Sciatica is the term given to pain down the leg, which is caused by irritation of the main nerve into the leg, the sciatic nerve.

Looking at this website probably means that you think you may have sciatica but are not sure. What you DO know is that you literally HAVE (not are) a pain in the bum! What you want to know is what is it, what caused it but most of all how do you get rid of it!

What is Sciatica? Route of the sciatic nerve down the thigh

Technically speaking, sciatica is a symptom not a diagnosis It is a non-specific term commonly used to describe symptoms of pain radiating downward from the buttock over the posterior or lateral side of the lower limb. It is usually assumed to be caused by compression of a nerve but this is not necessarily so.

A common neurological cause of this pain is entrapment of the sciatic and/or posterior femoral cutaneous nerves. But the pain may be caused by trigger points in the soft tissue. This latter case is easily overlooked and requires manual palpation of the musculature associated with the hip if the pain is not to be misdiagnosed.

Background

It is often assumed that there is sciatic nerve root entrapment, resulting in the compression of the nerve. Pain and symptoms being transmitted or referred from the low back to one of the buttocks and down the back of the leg along the pathway of the sciatic nerve. Hence the term sciatica.

The exact cause of sciatica is not fully understood but is commonly thought to involve a slipped or herniated disk. This means one of the disks, which lie between each of the vertebra in the lower back (lumbar area), has cracked and allowed some of the inner disk material to protrude out, putting pressure on the adjacent nerve root, which in this case is the sciatic nerve. The term ‘lumbago’ is often banded about as well which is a general term for low back pain. However, some people have been found to have a slipped disk but have no pain.

Sciatica Symptoms

Symptoms can vary from extreme pain in the low back radiating into one buttock and down the leg. Pain often increases on exertion or bending forward. Alternatively, there may only be a mild sensation in the leg or buttock. There may be numbness in the area, weakness in the leg and diminution of the reflexes. Pain may be triggered by coughing or straining and can be so severe that the lower back becomes locked in sideways bending position (scoliosis) caused by a strong contraction.

Alternatively, it may only come on when sitting or standing in a certain position. Clinical experience indicates that these certain positions are usually associated with continually holding a poor posture either at home or at work. For example, protruding the head forward peering at a computer all day or regularly lifting a baby out of the back of the car. But some or all of these symptoms are also associated with other conditions which is probably why the name is often misused as a catchall word for any pain affecting the buttocks or other parts of the leg. In this case the pain is triggered by a local trapping (trigger point) or straining of the nerve along its pathway. All of which can lead to sciatic-like symptoms, giving rise to conditions such as Piriformis, Psoas, Hamstring Syndromes, Back Pocket Sciatica and Pseudo-Sciatica.

Trigger Points

An area of extreme irritability that when compressed is very tender and can give rise to referred pain and tenderness.

Piriformis Syndrome

As the sciatic nerve passes through the buttock it goes through or under a muscle called the ‘Piriformis’. This muscle lies deep to the large buttock muscles (Gluteus maximus and medius) and is classified as a lateral (outward) rotator of the hip when it is in a neutral weight-bearing position as in standing or when extended during walking or running. In addition, it abducts (away from the center) the thigh when flexed. It also plays a restraining role by controlling medial rotation (inward) during the initial stance phase of walking or running. Sustained tension in this muscle can lead to the formation of trigger points resulting in the compression of the sciatic nerve and possibly the dysfunction of the SI joint (joint between the spine and the pelvis).

This tension in the Piriformis results in symptoms that are easily confused with those of a herniated disc. Absence or marked weakness of the Achilles tendon reflex would suggest a disc lesion. Radiograph reports of the narrowing of the disc space or degenerative changes with spur formation are not by themselves sufficient to account for the pain characteristics of the piriformis syndrome. Degenerative changes occur in the spine with aging and do not correlate well with these symptoms. Recognition of piriformis symptoms may avoid needless laminectomy.

Piriformis Syndrome Symptoms

May be a mixture of seemingly unrelated symptoms. Pain and paresthsias (pins and needles) may be apparent in one or more of these areas: the low back, groin, perineum, buttock, hip, back of the thigh, leg and foot or the SI joint. Swelling can occur in the painful leg and sexual dysfunction can occur. The condition can be aggravated by sitting, getting up, or standing. Conversely, activity can worsen the symptoms. It can also cause the buttock muscles to atrophy. Numbness of the foot and loss of position sense (proprioception) can lead to an unstable walk.

Activation

Piriformis syndrome can be activated in numerous seemingly different ways. For example, long drives in the car result in the accelerator foot being flexed for long periods, resulting in the tightening of the piriformis muscle. Lifting or lowering of a heavy weight, catching oneself from falling, twisting sideways while bending or lifting a weight such as a baby out of the back of the car. Direct trauma such as hitting the muscle itself or impact caused by a car accident particularly when the impact is from the side. Morton’s foot (second toe is longer than the big toe) can initiate the syndrome after a long walk. This is because the condition tends to cause medial rotation and adduction (inward movement) of the thigh, which puts a strain on the piriformis.

Gluteus Medius & Iliopsoas muscle tension

No other muscle has so many different functions, cause so much pain and is so difficult to palpate (touch).

Actually two different muscles, the psoas major runs along each side of the lumbar spine to the hip and the iliacus runs from each side of the pelvis joining the psoas at the hip. Their main function is to flex the thigh. The psoas can assist in lumbar extension (lordosis) and is involved in spinal stability. Its involvement in thigh flexion is currently being reconsidered. During running the iliacus is active in thigh flexion and with the psoas during the last 60 of a sit-up.

Symptoms

Trigger points refer pain into the low back, either alongside the spine or across the back. Pain is worse on standing upright and remains as a nagging pain when lying down. Often there is difficulty in getting up at all. Sciatic-like symptoms can be apparent. Pain is often felt in the front of the thigh.

Prolonged sitting, particular in the sloped seats of a car or lorry, causes the continual shortening of these muscles resulting in activation of trigger points in them. Similarly, sleeping with the hips flexed (fetal position) will have the same effect. Trunk rotation and side bending particularly when ‘core stability’ muscles are weak will result in activation of trigger points. Tightness in the anterior thigh muscles (rectus femoris) prevents hip extension, so generating tension in these muscles. Leg length discrepancies can also result in their activation.

Hamstring Syndrome

The hamstrings which run from the crease of the buttock to the back of the knee are supplied by branches of the sciatic nerve. These muscles extend the thigh at the hip joint and flex the leg at the knee joint. During standing and walking they work indirectly to maintain an erect posture.

Symptoms

Trigger points in the hamstring muscles result in pain being experienced on walking, possibly resulting in a limp. Sitting can also cause pain in the buttock, upper thigh and back of the knee. Pain also occurs on rising from a chair, particularly if sitting crossed legged, and can cause disturbed sleep. Confusingly, pain can be felt in the front of the thigh even though the trouble originates in the back of the thigh.

Because the pain distribution often follows the path of the sciatic nerve, patients are often misdiagnosed as having sciatica.

Activation

Classically this is caused by constant pressure on the hamstrings. For example sitting in chairs which have too high a seat. Patio or seaside furniture commonly has a canvas or plastic seat attached to a horizontal bar across the front of the seat. The seat bottom sags and the cross bar presses firmly against the hamstrings. Children placed in high chairs without a foot-rest experience the same problem. Particularly problematic for people with short legs sitting in long legged seating so their feet do not touch the floor.

Pseudo-Sciatica – Gluteus minimus

The smallest and deepest of the gluteal muscles, lying beneath the gluteal medius, its fibres run from the pelvis to the hip. Like the overlying gluteus medius it has a split role in life; the anterior fibres medially rotate the thigh whilst the posterior fibres assist lateral rotation, all fibres contribute to abduction of the thigh. It also helps to stabilise the pelvis during ambulation.

Symptoms and Relief

Hip pain that may cause a limp during walking. Lying on the affected side may be too painful and result in disturbed sleep. Pain on rising from sitting and standing up straight. The pain in the hip area can be severe and constant with no let up either lying down or walking. As this muscle lies close to the Piriformis, the pain patterns are similar. Like the Piriformis it can cause SI joint dysfunction. But whereas the Piriformis pain pattern can extend down to the knee, the minimus pattern includes the calf and the thigh. Low back pain in the sacral and sacroiliac regions is most likely be due to problems in the gluteus medius. Pain referred from trigger points in the gluteus medius is less likely to involve the thigh; gluteus maximus trigger points restricts flexion at the hip whilst Piriformis trigger points restricts medial rotation.

Activation

Trigger points may be activated by too much, too soon. For example, walking too far or too fast, especially over rough ground; overuse in running and sports such as tennis. Even painful blisters can alter the gait pattern sufficiently, or simply running awkwardly due to another injury.

Holding the foot constantly over the accelerator pedal during a long car drive results in hip muscle imobilization, resulting in activation of trigger points in this muscle. Likewise, prolonged standing will have the same effect. SI joint dysfunction will perpetuate the trigger points.

Sitting on a wallet placed in a back pocket can cause impingement on this muscle and therefore produce referred pain in a sciatic-like distribution pattern.

By Ron Dunn

PROFESSIONAL PHYSIOTHERAPY

Our physiotherapists at the Welwyn and Hatfield practice are skilled in the fast and effective relief of sciatica

The Hatfield Practice aims to provide Cost Effective  Professional  Physiotherapy services . Many of our patients receive a  combination of Physiotherapy, Osteopathy  or Acupuncture during the same session. Our unique and highly effective approach  will out perform any standard Physiotherapy / Osteopath treatment. We will reduce your pain fast and that  won’t cost you a penny extra ! .The Hatfield Practice Physio at its best.

Professional Physiotherapy, is  often referred to as physio or physical therapists. We use hands on methods, such as massage, manipulation, electrotherapy and exercises to promote your healing and well being. Our Physios will design a treatment plan especially for you. Your treatment is our reputation. 

We are happy to answer any questions you may have. The Hatfield Practice call us on 01707 888229.

£10.00 OFF PROFESSIONAL PHYSIOTHERAPY

 CHARTERED PHYSIOTHERAPY SERVICES

THE HATFIELD PRACTICE, call us on 01707 888229

“The mattress should be supportive enough to take the weight of the body without sagging, it shouldn’t be so supportive that it does not “give” comfortably when you lay down to rest”

Buying your mattress

Your mattress should be supportive enough to take the weight of the body without sagging. Old ones tend to sag and you may end up with a ver sore back or need Physiotherapy for back pain. However, the mattress does need to be firm enough to allow for shifts of posture during the night. Any sore joints or discs can stretch, bulge or inflame if not supported well. Possibly leaving you with that locked up feeling in the morning.

 Don’t be  embarrassed to lie on the bed in the shop for 20 minutes or so, for each mattress. Lie on your back as well as your side. This gives your body time to adjust and relax.You will be buying an expensive item that you will live with for years !! If in doubt call the Welwyn and Hatfield Practice Physiotherapy practice and ask to speak to Ian Norman.

The mattress should be comfortable to lie on and soft enough, with sufficient ‘give’, to support and cushion the body’s bony curves (for example like that provided by a ‘pocket sprung’ mattress). Don’t be embarrassed to lie on the bed for twenty minutes or so in the shop –it’s really  never as long as you’ll spend on it each night !

 A good quality mattress will need a strong base. It is always best to buy the base and mattress together if possible. If you buy these items separately do seek advice from the sales representative that they would make a suitable combination and get this in writing as otherwise the guarantee on either the base or mattress may be invalidated by misuse.Many of the mattress bases are spung as well.

Allergic disorders

 In one GP study 85% of Allergic disorders, such as asthma and eczema can be aggravated by sleeping on traditional  beds. The cause of these symptoms are generally  dust and bed mites. The mattress needs to allow for the easy evaporation of perspiration.The body loses between one and two pints of perspiration per night !! A divan or slatted base allows for good air circulation. Memory foam are especially good as they are hypo – allergenic, bugs like them least of all. If you are going to put a board under your mattress to improve support ensure it has holes. Hygiene and ventilation of the bed and covers are important. It helps (but can be  awkward) to hoover the bed once a month.Special protective covers are very helpful.

Beds vary in size from super king  to small single…

Are you and your partner  different size ? 

If you and and your partner are different sizes consider  link bed these are a great idea as they work independently from each other. Think about whats best  for you – if you are of average weight and need a supportive mattress but your partner is heavier and requires a firmer one, it might be better to choose a bed with separate mattress types on either side.

A brilliant option is a water bed.

Although they will not suit everone. Manufacturers claim that they support the body without distorting the spine and will last for many years without sagging.These beds  have no pressure point areas (so they are comfortable), they generally have the facility for internal heating which means if you have  stiff  joints or have back ache bed is a place to go to recover. You can also heat them up in winter or cool them down in summer months.They do require some maitenance involving conditioners  and there is less-likelihood of mites and dust asthey are hypo allergenic. However, as with many things, water beds are popular with some people, but others find them very difficult to relax in – try one before you pay in full.  Remember, there is no absolute best choice of bed.

The word ‘orthopaedic’  really just implies ” Firmness”

Be satisfied the bed you choose  it is right for you.  Remember that the word ‘orthopaedic’ is really meaningless, though it generally implies ‘firm’. If you require further advice on a back problem seek advice from our Physiotherapist or Osteopath at the Hatfield Practice. 01707 888229

Remember traditional mattresses need to be turned regularly – between every 6 weeks to 3 months. Get someone to help you turn them over, especially the heavier ones!  If you live on your own your may prefer a water bed, memory foam or latex mattress that requires no turning.Also dont forget to hoover the mattress from time to time to remove mites. A friend of mine used to leave his matress in the huge walk in freezer that he owned overnight or when he went on holiday. His idear was that it would kill any bugs or mites !!!

What else can help?

People tend to just rely on the mattress and pillows in isolation to fix their backs to improve their back condition. The reality is that really when you are young you could sleep on a pile  of bricks and still wake up rested. There are many other methods of improving your quality of sleep.

A memory foam “topper”

Heated under blanket in winter great for aching backs and kidney chills.

A bath before bedtime with a few drops of lavender.

Gentle walk or stretches an hour before you  sleep this moves blood and relieves stiff “TV style” joints.

Avoid alcohol and caffiene they speed your internal organs that self clense night time.

Turn off TV and have tech free evenings.Let yourself relax – No blood type zombie films !

Dont eat late if you can help it ( your liver will get anoyed with you and wake you at 2 a.m !!)

Dark and cool rooms help us to sleep well, less people tend to have curtains these days.

Why pain in bed

As we age the discs in our back wear, that’s normal really. They don’t always wear in an even way, spines are often twisted out of alignment.This creates torsions and tension along the spine which affects spinal joint spaces. these spaces are important as they allow the fluid between the joints to lubricate and nourish the cartilage. Wear is always uneven ( even on our shoes ! )

When we sleep any anomaly or lack of function along your spine will be tested. So if the joint is lax it will tend to stretch stressing the joint capsule or ligaments. If it is stiff blood flow will be reduced and it will ache as your body is made aware and it attempts to release your problematic area. Most commonly L4 and L5 at the base of your low back. Hey presto pain when you wake. Our ligaments tighten night time – recover. The main reason for this is that our discs even if worn,  absorb water – literally rehydrate night times . This is why we are taller in the mornings. This re hydration can also cause stiffness and pain as the body readjusts.

Professionalism in Physiotherapy

Edit this entry.

THE WELWYN AND HATFIELD PRACTICE – YOUR BEST CHOICE

Our physiotherapists, Osteopaths, Acupuncturists and Massage therapists  work as a integrated team, encouraged and trained to use our focused triage pain relief system.

We dont just give exercises. we design you a hands on “top end” treatment plan that will speed your recovery from injury or illness.

We have brilliant Communication Support System in place. Full time reception staff, personal practitioner email service. A emergency direct line (mobile) to our director & senior practitioner Ian Norman. Call Ian for advice, emergencies and feedback.   

“Our ability to  refer  between our specialists in a fast and effective way is cost effective and the future”.  

 ”if your condition is complex, non resolving or if your in a great deal of pain” we can  involve other specialist practitioners  with your treatment on the same day often during the same session. We also have a mobile Physio faster  service that will visit you at home or office 

Treatment starts with good working diagnosis ( i.e.  what the problem/ injury is). Its very important that you understand why your in pain and a clear idea of how long before you see any improvement in your condition. Most importantly a good understanding of why the problem happened in the first place . This must backed up with good quality educational advice so that the injury/condition is not repeated  over and over  again as many are.   

Physiotherapyis great for rehabilitation, Pilate’s, whiplash, repetitive strains, muscle imbalance, workstation assessments, exercises and core muscle stability advice. Physiotherapy is science-based and well researched, we are committed to extending, applying, evaluating and reviewing the evidence that underpins  its practice and delivery. Our Physiotherapy is  ” hands on”  and not just exercises. This approach has proven very successful and one of the best proven approaches for the treatment of joints, muscles, tendons, nerves and ligaments. As well as practising a wide range of  ” hands on “ techniques, our Physiotherapists are also trained in the use of electro – therapy such as     H- wave, ultrasound, laser, interferential and TENS.   

 Osteopathy is simply brilliant for loosening and improving spinal, muscle and joint function. Chronic muscle tensions caused by hours on the computer or by  not stretching and poor diet etc can leave people feeling tired and old. These chronic muscular tensions lead to inelastic fibrotic  muscle states that literally stiffen “strangle” our bodies almost like ivy on a tree. Stiffness in muscles and joints limit limit our range of movement. These changes can make us feel older than we are. The lack of movement affects cartilage nourishment eventually causing inflammation, osteoarthritis  “wear and tear”. Aging is in part  due to poor range of movement,eventually softening cartilage and weakened muscles .   

 Our osteopathy is not just cracks our practitioners  use a specific deep “neuro – muscular massage” which massively  improves blood flow, nerve elasticity and joint range of movement  improving and physical flexibility, function  and eased emotional patterns often “held” in our bodies   

Acupuncture is  simply brilliant for acute pain relief.  Systemic ( Internal organ) problems like, liver heat, kidney stress, digestive conditions such as acid reflux ,IBS, high blood pressure. Importantly  “stress origin” conditions like chronic fatigue, “burnout” are to do with the kidneys producing to much cortisol/ adrenalin. Brilliant for trapped nerve pain, Rsi, shingles, Irritable bowls and both male and female fertility infertility issues are just a few examples of the scope of Traditional Acupuncture.   

Interestingly in China the village acupuncturist would look after the health of locals. Checking on then all from time to time. The reason for this was ( apart from loving his work) he would not get paid if they became unwell and could not work ( brilliant !). Modern medicine often waits for disease to become established before intervention. Odd  really as like many things the more established a condition the harder it is to treat.   

Massage   

Our “Freedom Massage Treatment” starts with case history taking, full neurological examination, functional testing of muscular performance and joint movement structure and function. Then the treatment typically involves deep soft tissue work along specific nerve pathways. This tends to break reflexes and provides an amazing sense of lightness and freedom of movement. Of course  manipulation of the spine (helping the central control of the whole body), manipulation of peripheral joints and soft-tissue work including reflex- and trigger point therapy and neuro – release techniques to improve the tensions thorough the neuro system which often lead to pulled tissue disc, joint and nerve injuries. Deep neuro – muscular massage is undertaken by Ian Norman.   

Medication   

What about pain killers ? They cheaper than Physio  and proven right ?   

There is no doubt pain killers are a brilliant short term option. Directions on the box. Easy DIY how to  guide and of course  the side effects. Reality suggests the ”stronger the medicine” the stronger and more miserable the side effects. Painkillers don’t cure the condition they “manage”  the pain. But where is the education and understanding   

Some  pain killers  cause mental confusion, poor performance ( at work or driving! ) , gastro – intestinal inflammation, heart problems, kidney failure etc.       Many have been withdrawn due to the  adverse effects on  heart muscles.   

Many pharmacological products are clinically tested in isolation, in controlled conditions with no stress or any other tablets being taken in consideration.              In reality drugs are often taken by patients together with other meds. There are huge addiction problems. More recently the singer Michael Jackson.   

Long term effects of pain killers are quite well documented. Combined this with poor lifestyle habits  painkillers may not be the best option long term. Most importantly they don’t educate people  and may well encourage pain sufferers into more serious problems.Our unique selling point  is ”if your condition is complex, non resolving or if your in a great deal of pain” we can  involve other specialist practitioners  with your treatment on the same day often during the same session. We also have a mobile Physio faster  service that will visit you at home or office.  

 “Our success in treating difficult conditions is one of the characteristics that defines us”    

Good luck   

Ian Norman Osteopath and Practice Director.   

Welwyn Garden City  & Hatfield Physiotherapy Practice  

Welwyn Garden City Physiotherapy practices.  We have  more than 30 years experience in  pain management, rehabilitation and patient centered care. Our main aim  is that your treatment experience is second to none.   Chartered Physiotherapy, Registered Osteopathy, Licenced Acupuncture (specialist for infertility ) Holistic therapies, Sports Massage.  

Chartered Physiotherapists combine their knowledge, skills and approach to improve a broad range of physical problems associated with different ‘systems’ of the body.

In particular they treat neuromusculor (brain and nervous system), musculoskeletal (soft tissues, joints and bones), cardiovascular and respiratory systems (heart and lungs and associated physiology). Have a look at some conditions which physiotherapists often treat within these systems.

People are often referred for physiotherapy by doctors or other health and social care professionals. Increasingly, as a result of changes in health care, people are referring themselves directly to physiotherapists without previously seeing any other health care professional.

Physiotherapists work autonomously, most often as a member of a team with other health or social care professionals. They may be employed or self-employed and can work alone. Physiotherapy practice is characterised by reflective behaviour and systematic clinical reasoning, both contributing to and underpinning a problem-solving approach to patient-centred care.

Both becoming and being a physiotherapist is hard work but there is a rich and rewarding variety of work available to qualified physiotherapists and the opportunities within the profession, both in the UK and internationally are considerable. ( Source CSP web)

The Welwyn Garden city and Hatfield Physiotherapy Practice.

Physiotherapy helps restore movement and function to as near normal as possible when someone is affected by injury, illness or by developmental or other disability.

Physiotherapists work in a wide variety of health settings such as intensive care, mental illness, stroke recovery, occupational health, and care of the elderly. See more on what physiotherapists do in our site

A formal definition

A more formal definition of physiotherapy comes from the 2002 CSP Curriculum Framework:

It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status.

Physiotherapy is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery.

The exercise of clinical judgement and informed interpretation is at its core.”

( Source CSP web site)

Physical Therapy Explained. Physical therapists are medically trained professionals who treat patients by physical methods including manipulation, massage, infrared heat treatment and remedial exercise, etc. and not by drugs. There are three disciplines which mainly focus on the musculoskeletal system:

• Physiotherapists can be seen working in many areas of the NHS and in private practice. They work in all areas of musculoskeletal care and rehabilitation. In the NHS they are probably best known for their work in assisting patients through the rehabilitation process (such as post-op recovery, after sustaining an accident or major burns injury). They also commonly work in outpatients and in private practice where they treat sports injuries and acute & chronic musculoskeletal conditions.
  They employ a mixture of hands-on techniques but will also commonly use a variety of electrical treatments (e.g. ultrasound). Many physiotherapists now use acupuncture as part of their overall treatment approach.
• Osteopaths main focus is on maintaining the health of the musculoskeletal system. The osteopathic principle is to take a holistic approach to the treatment of a patient’s condition. They like to find out the cause(s) of why an injury has occurred and offer treatment to assist recovery. They will often give ‘self-help’ advice to a patient to help prevent the injury occurring again. Much of their work involves treating dysfunction (pain and disability) of the spinal area.
  The osteopath applies hands-on techniques to joints, soft tissues, muscles and ligaments to ease pain and improve mobility and to assist the natural healing process. Osteopaths mostly work in private practice. They also commonly use acupuncture as part of their treatment approach.
• Chiropractors are more aligned to osteopaths in their treatment approach. Similar to osteopaths, they focus on treating the musculoskeletal system and are especially known for their work with mechanical disorders of the spine. They take a holistic approach to restoring and maintaining health and as part of their treatment will often advise patients on general health care to maintain fitness and wellbeing. They use hands on techniques such as mobilisation and manipulation and are seen working predominantly in private practice.

A recent large-scale study on knee pain finds for instance, that torn cartilage that looks pretty abnormal, usually has nothing to do with the pain. People with pain-free knees have torn cartilage too.

If you went in for surgery to repair torn cartilage, it would not do anything for your painful situation.

A tear in an old person is not the same thing as one in a young person.

In an older person, a tear of the knee cartilage is just a part of growing old. The same applies for the spine.

Doctors used to look at scans of the spine and look at a lot of structures that looked abnormal; there would be herniated discs, degenerative changes and so on.

The doctors would worry that they needed to operate on everything they saw like that.

 It turns out that all these are normal in old people, and are usually pain-free i:e its normal. Usually because herniated discs can sometimes self-repair.  The doctors now are beginning to rethink the way they look at these things ( but not all of them !!!). They need to focus on arthritis pain relief, spinal pain relief, backache relief; they need to look at the specific reason behind it.Osteopaths have known for a long time that many of their patients have quite significant degenerative changes. Really through palpation and reduction in segmental movement or tissue fibrosis etc…

 MRIs don’t really help with that but they can often find “accidental” pathologies so that makes them priceless as they save lives.

So the medical community is proposing a new way in which to study MRIs and other scans. If an abnormality shows up in one, the radiologist is supposed to place it in context by providing information that speaks of how many times it’s been found that the abnormality in question is actually known to cause any pain.

2. Do drink some water to hydrate your muscles and soft tissues.

3. Arrive in plenty of time so you’re not rushed and can relax.

4. Tell your therapist if you haven’t had massage or this type of massage before.

5. Ask any questions you have about the massage treatment and what will happen.

6. If something doesn’t feel right during the treatment, it probably isn’t, so tell your therapist what you are feeling.

7. Also tell your therapist if:

•the pressure is too deep
•you are too hot or cold
•you don’t like the music
•you are uncomfortable in any way
•you are not happy with what they are doing
•you want the session to end
Remember this is your time and you are paying the therapist.

8. If you want to talk during your treatment, talk, if not don’t. The choice is yours.

9. Try to remain relaxed during the session, concentrating on your breathing will help.

10. Gather your thoughts before getting up from the table, you might feel lightheaded for a moment or two.

11. Drink sufficient water after to rehydrate your muscles and soft tissues.

12. Schedule time in after the massage treatment to relax and absorb the effects, at least 15-30 minutes.

Substantial numbers of UK workers risk their health and increase the possibility of developing injuries every day as a result of poor work habits.

A UK wide survey of more than 2000 employees by the CSP5 found that:

• one in four people (25%) regularly work all day without taking a break

• 31% experience physical pain at least once a week

• 46% of workers say their physical pains are due to working in the same position for a long time

• 53% cent of workers said they ‘always or usually’ go to work when they feel physically unwell.

Heavy workloads seem to be largely responsible for these poor work habits:

• half of those who work through their breaks (50%) do so because they have too much work to do

• almost a third (31%) say it is because there are too few staff to cover the workload.

A recent TUC report reveals that across the UK more than 5 million people worked on average in excess of seven hours a week unpaid overtime in 2009 – worth more than £27.4 billion. 9 This type of work culture has a detrimental impact on physical and mental well-being which can drive down an individual’s ability to cope. Performance and productivity can actually decline.

Encouragingly, when the CSP surveyed managers and employers6, 69% of small-medium enterprises (SMEs) said they felt it was important for their staff’s health that they had at least a 30 minute break at lunchtime.

from www.csp.org