherapy pool is at Knox Leisureworks in Boronia. The centre has a lot to offer, actually. There is the hydrotherapy pool, as well as a kids pool, a regular lap pool, a spa and sauna, and an onsite gym.
So why is Hydrotherapy such a great option?
Buoyancy – Being in the water takes the pressure off the joint due to the water supporting your body weight. This makes it a great option for weight bearing joints like hips, knees and ankles, especially following injuries or surgeries like hip and knee replacements or fractured bones.
Warmth – Heated hydrotherapy pools allow muscles to stay warm and relaxed while exercising. Typically a hydrotherapy pool is heated to about 33*, warmer than a normal swimming pool.
Low Impact – Unlike running, doing exercises in water is friendly on vulnerable joints. The water doesn’t allow you to move as fast as in air, so the force of impact is less than running or jogging on a hard surface.
Resistance – The water provides great resistance for strengthening the body, without feeling painful. It can be tiring afterwards due to the resistance of the water, though, so starting with short sessions is best.
Low Cost – Knox Leisureworks has a great hydrotherapy pool. You can access the hydro pool with your standard pool entry fee of around $8, or if you plan to go frequently they have multi visit passes or memberships.
What kinds of pains or conditions does it work well for?
Hydrotherapy is fantastic for helping with pain in big joints and weight bearing joints, like hips, knees and ankles. Lower back pain can respond very well to hydrotherapy because of the way the water helps take pressure off the spine and support the weight of the body while you move. It can also be great for things like arthritis, and rehabilitation after a fracture or surgical repair.
It can be great for general fitness, too!
How do you get started?
Initially just walking through the water can be really helpful. You can also include day to day movements like bending and straightening your knee or hip while standing with you back against the pool wall for support. You can use a floating board or pool noodle to hold onto and do gentle squats or lunges.
If you’re uncertain, talk to us about specific pool exercises at your next appointment and we can help create a program tailored for you.
If you work at a desk for hours on end, you know that it can be uncomfortable at the best of times. Office workers have just as much risk of injury and chronic pain as other more physically strenuous occupations. You may be at risk of issues including back pain, neck pain, repetitive strain injury or RSI and carpal tunnel syndrome.
So how can you minimise your chance of hurting yourself and stay at the top of your game? Our myotherapist Emily shares some of her tips for staying healthy and preventing pain and injury for office workers.
When you’re focused on your work, you often forget to shift position. Unfortunately, our bodies weren’t designed to stay in a position for hours at a time. That’s why the simplest tip is to stretch whenever you feel stiff, sore or fatigued.
Stretching can also help to boost blood flow to the brain, which means you are more focused and productive.
You can simply stretch at your desk if needed – stretch out your neck, shoulders and back, and do some circles with your ankles. But you can also do a standing stretch, which brings us to our next tip.
Set yourself reminders to move
Small amounts of movement throughout the day add up when it comes to preventing office injuries. But when you’re in the zone, you might forget! That’s why it’s useful to set yourself a reminder or alarm on your phone or computer.
Aim for at least 1-2 minutes per hour of movement. This might be standing and stretching, going and getting a glass of water, making yourself a coffee or tea, going to the toilet or just walking around the office to get your muscles and joints moving.
Give a sit/stand desk a try
Desks that can alternate between a seated and standing position have become popular recently. They allow you the best of both worlds – you can sit for a bit, then switch to standing as a break from sitting.
Have a chat to your employer about whether you can trial a sit-stand desk. The good thing is that many people find sit-stand desks boost productivity, so employers are often open to them.
If you work for yourself or you are the boss, you can hire sit-stand desks and other equipment before purchasing.
Make the most of lunchtime
It can be tempting to eat lunch at your desk and power through the to-dos. But your lunch and break times are an opportunity to move around and give your muscles and joints a break as well.
Get up and get moving. Head to a local park to have your lunch if it’s sunny outside. Grab a coffee from the café around the corner. You can even go for a brisk 5-minute walk around the block at the end of your break to wake up your brain and your body. That way, you’ll go back to work feeling refreshed.
Get moving before or after work
Some days you won’t get much time to move at work, so make the most of the hours outside of work. Find a way to get your body moving on a regular basis.
This doesn’t mean you need to slog away at the gym for an hour every day. You can do some yoga stretches at home, walk the dog or go to the playground with your kids.
If you do find yourself too tired to move after work, try getting up 15 minutes earlier and go for a walk around the block before work. It seems counter-intuitive, but exercise actually boosts your energy and relieves fatigue. Even a little bit each day will add up!
Get a regular remedial massage or myotherapy treatment
Your muscles and joints need care, just like every other part of you. That’s why regular treatments can help to prevent injury and pain.
Our desk worker clients find that a treatment every 2-6 weeks helps to relieve tension and pain. Many report that they have fewer headaches, lower stress levels, improved sleep and mood and greater movement in joints and muscles. So if any of those are on your wish list, regular massage and myotherapy might be the answer!
Is regular massage or myotherapy on your to-do list? Our myotherapist Emily is currently open for new clients. You can book with a session with her here.
Do you love your heat pack? Me too!
There are plenty of reasons to keep your heat pack close by, and not just because we're entering winter!
Heat treatment is great for muscle pain - its cheap, effective, and drug-free! Have you ever wondered why heating your sore muscles helps them so much?
Some pains are categorised as ischaemic pain - that means that the tissue has a reduction of oxygen supply which is needed for normal cell activity. This tends to happen if we're in positions that compress or over stretch areas for a long time - like sitting at a desk for a few hours without getting up to move around. Heating an area increases the local blood flow, which means the blood vessels widen to get more fresh, oxygenated blood into your muscles and joints.
What kind of pain should you use heat for?
Many kinds of non-inflammatory pains will respond really nicely to heat, including things like cramping and spasming, stiffness and persistent tight or pulling muscles.
Heat packs are easy to use for neck, shoulder, lower back or hip pain.
If you have a lot of painful areas, a warm bath can be another great way of getting heat into your muscles - why not add some Epsom salts for the added magnesium benefits for sore, tight muscles!
When should you not use heat?
Avoid heating up any fresh injuries, especially if you have open wounds or if the injury has become infected. These kinds of injuries will be in the inflammatory stage of healing - you'll be able to tell because the area may be swollen, red and hot, and most likely it'll be much more sensitive than usual!
Of course, you do need to be careful with heat packs or hot water bottles to make sure you don't burn yourself. Always wrap your heat pack or hot water bottle in a something like a pillow case, thin blanket or a towel so you don't have the hot surface directly on your skin. Using heat for too long might give you heat rash, so I usually suggest about 20 minutes at a time.
Heat on its own is more for symptom relief than for resolving the underlying issue. If you have an injury or feel that you have a lot of long term tension built up in the muscles, book a treatment with your local Myotherapist.
You might be familiar with that sharp, shooting pain sensation in your lower back, hip and leg. It can also be felt as numbness, pins and needles, tingling or burning type of sensations. Whatever way the pain or symptoms present, it runs along the Sciatic nerve - which is why this is referred to as Sciatica.
But did you know theres more than one potential cause behind this pain?
Often this pain can be linked to muscle tension in the glutes and hips. The Sciatic nerve runs underneath the muscles of your glutes, and when it gets compressed there it can be a real pain in the bum - literally!
Because this nerve runs all the way down to your feet, the jolts of nerve pain can sometimes be felt anywhere from just localised in your buttocks and hip, to the back of your thigh, behind the knee, straight down your lower leg and even into the base of your foot.
The Sciatic nerve can be impacted at the root of the nerve near the spine, however this doesn't always mean there will be pain. Often this is called a Bulging Disc or Herniated Disc, but you might be surprised to learn that even though "Bulging Disc" sounds pretty awful, studies have shown that more than 50% of people over 40 with no pain symptoms at all can have a disc bulge show on scans.
Irritation or compression of the Sciatic nerve can be common after serious trauma to your leg or lower back. Things like car accidents, falls, and horse riding accidents are all common high impact incidents that can aggravate the nerve. If you've had an injury like this, its wise to seek treatment for it.
Do you have Sciatic nerve pain or nerve symptoms of numbness, tingling and pins and needles? Book an appointment with us to have an assessment and treatment. If we can resolve the issue, we'll create you a treatment plan that includes manual therapies and a take home exercise program.
More serious causes do exist, so if treatment of the muscles and joints is not relieving your pain, we'll refer you to see your GP to rule out any serious structural or pathological conditions.
Most people understand joint dislocations. But subluxations, or partial dislocations, are a bit different. As a myotherapist, I see plenty of subluxations and related injuries every week. So let’s look at why subluxations aren’t quite dislocations, and what you can do about them!
What is a subluxation?
Unlike a dislocation, a subluxation is a partial displacement of the joint. With a dislocation, the bone is completely out of the joint it belongs to. But with a subluxation, the bone is only partly out.
Just because it is not a full dislocation doesn’t mean that it won’t hurt! Subluxation can still be painful, as the joint is being wrenched out of its usual spot. It can also leave you at higher risk of chronic pain if the joint isn’t rehabilitated after the injury.
In the image above, we're looking at the ball and socket joint of the hip. The Normal hip joint shows the ball of the femur (thigh bone) sitting neatly inside the socket joint of the pelvis. In Dysplasia, the shape of the socket is not correctly formed so the socket doesn't snugly hold the ball of the femur. In Subluxation, the ball of the femur has partially slid out from the socket, and while its still almost in the right spot, it likely won't move smooth and painfree like the normal hip. And in the Dislocation, the ball of the femur has entirely moved out of the socket.
Why do joints sublux?
It is easier for a joint to sublux than it is to dislocate. That being said, if you have full strength and integrity in your joints, it will take a high-impact injury to sublux a joint. This is usually something like a fall, car accident or a sports injury.
However, some people are at a higher risk due to weak, unstable or unusually shaped joints. A previous history of dislocation or subluxation can weaken the joint and make it more prone to a sublux.
People with hypermobile joints can sublux joints with minimal force, because the ligaments (connective tissue that holds the joint together) are more elastic than they should be. This can lead to the person being very flexible but also more prone to subluxations – some of my more hypermobile clients can sublux joints while walking, sitting, or even sleeping!
You can also have variations in the shape of your hip or shoulder joints that make it easier to sublux. Hip dysplasia is one common variation that increases the risk of subluxing a hip joint, like in the image above.
Joints at risk of subluxation
In the clinic, I’ve seen almost every subluxation possible, thanks to my hypermobile clients! But there are several joints that are easier to sublux due to their location and structure:
If you have hypermobile joints, you may be at risk of subluxing other joints like ribs, jaw and collarbone.
How is a subluxed joint rehabilitated?
It can depend on the type of subluxation, and how it occurred. If it was due to high-impact trauma, there’s likely to be a decent amount of joint damage that needs attention. It could take weeks before the pain subsides enough to focus on rehabilitation.
But if the sublux occurred due to hypermobility or dysplasia, it might just need a little TLC for a week or two. After that, the focus will be on building up the muscles that support the joint to reduce the risk of recurrence.
Either way, the focus for rehabilitating the joint will include stabilising it, minimising any symptoms, and rebuilding the strength and integrity.
What can a myotherapist do for subluxations?
If you’re dealing with a subluxed joint (or multiple!), I’m here to help. Let’s look at how myotherapy can help with subluxations:
So don’t sit at home and feel sore after a joint has subluxed. Come see your favourite myotherapist. We’ll have you feeling better in no time! Click here to book an appointment.
Your back is aching again. You assume that you slept wrong, or have been sitting for too long with your back in a poor posture. But what if the pain is actually coming from elsewhere?
Back pain might not be in your back
The body is a complex thing! Every muscle, tendon and ligament is connected to different areas of the body. So just because you feel pain somewhere, doesn’t mean that is where the problem lies. In fact, it’s often the muscles that are overcompensating for weakness elsewhere that get sore.
So let’s have a look at a few causes behind your back pain that aren’t your back.
A weak core
The “core” muscles are more than just your abs! In fact, the core is made up of many muscle groups, including your superficial abs, deep abs, obliques, back muscles and pelvic muscles.
Often, if you have a generally weak or imbalanced core, it can lead to one part of the core – the back muscles – to take on more strain. And this means pain.
Try: Talking to a personal trainer for a personalised program to strengthen your core muscles. Better yet, see your friendly local myotherapist who can assess which muscles need strengthening!
Weak or tight front chain
For those who aren’t up on anatomy lingo, the “front chain” is a chain of muscles that run down the front of the body. This chain, also called the anterior chain, is made up of muscles like your chest muscles, abdominals, quads and shin muscles. We also have a posterior chain, which includes the back.
These two chains need to be balanced in order for the body to work optimally. If one is tight, the other gets stretched out, and if one is weak, the other picks up the slack. So when the front chain is weak or tight, the back is one of the muscle groups to cop the strain.
Try: Balancing out your workout and stretches. Both the front and posterior chains need to be exercised AND stretched out to keep the body in balance.
Hips and pelvis
It’s all in the hips! Or at least, it might be. As mentioned, the pelvis plays a part in core strength. So if it’s out of alignment, so is the rest of your body.
If the muscles in the hips and pelvis are too tight, pain can radiate up the back. Or if they are out of alignment and muscles are weak, the back will pick up the slack.
Try: Using a foam roller to release tight hip muscles. It will probably hurt – but you’ll feel better afterwards!
No matter where your back pain is coming from, I’m here to help. To get your body balanced again, book in for an appointment, and we’ll put together a plan that addresses the issue.
Mel is a Myotherapist based in Ferntree Gully.