So you are a chiropractor…that’s feet isn’t it?

NO!!! I’ve lost count of the number of times I’ve been asked “what can you do for my corns?” and other such feet related questions. There is a clear and marked difference between chiropractors and chiropody. Chiropody is for feet and quite different from chiropractic. That said, there are some things that the two professions have in common and both deal with musculoskeletal problems. I often refer patients with difficult foot problems to a podiatrist as they really are the experts in feet! Whether is addressing the problems from fallen arches, fitting custom made orthotics for sports people or improving foot mobility to ease foot pain in worn out arthritic joints, specialist treatment from a podiatrist in combination with chiropractic treatment can yield excellent results.

A recent piece of research into podiatry care in the British Medical Journal this week caught my eye (see link below or The study by Spink and colleagues found that podiatry intervention resulted in a 36{8c34c0d03372d798e22443fa1cd79a4c0c458739bec8c1532104b8390ef42220} reduction in the rate of falls in older people over a 12 month period. Podiatry “treatment” in this study involved a variety of interventions including foot orthoses, footwear advice, a home based foot and ankle exercise program and routine podiatry care for 12 months. Helping people stay active, fit and mobile is what I try to do so maybe we are not that different after all? But I don’t treat corns!! You podiatrists can keep your feet.

Back Pain Tip 6: Getting a Good Night’s Sleep?

Back pain first thing in the morning is a common complaint you hear as a chiropractor and if you regularly wake up sore and achy then maybe you need to look at how you are sleeping.

Leeds Chiropractor Alison Eaves has some advice to help you get a better night’s sleep. As you sleep you may be unwittingly putting additional strain on your low back that could be contributing to back pain. You can have the most expensive pillows and mattresses but if you sleep in the wrong position you are wasting your money! Poor sleeping position can lead to and exacerbate back pain.

The Good, The Bad and The Ugly, take our sleep test and find out which you are and what you can do to improve your sleep posture…

The Good : I sleep on my side in the foetal position

Excellent! Sleeping on your side in the foetal position with your knees bent is the best position for your back as it supports the spine. To improve things further pop a pillow between the knees to take the stress off the low back.

The Bad : I lie flat on my back

You are putting the spine into an unnatural position and putting additional load on the spine. You should sleep in the foetal position (on your side).

The Ugly – I’m A Front Sleeper

No, no, no!! Quite possibly the worst position you can choose to sleep in. It puts additional pressure on the joints, muscles and ligaments of the low back. You also end up twisting the neck and so you give yourself neck pain as well.

Another Ugly : I love pillows!!

Unless you are 6 foot 4 rugby players with huge broad shoulders you should only really be using one good quality, medium thickness pillow. This will support your head and neck in a neutral position. Too many pillows/one small, flat pillow and your neck will flex too far one way or the other.

You can also try some simple stretches before you go to bed and this should help you feel looser in the morning. Keep an eye on the blog for videos coming soon!

Back Pain Tip 5: Maintain Good Posture

Chiropractor Alison Eaves at Revive Chiropractic in Adel, North Leeds has some help and advice to get you through the working week with minimal discomfort in your back. We know that poor seated posture can contribute to back pan and neck pain by putting additional strain on the joints, intervertebral discs, muscles, ligaments and soft tissues.

You may have the best, most expensive, all-singing, all-dancing office chair but are you sitting in it correctly? A great chair means nothing if you slouch in it!

How to sit correctly

1) Use a lumbar support.

If your chair has a lumbar support then make use of it. Sometimes the lumbar support can be adjusted for optimum comfort and some you just strap on to the appropriate chair. If you don’t have one, don’t worry as a rolled up small towel such as a hand towel will work just as well. Place the support in the small of your back, just above the top of the pelvis, where you feel a natural hollow. Using a lumbar support ensures that you sit up straight and maintains the normal curvature of the low back. We can all be guilty of slumping in a chair so whether at work or at home make sure you are sitting correctly.

2) Try a “Brugger Break”

Brugger posture exercises.

Sit on the edge of your chair:

Hold your head up high

• Spread your legs slightly apart to the sides

• Turn your legs out slightly

• Rest your weight on your legs and feet and relax your abdominal muscles

• Tilt your pelvis forward and raise your breastbone up

• Turn your hands palms-up

• Turn your arms slightly outward

Hold this position and take deep "belly" breaths for 10 seconds.

Within our society, a very common postural syndrome may be found where a person’s head is drawn forward with stresses at the top of the neck beneath the skull, and then in the neck and upper back near the shoulders. The slumped posture taken by most may also result in stresses in the middle and lower back.

The slumped posture places increased stress on the spinal discs. If the uneven stresses are allowed to progress over time, the discs may wear out prematurely and give way to deterioration, bulging, herniation of the discs, and eventual arthritis of the intervertebral joints. Faulty slumping posture is also associated with increased muscle tension and poor breathing habits.

Brugger’s relief position allows for a mini-break from the slumping posture and may help to prevent the buildup of stresses that occur throughout the day.

If a person works for long hours in a constrained, slumped posture, he or she needs to find some ways to sit more upright, using lumbar supports if possible. Then, micro-breaks every 20 minutes for about 10 seconds may be useful.

Back Pain Tip 4: Avoid Back Pain at Work

Leeds chiropractor Alison Eaves at Revive Chiropractic in Adel offers advice on how to prevent back pain at work. A chiropractor can help you with back pain and having chiropractic treatment for low back pain is a great way to start sorting out your back pain issues. Chiropractic treatment at Revive Chiropractic in Leeds can help but chiropractic treatment alone may not be enough to completely rid you of your problems. Certain lifestyle factors also need to be addressed and a good place to start is the workplace. This is where we spend the vast majority of our time and so we need to start looking after or backs when at work. At Revive Chiropractic in Leeds I work with my patients to encourage good posture and ensure patients have correct workstation setup.

We already know that sitting in the same posture for prolonged periods is bad and puts additional pressure on our joints and muscles. So if you’re sat in the office get up out of your chair and take a walk every now and then. Why not surprise your colleagues and volunteer to make the tea and coffee for a change? They will be ever grateful and you will be a whole lot more comfortable. Don’t like being the tea boy/girl? A quick 30 second circuit of the office is all that is required to fire up our muscles again and reawaken our postural sensors. Can’t manage 30 seconds away from your desk? Then keep an eye out for some exercises to be posted on the website soon. No excuses, it really can be that simple!

A good office chair should provide lumbar support to the lower part of your spine. If your work chair isn’t fit for purpose then a great and cheap tip is to get a rolled up hand towel and use it like a lumbar roll in the small of your back. A small jumper/cardigan rolled up will work just as well. There are all sorts of expensive gadgets out there on the market but often you can get by with a homemade alternative! Sitting with some form of lumbar support prevents you form slouching and stops muscles getting overworked. Overworked muscles and connective tissue can and often do become painful and lead to back pain.

If you would like an appointment at Revive Chiropractic in Leeds then please call 07828 686026 and book an appointment today.

Back Pain Tip 3: When to apply heat?

Alison Eaves, chiropractor at Revive Chiropractic in Leeds is on hand with back pain tip 3.

If you have back pain then applying heat to the injury site may help but not always! You have to know when to apply heat and when to apply ice. A chiropractor can help to advise you and my previous blog entry talks about when to apply ice

Do not use heat on a new injury as this will increase bleeding and make the injury worse. Applying heat includes taking a hot bath, as well as using a hot water bottle or a deep heat type cream! If the pain has been present for over two weeks then you will probably find that heat is beneficial. There is no hard and fast rule so it is a good idea to try both heat and ice and see which one brings most relief.

How do I apply heat?

A reusable heat/ice pack works well, as does a hot water bottle but make sure only GENTLE WARMTH is applied to the skin. You don’t want burns added to the mix as well! You can also use heat packs and deep heat muscle creams.

How does heat work?

Heat causes blood vessels to open up wider so that more blood flows to the area. Heat will also have a direct effect of soothing and reducing pain. If there is a lot of muscle spasm then heat can work well to relieve this and relax muscle tissue.

When should I not apply heat?

If the injury is less than 48 hours old

If skin is in poor condition

If skin has poor sensation to heat and cold

Over areas of the body with poor circulation

If you are diabetic

If you have an infection or open wound

Back Pain Tip 2: Should I apply ice?

So you have back pain and the first thing is panic! Follow the back pain advice of Leeds chiropractor Alison Eaves at Revive Chiropractic and you may even be able to treat the problem yourself. When back pain strikes the first thing you should do is reach for the ice pack as treatment for back pain.

When a footballer gets injured the ‘magic spray’ comes out and normally this is a form of cold spray. What about sports players taking an ice bath after a game? It is widely accepted by chiropractors, physiotherapists and sports medicine doctors that ice helps acute injuries.

Do I apply ice or heat is a common question my patients will ask and as a general rule of thumb, apply ice if the injury is acute (less than two weeks) and heat if the pain is chronic (two weeks or longer).

For acute injuries: Take an ice pack and wrap it in a tea towel or similar (prevents ice burns!) and place on the affected area for 15-20 minutes. Repeat this process on the hour every hour if possible. The more you can ice it the faster the injury should heal, especially straight after the injury or when you first start feeling pain. The basic theory behind ice is that it acts as an anti-inflammatory by causing blood vessels to narrow and so reducing blood flow and bleeding in the injured area.

Do I need an expensive ice pack? Well not really because they are inexpensive and most are reusable. You can buy them from your local chemist or pharmacist for less than £10. A bag of frozen peas will also do the trick but specialised ice packs are more convenient and mould better to the injury site.

Please note that strong evidence of the effectiveness of ice is still lacking. Read more by clicking on the link below.

Look out for the next tip on when to apply heat.

When should I not apply ice?

Do not apply ice packs around the front or side of the neck

If skin is in poor condition

If skin has poor sensation to heat and cold

Over areas of the body with poor circulation

If you are diabetic

If you have an infection or open wound

Don’t just take my word for it, read what the experts say and click on the link to a major scientific review of the benefits of heat and ice therapy.

Please note that strong evidence of the effectiveness of ice is still lacking. Read more by clicking on the link below.

Look out for the next tip on when to apply heat.

When should I not apply ice?

Do not apply ice packs around the front or side of the neck

If skin is in poor condition

If skin has poor sensation to heat and cold

Over areas of the body with poor circulation

If you are diabetic

If you have an infection or open wound

Back Pain Tip 1: Keep Active

So you have back pain?! It hurts?! Whether this is your first experience of back pain or you’re it is the latest episode of many and you think you are the expert, do you know the right things to do? Don’t panic…there are some simple steps you can follow to help ease the pain. Visiting a chiropractor is about more than just hands on treatment, chiropractors will give you lots of back pain advice and suggestions for how to manage your back pain and help prevent it from returning. Leeds chiropractor Alison Eaves at Revive Chiropractic in Adel, a suburb of north Leeds has the following advice.

Back Pain Tip 1: Keep Active

If you have injured your back the last thing you should do is rest. Keeping active helps stimulate blood supply to the affected area and aids the normal healing process. Lying in bed or worse still, lounging on the sofa will only stiffen things up and your back pain will feel worse. You may not want to go out and run a marathon and it is advisable to avoid heavy lifting and being in the same position for long periods of time but normal day to day activities such as going to work should be perfectly manageable.

Keep on checking back for more tips on coping with back pain.

Painkillers "increase risk of heart disease"

As a chiropractor in Leeds, many of my patients will come and see me with back pain or neck pain or other joint pain. Many of these chiropractic patients will also be currently taking or have previously taken anti-inflammatories such as ibuprofen. Anti-inflammatory drugs are used by millions of people to treat pain and inflammation from many conditions such as back pain and neck pain.

Study raises concerns over use of painkillers

A recent study has raised concerns of side effects with anti-inflammatory medication. People who take anti-inflammatory painkillers daily could be putting themselves at an increased risk of heart disease say scientists from the Aarhus university hospital in Denmark. They looked at the habits of more than 30,000 people who took non-steroidal anti-inflammatory painkillers daily and who have atrial fibrillation (an irregular heartbeat).

Studies found that the risk of developing atrial fibrillation increased by up to 70 per cent in those taking regular pain medication for common complaints such as arthritis. An irregular heartbeat can lead to serious conditions such as heart disease, and can increase the risk of having a stroke.

Senior cardiac nurse at the British Heart Foundation, Natasha Stewart, said: “Those most at risk are the elderly or people with other illnesses, such as chronic kidney disease of rheumatoid arthritis.” Stewart stressed that any risks were very small but that those with concerns should talk to their GPs.

So this research has to be viewed in context but it does show that there are known risks associated with taking medication, especially with the elderly. As I chiropractor, I never advise my chiropractic patients to stop taking prescribed medication but many of them are able to reduce the dose after a course of treatment. If manual therapy and chiropractic treatment helps them to do this and therefore reduces potential risk surely that can only be a good thing and is worth investigating further?

NB Patients reducing their medication is a personal choice and I would never recommend a patient reduce doses of prescribed medication without first discussing this with their GP.

Is surgery better than exercises for low back pain?

Chiropractic treatment is only one method of treating back pain. Whilst chiropractic treatment has a good success rate for most patients with back pain there are other treatment methods available and surgery is an option in the most extreme cases. A recent study published this month (well a few months ago as I’m updating the blog) in the British Medical Journal looked at whether surgery with disc prosthesis (disc replacement) was more effective than rehabilitation in patients with low back pain and disc degeneration.

Is surgery better than exercises?

At 2 year follow up patients improved more after surgery than rehabilitation but both groups improved overall. The improvement following surgery over rehabilitation was not deemed significant enough in clinical terms. The study concluded that the risks associated with low back surgery should be carefully considered given that rehabilitation worked seemingly almost as well for low back pain.

Rehabilitation and chiropractic treatment

Chiropractors do apply manual therapy techniques with patients but a lot of what we do also includes both rehabilitation and advice to patients on how to manage their back pain and the rehabilitation methods in this study have a lot in common with a visit to see a chiropractor. In this study, patients in the rehabilitation group took part in a variety of physical exercises including training of the abdominal muscles and lumbar multifidi muscles. They also received training on the origins of back pain and were taught coping strategies for getting back to everyday activities. In total they received about 60 hours of outpatient care over three to 5 weeks. There was significant improvement in the rehabilitation group without the risks of surgery! I believe surgery has its place in the management and treatment of back pain but this article is really important in reminding us clinicians to evaluate all the options.

In what cases is surgery appropriate?

As a chiropractor I favour a conservative approach to treating back pain. In the vast majority of cases, patients respond very well to a course of chiropractic treatment even in cases of severe back pain. I have even had cases whereby patients are scheduled appointments with neurosurgeons and following a course of treatment feel they do not need to continue down the surgical route. However it is also true in some cases that patients do not respond and I will then discuss alternative options with the patient. Should this be the case then I will write to a patient’s GP to discuss referral to an appropriate specialist and in some cases this ends up being a referral to a spinal surgeon.

Read the article for yourself

If you would like to discuss any aspect of chiropractic care for low back pain or any of the points raised in this article then do get in contact.

New Look Blog

Hi I’m is Alison Eaves and I am the principle chiropractor at Revive Chiropractic in Leeds. Thanks for reading my chiropractor’s blog. The blog will concentrate on giving advice on back pain, neck pain and lots of other conditions. Sometimes this will be exercises, videos, the latest research articles or interesting chiropractic news. It’s also a great place to find out about the latest clinic news and offers.

Generally there will be blog entries going out every week so Leeds chiropractor Alison Eaves can keep you up to date with back pain news.