#rockingham physio

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Suffering Sciatica Treatment in Grange | Chronic Low Back Pain Treatment - Grange Physiotherapy

Suffering Sciatica?

Sciatica pain comes from the large sciatic nerve which passes down through the buttocks, down the back of the thigh and then divides into other nerves in the low leg.  There are many reasons as to why this nerve becomes inflamed but it may originate from the lower back.  The sciatic nerve is formed in the mid to lower part of the back and comes out at various levels in the lower back.  If the back has been injured or has undue stress on it then swelling and inflammation may occur and then may then place stress on the sciatic nerve leading to what many people called a pinched nerve.  This can cause severe pain in the back and down the leg/s and pain can be quite debilitating.

It is certainly worth talking to your G.P about your concerns.   Physiotherapists are trained to treat these type of conditions. Ensure that a full history of your back pain is taken as well as an intense assessment of posture, bio-mechanics and movements.  A proper diagnosis cannot be given unless a full history and assessment has been done.   Scans may or may not be needed.  They are usually only needed if treatment has occurred without improvement.   Manipulation should not occur without a full assessment of the spine.

Advice on home management is vital to ensure minimization of pain and enhance recovery.   A regular home exercise regime with advice will encourage normal spinal movement and nerve function.   Grange Physiotherapy therapists treat and given  comprehensive home management.  This is progressed and adjusted with improvement of symptoms.  A written analysis of your diagnosis and treatment plan will be provided with recommendations.  This may include further tests or referral to other specialists.  You will be reassessed at each appointment so your progress is optimal.  Full assessments occur at regular intervals.  Should you need to start a supervised exercise program this will be suggested and implemented with your approval.  Our focus is your recovery to full function in combination with your goals.   While Sciatica may take some time to improve due to the sensitivity and healing ability of nerves, conservative treatment generally provides good results and surgery can usually be avoided.

Chronic Low Back Pain

Chronic low back pain can be both painful and frustrating.  It is also very common.  Research indicates persistent low back pain is due to a range of factors including: poor disc hydration/health, stiff spinal segments, poor muscle control, degeneration of the spine, nerve compression and is influenced by psychosocial issues.  This may lead to not enough or too much movement between the vertebrae segments thus causing pain.  If this is the case then specific exercises aimed at improving normal spinal range and function will improve the back’s function and decrease pain.  These exercises involve both back muscles and abdominal muscles but play an entirely different role to the abdominal muscles we use with exercises such as sit-ups. In fact there is a theory that these type of exercises such as sit ups can actually cause an increase in chronic pain because the wrong type of muscles are being used and they are unable to stabilise and give the support necessary.  The muscles that stabilise the spine are the lower abdominal muscles, which include the transverse abdominus, and the internal oblique muscles.  These muscles can be felt in the lower tummy area just below the front hipbones felt through the lower tummy. The simplest way to exercise them is to try to gently pull in these muscles without tightening the upper abdominal muscles.  This type of exercise then becomes incorporated with activities of daily living so that it becomes an unconscious action involved in posture.

Before you start on an exercise program ensure you get a full assessment of your problem, as instability or weak muscles may not necessarily be the cause of your problem.  Your posture and spinal range needs to be assessed.  The lower abdominal muscles need to be tested  in specific positions to see how strong they are.  Finally you will probably need an individually planned exercise program incorporating both strength exercises and stretches.  On top of all that you need to stick with your exercise program as initially progress can be slow. The longer the problem has been, the slower the rehabilitation can be.  But persist.  With a good physiotherapist your pain can be managed in most cases without surgery.

At Grange Physiotherapy we specialise in low back pain and use a variety of techniques including Acupuncture, mobilisation and exercise to regain range of movement in the spine and strengthen the core muscles which support the spine. Our Clinic offers Clinical Pilates, Hydrotherapy, remedial massage therapy and gym classes to combat low Back pain with great results.

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Tailbone Pain Treatment in Grange | Back Pain Physiotherapy Treatment in Grange

Tailbone Pain?

Back Pain can range from just a niggle to major injury and can affect the sacrum  and coccyx (tailbone).  The physiotherapists at Grange Physiotherapy treat a lot of clients with spinal pain.  It is very common in our society and the majority of the population will suffer from back pain at some point during their lives.

Occasionally falls or injury will produce instability and injury to the sacroiliac/coccyx joints.  These joints are where the tail bone attaches to the pelvic and connect to the spine.  Often if these structures are involved, bladder problems may emerge and may settle with treatment to the tailbone and a good exercise regime.  There is a lot of research in this area and there is still a lot more to do however this may be the problem and help from an experienced physiotherapist is required.  If the tailbone joints have become unstable due to injury to the ligaments or muscles then this needs to be addressed.  The exercises that mainly need to be concentrated on are the lower abdominals, pelvic floor and gluteal muscles which are in the buttock. You may also need to concentrate on certain stretches to take the pressure off the joint. Find a physiotherapist who has some knowledge of the recent research in this area and make sure you have a full assessment to ensure the proper diagnosis is made.  It would also be of benefit to talk to your G.P concerning these problems and get some advice.  You may need to be referred to an orthopaedic specialist for further assessment and treatment, if conservative treatment is not successful.

Sitting on a comfortable coccyx specific pillow with good posture may assist in unloading the area to allow healing.  Get some advice and see your  physiotherapist for a full postural and biomechanical assessment of the problem.

Scoliosis Pain?

Scoliosis is an abnormal sideways curvature of the spine.  Instead on of the spine being straight when viewed from the back, there is a curve to one side or the other or a combination of curves.  Scoliosis is generally classed as those curves that are severe or cause symptoms.  They can be idiopathic although there are other causes.   They may occur due to an irregularity such as a short leg, or due to bad posture or increased muscle use on the dominant side of the body.  Sometimes it can be due to abnormalities or disease of the bones, soft tissue or nerves associated with the spine.  Minor curves are normal in the local population and do not necessarily need treatment.  They can however cause discomfort in the back or neck and treatment will relieve symptoms.

Abnormal spinal curves require a spinal and posture assessment.  If the curve is severe, a specialists opinion may be sought.  All  children should be assessed for scoliosis before they finish growing.  If this is diagnosed early, treatment is much more effective.  Treatment often consists of an appropriate exercise program, treatment and advice in order to minimize the curve and keep it mobile to avoid complications. Severe scoliosis may cause wedging of the bony vertebral segments as well as stiffness, and treatment may be needed during flare-ups. Maintenance treatment for spinal curvatures is encouraged to ensure full range and function in the back and neck.

Physiotherapists have specific training in the treatment of scoliosis and can assist in setting up a home program to self manage as well as provide maintenance treatment when needed.

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Tailbone Pain Treatment in Grange | Back Pain Physiotherapy Treatment in Grange

Tailbone Pain?

Back Pain can range from just a niggle to major injury and can affect the sacrum  and coccyx (tailbone).  The physiotherapists at Grange Physiotherapy treat a lot of clients with spinal pain.  It is very common in our society and the majority of the population will suffer from back pain at some point during their lives.

Occasionally falls or injury will produce instability and injury to the sacroiliac/coccyx joints.  These joints are where the tail bone attaches to the pelvic and connect to the spine.  Often if these structures are involved, bladder problems may emerge and may settle with treatment to the tailbone and a good exercise regime.  There is a lot of research in this area and there is still a lot more to do however this may be the problem and help from an experienced physiotherapist is required.  If the tailbone joints have become unstable due to injury to the ligaments or muscles then this needs to be addressed.  The exercises that mainly need to be concentrated on are the lower abdominals, pelvic floor and gluteal muscles which are in the buttock. You may also need to concentrate on certain stretches to take the pressure off the joint. Find a physiotherapist who has some knowledge of the recent research in this area and make sure you have a full assessment to ensure the proper diagnosis is made.  It would also be of benefit to talk to your G.P concerning these problems and get some advice.  You may need to be referred to an orthopaedic specialist for further assessment and treatment, if conservative treatment is not successful.

Sitting on a comfortable coccyx specific pillow with good posture may assist in unloading the area to allow healing.  Get some advice and see your  physiotherapist for a full postural and biomechanical assessment of the problem.

Scoliosis Pain?

Scoliosis is an abnormal sideways curvature of the spine.  Instead on of the spine being straight when viewed from the back, there is a curve to one side or the other or a combination of curves.  Scoliosis is generally classed as those curves that are severe or cause symptoms.  They can be idiopathic although there are other causes.   They may occur due to an irregularity such as a short leg, or due to bad posture or increased muscle use on the dominant side of the body.  Sometimes it can be due to abnormalities or disease of the bones, soft tissue or nerves associated with the spine.  Minor curves are normal in the local population and do not necessarily need treatment.  They can however cause discomfort in the back or neck and treatment will relieve symptoms.

Abnormal spinal curves require a spinal and posture assessment.  If the curve is severe, a specialists opinion may be sought.  All  children should be assessed for scoliosis before they finish growing.  If this is diagnosed early, treatment is much more effective.  Treatment often consists of an appropriate exercise program, treatment and advice in order to minimize the curve and keep it mobile to avoid complications. Severe scoliosis may cause wedging of the bony vertebral segments as well as stiffness, and treatment may be needed during flare-ups. Maintenance treatment for spinal curvatures is encouraged to ensure full range and function in the back and neck.

Physiotherapists have specific training in the treatment of scoliosis and can assist in setting up a home program to self manage as well as provide maintenance treatment when needed.

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Correct Lifting - Correct Lifting Techniques | Proper Lifting Technique

Lifting injuries are a common cause of back pain. You can protect yourself against damage with good lifting habits, both at home and in the workplace.

How Lifting Can Injure Your Spine

When you lift, your spine is put under stress. Twisting or jerking while lifting and carrying can injure the small joints of the spine. The discs which separate the vertebrae (spinal bones) and the ligaments which hold the vertebrae together are also at risk. The discs are composed of a jelly-like core, surrounded by a strong fibrous ring. With repeated unsafe lifting, the fibrous ring or its supporting ligaments may tear or rupture. This is commonly known as a disc bulge or herniation.

Heavy lifting while bent forward will increase the stress on your spine. Contributing to this stress are factors like the weight of the load, how far it is held from your body, how often and how fast you lift and how long you hold the load.

To protect your spine from injury, always attempt to take the following steps:Get a firm footing with your feet apart for a stable base.

Bend your hips and knees instead of bending at the waist. This allows the leg muscles to take some of the load and not the spine.

Tighten your abdominal muscles. Abdominal muscles support the spine when lifting.

Ensure that you have a strong grip and that the load is as close to you as possible.

The closer it is to your spine the less force it exerts on your back.

Brace yourself for the lift but continue to breathe normally through the lift.

Lift steadily and do not jerk the load. Look straight ahead, not down.

Keep your back straight and avoid twisting or bending to the side.

To lower the object, place your feet as you did to lift, tighten stomach muscles and bend your hips and knees.

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Correct Lifting - Correct Lifting Techniques | Proper Lifting Technique

Lifting injuries are a common cause of back pain. You can protect yourself against damage with good lifting habits, both at home and in the workplace.

How Lifting Can Injure Your Spine

When you lift, your spine is put under stress. Twisting or jerking while lifting and carrying can injure the small joints of the spine. The discs which separate the vertebrae (spinal bones) and the ligaments which hold the vertebrae together are also at risk. The discs are composed of a jelly-like core, surrounded by a strong fibrous ring. With repeated unsafe lifting, the fibrous ring or its supporting ligaments may tear or rupture. This is commonly known as a disc bulge or herniation.

Heavy lifting while bent forward will increase the stress on your spine. Contributing to this stress are factors like the weight of the load, how far it is held from your body, how often and how fast you lift and how long you hold the load.

To protect your spine from injury, always attempt to take the following steps:Get a firm footing with your feet apart for a stable base.

Bend your hips and knees instead of bending at the waist. This allows the leg muscles to take some of the load and not the spine.

Tighten your abdominal muscles. Abdominal muscles support the spine when lifting.

Ensure that you have a strong grip and that the load is as close to you as possible.

The closer it is to your spine the less force it exerts on your back.

Brace yourself for the lift but continue to breathe normally through the lift.

Lift steadily and do not jerk the load. Look straight ahead, not down.

Keep your back straight and avoid twisting or bending to the side.

To lower the object, place your feet as you did to lift, tighten stomach muscles and bend your hips and knees.

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Back Pain After Sitting? Physiotherapy for Back Pain Relief in Grange

The reason that driving or sitting for that matter causes your back to ache is fairly simple. The entire back in standing is very cleverly designed to form an “S” curve when viewed sideways in order to cope with the everyday stresses placed on it. This creates a spring or bounces effect with stresses to the back. The lower back, in particular, has the inward curve of the “S” so that when viewed from the side the curve curves towards the tummy. When sitting, your legs are high in front of you, and this pulls the pelvic bones around so that this inward curve becomes either straight or curves the other way. So often your back takes on the “C” shape instead of the “S”. This places a significant amount of stress on the back which can be enhanced and aggravated by vibration e.g. when travelling. At first, you may only experience stiffness getting out of your seat, then this will progress to stiffness and eventual pain while sitting and sitting to stand. The back can only take so much stress until small degenerative changes start to occur ever so slowly to try to accommodate this stress. We are not designed to sit for long periods in this poor postural positioning. In most cases, the stress builds up slowly until it becomes too much and pain begins.

Despite technology, most seats do not have enough lower back support. There are a variety of supports that can assist to reduce a load of spines in sitting. These are worth trialling. The reality is our bodies are not designed to sit for a long period of time. Stretching and standing activities should be done regularly if sitting for long periods.

Travelling by car? Newer cars are much better than the older cars where there is often little choice between a bucket seat and a straight-backed seat. The newer cars do have adjustable lower back support which while being an improvement on the older cars still need some technology years to refine the perfect sitting position. Let’s face it they are still trying to find the perfect chair for office work and more technology is needed for this. While we are not suggesting you buy a new car, the seat may need replacing if it is considered vintage. However, there are various supports that you can buy which fit into a car seat and will support your back.

Basically, you need to produce an inward curve of your lower back and if you do that you will be able to drive long distances much more comfortably. A quick solution is to invest in a lumbar roll which retails cheaply from most physiotherapy clinics and adds some support. A cushion/pillow may also assist as long as your lower back is in an inward curve position. There are also more fancy expensive options which support both the back and the pelvic area. Mind you in saying all this there are some seats that despite back cushions and modifications etc. need to be put on the trash heap. No matter what you do to them, they stress your back. When travelling if possible, make sure your knees are below your hips as this will help reduce the load on your back by maintaining the normal curves.

If your pain does not settle or seems to be getting worse, get some advice/treatment from your local physiotherapist. Often treatment combined with a home program will resolve the pain. Surgery and invasive treatments can usually be avoided with early physiotherapy.

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Squatting correctly - Physiotherapy in Grange | Squat Corrective Exercises

4 tips to Squat correctly Squats are one of the best exercises for people with knee pain or arthritis.  They maintain the strength in major leg muscle groups such as glutes (buttocks) and quads (front of the thigh). They are a great weight-bearing exercise for optimizing bone health, Many clients avoid squats due to knee arthritis, but interestingly, people with knee arthritis are often the ones who need squats the most.

Strength around the knee joint is the best way to reduce pain and protect the joint surfaces. Your muscles are like the ‘springs’ in your car suspension – they are the ‘shock absorbers’ around your joint. If they are not working optimally, your knee joint will not be happy. In order to get the muscles working optimally, you have to squat correctly.

Here are our tips:

Keep your knees pointing the same direction as your middle toes!

If your feet are pointing straight ahead, your knee-caps should face straight ahead. If your feet are ‘open’ slightly in a V-shape, your knee-caps should point that way too. Avoid ‘knock knees’ at all costs when squatting! Even letting the knees slightly dip together will put undue stress on the inner part of your knees and will turn off your glute muscles, defeating the purpose of the squat.

Keep your knees behind your toes!

Your knees doing over your toes increases the pressure in your ankle and behind your knee-cap, which can be very uncomfortable for people with issues in either of these areas. Keeping your knees behind your toes will decrease this undue pressure.

Lead with your tailbone (stick your bottom out!)

Sticking your bottom out will help you keep your knees behind your toes, but it will also help you turn your glutes on more effectively. Ever wondered why you don’t feel squats working your buttocks? Might be that you’re not sticking that tailbone out enough!

Keep your lumbar curve (that natural hollow in your lower back) but don’t over-arch it!

Lean forward when you stick your bottom out, keep your ribs ‘in’ and your lower belly muscle engaged (about 20%) so you don’t end up over-arching your back (see the picture below for a perfect squat).

Following these 4 steps will have you on your way to more effective and less painful squatting and lifting in no time!

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Carpal Tunnel Syndrome - Carpal Tunnel Syndrome Treatment Grange

The carpel tunnel is a narrow bony and soft tissue passageway at the wrist which allows certain nerves and other soft tissue vessels to pass through into the hand. Sometimes pressure can build up in this tunnel causing pressure on the soft tissue structures and often in particular on the nerves passing through. This can cause numbness, pins and needles and often pain.  It is commonly seen during pregnancy or those with excessive fluid.  It is commonly a problem at night due to resting positions of the wrist. Physiotherapy can be of benefit and treatment can be successful with conservative treatments.  We always use our hands!  So living with pain and stiffness in this area can be difficult. 

Sometimes surgery is necessary.   Surgery release of this tunnel involves a small operation where they release some of the soft tissue structures in order to take the pressure off these vessels. Following surgery, it will take some time for swelling and pain to settle.  The hand is a complex structure which tends to stiffen up very easily with minimal effort.  Some advice following surgery:

Gently massage in a little emu oil or moisturizer into the scar and the swollen aspects of the hand and wrist.  Do this two to three times a day if possible.  Use your thumb in a circular motion to break down any adhesion’s that may be forming from the scar tissue.

Perform gentle stretches to the wrist and fingers.   Don’t push past pain, rather stretch to a stiffness sensation.  Curl your fingers into a fist and open regularly throughout the day. Practice playing a pretend piano and practice taking each finger to the thumb to create the pincer grip.

Don’t try to perform heavy lifting or difficult tasks for the initial 6-8 weeks until you are confident of strength and function

Don’t try to do repetitive tasks for long periods of time.  Vary activity regularly.

Physiotherapists understand the importance of getting normal range and function back into this area with or without surgery.  See a specialist if things don’t improve.  Physiotherapy is recommended for best results.  Sometimes it is only possible to stretch your hand so far and treatment with your physiotherapist is needed in order to regain full movement and function.