back-pain-fit

Are back pain myths hindering your recovery?

Back pain is an almost unavoidable part of life.

1 in 6 people on the Northern Beaches are currently suffering from back pain of some description.[1] Back pain affects your work, sports, mental health, sleep and is a leading cause of disability worldwide.[2]

What if our attitudes and beliefs towards pain were also making it harder to recover from back injuries?

Studies have actually shown that how disabling back pain is to a person is more closely linked to their back pain beliefs, fear of physical activity and behaviours than the actual intensity of their pain.[3] These unhelpful beliefs about back pain are associated with higher levels of pain, disability, work absenteeism and medication use.[4]

The problem with unhelpful beliefs is that they too easily turn into often unhelpful behaviours. This makes the road to recovery longer and more painful. Behaviours such as avoiding normal spine postures (slouching while sitting) and meaningful activities (lifting, physical activity, activities of daily living and work) often lead to unhelpful protective behaviours such as muscle guarding, bracing core muscles and slow and cautious movement.[5]

Common back pain myths I’ve heard as a musculoskeletal physio

My back pain will be recurring and deteriorate as I get older

  • Even though lower back pain and back pain can be very painful quickly, with treatment from a great physio, pain can be reduced within a few weeks to months for most people.[6] Only a very small number of people develop long term or disabling problems when musculoskeletal therapy is sought early.[7]

Scans are always needed to detect the cause of back pain

  • Massive amounts of money are spent every year on X-rays, CT and MRI scans that benefit the prognosis and recovery of a very small number of people.[8] Scans can’t always determine the prognosis of back pain, the likelihood of future disability, or improve back pain clinical outcomes.

Back pain is caused by a weak core

  • Being weak in your core muscles alone isn’t the cause of your back pain. Recent studies have shown that there is no supporting evidencethat those with back pain have weak core muscles. Most likely is that any muscle deficit or atrophy is actually the result of back pain rather than the cause.[9] Learning to relax your core muscles during everyday tasks can actually be helpful, because being tense, or tensing your muscles for long periods of time is counterproductive.

If I have back pain I should stay in bed and rest

  • Avoiding aggravating activities for a few days after your initial injury should help to relieve pain. But, there is strong evidence that prolonged bed rest is unhelpful and is actually associated with higher levels of pain that last longer, greater disability and poorer recovery times. [10] Keeping active and returning your normal work, sport and hobby activities has been shown to aid recovery in the long run.[11]

Combining treatments to combat back pain

Depending on your specific type of back pain, your physio will usually recommend combined treatments for the most effective recovery. Combination programs have been shown to improve functions of the musculoskeletal system, resulting in reduced pain, reduced disability and improved quality of life.

Improving Spine stabilisation and keeping a correct posture can help keep back injuries at bay. [12]  Clinical pilates offers a highly targeted and researched methodology for targeting those core stabilisers. Strengthening the core through guided clinical pilates exercises can be the key to ensuring this process is maintained regularly.

Clinical Pilates sessions at Fixio are designed and run by experienced physiotherapists, experts in musculoskeletal function and rehabilitation. Clinical pilates at Dee Why has never been so personalised. Each session is conducted as an individualised program suitable for all ages and levels of fitness.

If you are suffering from back pain on the Northern Beaches and avoid seeing a physio, you are increasing your chances of your back pain persisting longer and a recurrence of the injury in the future. Don’t wait until the pain becomes severe or chronic, give Fixio a call and book in with a musculoskeletal physio.

 

[1] https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/what-are-back-problems

[2] Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet 2018;391:2368–83.

[3] Urquhart DM, Bell RJ, Cicuttini FM, Cui J, Forbes A, Davis SR. Negative beliefs about low back pain are associated with high pain intensity and high level disability in community-based women. BMC Musculoskelet Disord. 2008;9:148.

[4] Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 2010;24:205–17.

[5] O’Sullivan PB, Caneiro JP, O’Keeffe M, et al. Cognitive functional therapy: an integrated behavioral approach for the targeted management of disabling low back pain. Phys Ther 2018;98:408–23

[6] Grotle M, Brox JI, Glomsrød B, Lønn JH, Vøllestad NK. Prognostic factors in first-time care seekers due to acute low back pain. Eur J Pain. 2007;11:290-8.

[7] Lehmann TR, Spratt KF, Lehmann KK. Predicting long-term disability in low back injured workers presenting to a spine consultant. Spine. 1993;18:1103.

[8] Chou R, Qaseem A, Owens DK, Shekelle P. Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care From the American College of Physicians. Ann Int Med. 2011;154:181.

[9] Wirth, Klaus, Hagen Hartmann, Christoph Mickel, Elena Szilvas, Michael Keiner, and Andre Sander. “Core stability in athletes: a critical analysis of current guidelines.” Sports medicine47, no. 3 (2017): 401-414

[10] Hagen K, Hilde G, Jamtvedt G, Winnem M. Bed rest for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2009;

[11] Maher C, Latimer J, Refshauge K. Prescription of activity for low back pain: what works? Aust J Physiother. 1999;45:121-32.

[12] Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2006). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283-98.

frozen-shoulder

What is frozen shoulder and how is it treated?

What is frozen shoulder?

Frozen shoulder is a painful condition known by many names –

  • Adhesive Capsulitis – even though it’s not associated with capsular adhesions[1]
  • Idiopathic frozen shoulder
  • Periarthritis Scapulohumeralis

But no matter what label is put on it, shoulder guru Ernest Codman got it right way back in 1934 when he first described frozen shoulder as being “difficult to define, difficult to treat and difficult to explain from the point of view of pathology”.[2]

If the body wasn’t already stiff and sore enough already as we get older, frozen shoulder most commonly affects people in their 50s and is a prime culprit for limiting daily activities and disturbing sleep. It is a rare diagnosis before the age of 35 years and is unusual in patients over 70 years, with women marginally more affected than men.[3]

What does frozen shoulder feel like?

Frozen shoulder is characterised by a number of symptoms that can vary between each individual patient, but normally including a mix and match of:

  • Shoulder stiffness
  • Shoulder pain in the deltoid insertion area
  • Pain during the night pain that may wake you from sleep
  • An inability to lie on the affected side
  • Restriction of active movement and external rotation of the shoulder
  • Pain that radiates down the arm

The onset of frozen shoulder is usually gradual and can be brushed off as a general ache or pain before developing rapidly over a day or two.[4]

 

How long does frozen shoulder last?

The pain from frozen shoulder has been observed as passing through three distinct phases.[5]

  • Phase 1 or Freezing: 2–9 months – The painful phase, with progressive stiffening and increasing pain during movement
  • Phase 2 or Frozen: 4–12 months – The joint stiffening phase, where there can be a slight reduction in pain but increase in stiffness and restriction in range of motion
  • Phase 3 or Thawing: 12–42 months – The regaining mobility phase, where with physiotherapy treatment there is improvement in range of motion and resolution of stiffness

Can physiotherapy fix frozen shoulder?

Physiotherapy has been shown to be an effective supporting treatment for frozen shoulder, speeding up recovery, improving mobility and decreasing pain levels. A Fixio sports physio can assess your shoulder and use several methods to increase movement and decrease pain.

The goals of your treatment will depend on what stage of frozen shoulder you are currently in. These could be a mix of:

  • Relieving pain
  • Increasing arm movement
  • Reducing the duration of symptoms
  • Returning to normal activities

Regardless of treatment, studies have shown that patient success is directly influenced by the amount of knowledge they have about their frozen shoulder condition.[6] At Fixio, we believe that patient education is essential to managing your recovery.

What to remember about frozen shoulder:

  • At first, the pain will be your main problem: worse in bed, especially if lying on that side
  • The pain slowly eases, but stiffness then increases, becoming the main problem,
  • The whole process could last from a few months to two to three years without treatment
  • Using your arm will not do you any harm, but avoid doing too much
  • The treatment options are most effective depend on your circumstances; discuss treatment with your sports physio or musculoskeletal physio based on your needs

If you’ve got questions, Sports and musculoskeletal physios are experts in injuries, movements and activities related to sport, work and the day to day activities that were aggravating your shoulder so that you can get back to what you were doing before the pain.

[1] Maund E et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess 2012; 16: 1-264

[2] Codman EA. Arthritis, periarthritis, and bursitis of the shoulder joint. In: The shoulder. Boston: Thomas Todd Co; 1934. p. 216e24.

[3] Hand GC, Athanasou NA, Matthews T, Carr AJ. The pathology of frozen shoulder. J Bone Joint Surg Br 2007;89B:928–32.

[4] Dias R et al. Frozen shoulder. BMJ 2005; 331: 1453-6.

[5] Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005;331:1453–6.

[6] Jones S, Hanchard N, Hamilton S, Rangan A. A qualitative study of patients’ perceptions and priorities when living with primary frozen shoulder. BMJ Open 2013;3:e003452. doi: 10.1136/bmjopen-2013-003452. pmid:24078753.

slipped-disc

Back Pain – Part 2: Common disc problems and how physiotherapy treats them

Last week we looked at the symptoms, causes and risk factors of some of the back pain that stems from disc related injuries. This week we’ll be taking a peek at some of the most common disc related injuries and how sports physiotherapists accurately diagnose and treat them.

Read Part 1 here.

When it comes to back pain, it can be related to any number of different types of feelings that come from muscles, bones, vertebral joints and intervertebral disc or other structures in the spine. Some studies have shown that up to 28 to 40% all patients suffering low back pain were caused by a discogenic affliction.[1] Before you start bopping away to Saturday Night Fever, a Discogenic affliction isn’t anywhere near as funky as it sounds.

What are the most common discogenic injuries?

If you are suffering from chronic lower back or neck pain without the presence of a herniated disc, you may have discogenic pain stemming from degenerative disc disease, ruptured (or ‘slipped’) disc or sciatica.

Sciatica

Your sciatic nerve is the longest nerve in your body, so it should be no surprise that sciatica is one of the most common issues seen to by sports physiotherapists. Sciatica is the Latin word for “Pain down the back of the leg” but could really be described as more of a pain in the butt, hip, hamstring or lower back. Sciatica pain can cause a range of pain types from short and sharp, to infrequent and dull to debilitating. The most common cause of Sciatica is compression of the sciatic nerve due to a ruptured disc. Luckily, uncomplicated sciatica is very treatable and with a hands-on approach and some exercises with your physio, you should be all good to go shortly.

Ruptured disc

A ruptured disc injury is a common injury and can occur in your lumbar spine (lower back), thoracic spine (upper and mid-back) or your cervical spine (neck). The term ‘slipped disc’ is used interchangeably with ruptured disc, but this doesn’t paint an accurate description. You see, your discs are held in place by ligaments, muscles and the vertebrae structure and if they are slipping around the place, you’ve got bigger problems to fix I’m afraid. When the disc bulge is large enough for the disc nucleus to come out of the annulus, this is known as a herniated disc, about as close to a ‘slipped disc’ as medically possible.

How do physiotherapists treat disc injuries?

Physio has been shown to be an effective treatment for acute back pain associated with a discogenic injury in the lumbar spine. Due to the myriad of causes of discogenic pain, there are many different treatment protocols and possibilities. Firstly, your physio will take you through a thorough subjective and objective examination. Snapshots such as an MRI or CT scan may be required to confirm the diagnosis and extent of a lumbar disc bulge. Because physiotherapists are experts in human movement and musculoskeletal disorders, we understand the complexity of spinal structures and how these work together and how injuries occur. Your sports physio will be able to assess the problem associated with a disc bulge and provide an outline of the safe and effective treatment.

Physiotherapy treatment is designed to reduce the amount of inflammation and pain in the area by using a variety of mobilisation and soft tissue releases along with lower back strengthening exercises.

Our SMART Physiotherapy treatments are safe, effective and based on the most up to date research, guidelines and first-hand experience from sports physiotherapists.

Your treatment program could include:

  • Massage therapy along with spinal mobilisation
  • Specific exercises designed to improve mobility and decrease pain
  • Biomechanical assessment, correction and ergonomic advice
  • Activity modification – being active leads to faster recovery time – avoiding bed rest, prolonged sitting and poor lifting technique improves recovery

Functional training program

  • Information on correct bracing or taping

Using Clinical Pilates to increase Core strength and reduce back pain

Spine stabilisation and maintaining a correct posture is the key to keeping back injuries at bay.[2] Without strengthening your core this is just a pipe dream. FIXIO’s Clinical Pilates classes focus on targeting those muscles that are most important, while bringing your attention to the control and feel of how the exercises affect your muscles; increasing your own awareness of your body. Core strength plays a large part in a number of everyday activities like sitting for long periods of time, lifting weight, playing sports and even standing.[3] The more you work on and are aware of your core the less pain will suffer.

For more information on Pilates for core strength and treating back pain, give us a call on (02) 8964 4086 or book an appointment.

 

[1] Fukui S et al. Intradiscal Pulsed Radiofrequency for Chronic Lumbar Discogenic Low Back Pain: A One Year Prospective Outcome Study Using Discoblock for Diagnosis. Pain Physician 2013. Level : 3A

[2] Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2006). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283-98.

[3] Hsu, S. L., Oda, H., Shirahata, S., Watanabe, M., & Sasaki, M. (2018). Effects of core strength training on core stability. Journal of physical therapy science, 30(8), 1014-1018.

 

straight-back

Back pain – Part 1: What are the symptoms of disc related injuries?

Back pain doesn’t discriminate; it can affect people of all ages, sizes and backgrounds and getting to the bottom of the root cause of back pain can sometimes make a sports physio feel like Sherlock Holmes. With so many structures making up the back and spine, when a patient comes in and lays the blame of back pain on ‘a slipped disc’ or ‘pain in one of the discs’ I have to put my detective’s cap on rather than taking the pain at face value.

What is a disc?

Well it’s not a floppy disc (or so we hope!), it’s actually more like a jam donut. The term ‘disc’ is actually short for the term – ‘intervertebral discs’. Your spine is made up of 24 hard vertebrae that are placed on top of each other like building blocks. Between each of these hard building blocks are the spongy cushions (discs) that separate them. The hard outer shell of the disc is known as the annulus fibrosis and the soft, jam donut inner core is the nucleus pulposus. These intervertebral discs can take quite a lot of pressure before they become damaged, but particular movements and injury pathologies can damage the discs if in the wrong spot.

What are the symptoms of disc problems?

Damaged discs can cause a variety of symptoms and feelings in the area depending on the vertebrae in question and the severity of the injury. It’s actually quite common for disc injuries to fly totally under the radar and only become known from a scan or x-ray. Unless of course the disc has slipped far enough to catch the nerve roots extending from the spinal cord, then it’s a new world of pain. Common symptoms include:

  • Pain localised to the back/spine
  • Radiating pain in the butt, thighs, lower legs or even the feet
  • Pain that gets worse when bending over or sitting down
  • Pain exacerbated by sneezing or coughing
  • Pins and needles or numbness in an arm, fingers or leg
  • Muscular weakness in the back, core or legs

What are the common causes of disc related injuries?

Sports physiotherapists on the Northern Beaches are seeing an increase in disc related injuries that come as a result of inactivity rather than activity. This is because of the increasing amount of time people sit on their butts with poor posture, weak abdominal strength and a lack of stability in the lower back. Disc related injuries are more likely to occur when performing repetitive flexion & rotation movements like lifting heavy loads. The most common causes of disc issues we see normally come as a result of:

  • Prolonged sitting (especially with poor posture)
  • Bending over without engaging the core
  • Lifting (especially with poor form or without safety equipment)
  • Twisting
  • Pulling or dragging (again with poor back stability or core technique)

Who is at higher risk of developing disc related problems?

Often, there is no recognisable risk factor present that sets patients apart who have disc problems. However, some people are more susceptible to disc problems if they engage in a number of risk activities or suffer from other health problems such as:

  • Obesity
  • Poor muscle tone
  • Lack of regular exercise
  • Cigarette smoking
  • Advancing age
  • Poor posture
  • Incorrect lifting techniques.

Do I need surgery for a disc injury?

Luckily for most, surgery is not usually required in order to alleviate the pain caused by disc problems and get patients back to normal programming. With early intervention with a physiotherapist and a bespoke plan in place to treat and combat disc pain symptoms and causes, most flare ups only last a few weeks.

Surgery should only be considered after non-surgical options have been explored and a thorough course of action has been explored by doctors, surgeons and physiotherapists.

Read Part 2 here.

lower-back-stretch

Good news for lower back pain sufferers on the Northern Beaches

If you’re suffering from lower back pain that won’t go away, you’re one of approximately 4 million Australians who suffer from the condition at any one time.[1] Having spent my career as a sports physio on the Northern Beaches, I’ve seen my fair share of sport related back injuries along with back pain that seems to be related to nothing at all. For most of us who suffer a bout of back pain, it doesn’t usually last longer than 6 weeks, but for an unlucky group it becomes chronic, lasting 12 weeks or longer. I’ve been there myself and it’s absolutely the pits.

What causes lower back pain?

Back pain can be caused by sitting too much, standing too much, bending over too much, reaching out too much, running too much, lifting weights incorrectly and any other movement that puts  pressure on the body. Basically, lots and lots of things can cause lower back pain.

The majority of lower back pain is caused by the degeneration of the spine due to normal wear and tear as we get older. Lower back pain can also easily be caused by injury, obesity, pregnancy, poor posture and awkward sleeping positions.

What is different about chronic back pain?

Chronic pain is complex and can be difficult to pinpoint straight away. Associate Professor Daniel Belavy of Deakin University’s Institute for Physical Activity and Nutrition understands just how difficult non-specific chronic lower back pain can be to treat; “it means there is no specific anatomical cause – a bone defect or compression” with patients typically hurting their back in a random way and it doesn’t resolve itself as it normally would.

Belavy added that “when the pain has been there for more than 12 weeks … there are changes that happen in the brain and central nervous system that can cause the pain to stay there,” which adds to the difficulty in treating chronic lower back pain.

When do I see the physio?

The sooner the better. If you have suffered an acute injury playing sports or on the weekend mowing the lawn, FIXIO is your Dee Why physio chronic pain specialist. The longer an acute injury of the back is left to fester, the more chance of the body over compensating in other areas and causing further imbalances and referred pain.

People with lower back pain need to get to their doctor if they have any of the following symptoms:

  • difficulty walking or moving the legs
  • loss of bowel or bladder function
  • loss of sensation in the legs
  • very severe pain

How do physiotherapists treat back pain?

Physiotherapists can draw on years of study, observation and curing back pain of all varieties and use literally dozens of different techniques for treating back problems. First, your physio will take you through an in-depth physical examination in order to determine the exact cause of your back pain – back pain can have a variety of root causes.

Titled Musculoskeletal Physiotherapists are uniquely qualified to understand the complexity of lower back pain and use an evidence based approach to injury management in order to get results. Musculoskeletal physiotherapy is the most common form of intervention for chronic back pain and your back pain physio on the Northern Beaches will create and prescribe a bespoke program to not just combat the pain, but to protect and strengthen your back against future problems.

If you are suffering from back pain on the Northern Beaches and avoid seeing a physio you are increasing your chances of your back pain persisting longer and a recurrence of the injury in the future. Don’t wait until the pain becomes severe or chronic, give FIXIO a call on (02) 8964 4086 or email us to book at info@fixio.com.au.

[1] Australian Institute of Health and Welfare. (2004). Eighth biennial health report of the Australian institute of health and welfare. Canberra, Australia: Author

j11

4 Scoliosis tips from your local Physiotherapist

In my time as a physio on the Northern Beaches one of the most common concerns people bring up during their physical assessments is their ‘Scoliosis’. Scoliosis is one of those conditions that just sounds horrible isn’t it? I want to start by saying the likelihood of you ending up with a Quasimodo-like hump on your back due to the condition is AT LEAST a million to one. Scoliosis is simply derived from the Greek word for bent or curved and is used today to describe the lateral curve in the spine caused by the condition. Scoliosis commonly presents as one curve, called a C-curve, or two curves, called an S-curve and is classified as either structural or non-structural depending on whether or not there is an added rotation on the spine present with the curvature.

What are the signs of Scoliosis?

Unless you can turn your head 180 degrees to the back (in that case we have bigger problems than mere scoliosis) it might be hard to self-diagnose the possibility of scoliosis, but physiotherapists look for the following as indicators of scoliosis:

  • Your head is not centred directly over your body
  • One shoulder sits higher than the other
  • One shoulder-blade sits higher or is more prominently sticking out
  • You have unequal gaps on one side of your body between your arms and your trunk
  • One hip bone is more prominent than the other
  • You suffer pain around those areas that are imbalanced

What to do if you have been diagnosed with a scoliosis

Did you know that Usain Bolt was diagnosed with scoliosis early in his career? It’s certainly not a career ending condition by any stretch of the imagination. Depending on the position of the scoliosis in your spine, your physiotherapist will give you a number of exercises or stretches to regularly perform. There are also a number of things to avoid if you have been diagnosed.

  1. Getting sucked into buying lots of things to fix it

“When I first bought a tempurpedic pillow it made me realise I was basically sleeping on a pile of rocks up until that point.” Human being have been in our current form for at least 200,000 years. For how many of those years have we have nice soft mattresses and perfectly contoured pillows? There is no evidence to support the hype around sleeping paraphernalia. That being said, if you are having pain at night, it’s time to talk to your local musculoskeletal physio about it! Sleeping accoutrements aside, other nonsense things to avoid are posture braces, long term orthotics and consistently taping!

  1. Get strong

It is important to find yourself a local physiotherapist who is knowledgeable in a number of complementary treatment options. Recent studies have shown that clinical Pilates and Yoga can be an effective reliever of chronic discomfort along with other non-surgical options such as meditation, massage therapy and a well designed functional training program.

  1. Don’t sit for hours on end

You would be surprised at how much spine and neck pain is exacerbated simply by sitting and doing nothing. Unfortunately, whether you’re sitting at your work desk all day or on the couch watching cricket for hours on end, it’s likely that your neck and spine aren’t in their optimal positions. Get up at least every hour and stretch your body from side to side and have a walk around to avoid placing too much pressure on these areas constantly. If the pain is getting worse, walk on down to your Dee Why physio and pick my brain.

If you think you may have scoliosis, or you have been diagnosed with scoliosis but have been neglecting your exercises or you have never been given a full body assessment for your condition, it is important to visit a local physiotherapist with the skills and equipment to create an in depth program for you. Scoliosis is a relatively benign condition when treated correctly, but can lead to further complications in the future if it is neglected.

j10

5 hot tips to get rid of “sciatica”

The sciatic nerve is the longest nerve in the human body, so it should be no surprise that sciatica is one of the most common issues seen to by musculoskeletal physiotherapists. Sciatica is the Latin word for “Pain down the back of the leg” but could really be described as more of a pain in the butt, hip, hamstring or lower back. The most common cause of pain in the sciatic nerve distribution (which I shall call sciatica for this article) is compression of the sciatic nerve. It’s a tricky one as sciatica can manifest itself in many ways, none of them painless. Because the sciatic nerve runs through so many major parts of the body, it is common to see sciatica misdiagnosed as other localised ailments, meaning a longer recovery time and no shortage of pain. Sciatica pain can cause a range of pain types from short and sharp, to infrequent and dull to debilitating.

Signs you may have sciatica

  1. The pain usually only affects one side of the body
  2. Pain radiates through the lower back to buttocks and down your leg
  3. The pain is worse when sitting or remaining still
  4. There is burning, tingling or weakness in the leg on the affected side
  5. Light exercise (such as walking) may ease the symptoms

The good news is that sciatica is very treatable, and your local musculoskeletal physiotherapist is perfectly positioned to diagnose and treat your pain. While it’s relatively easy to diagnose the sciatica itself, usually there is an underlying cause from a different origin point. The following steps can help to keep some of the pain at bay, and rehabilitate the area so you can stay pain free longer.

  1. Sit less

Get off your butt! It might seem counterproductive when you have a sharp pain in your buttocks and leg to get up and walk around, but that’s exactly what you should be doing. Sitting for too long, such as at a desk or on the couch watching the cricket can cause your hip flexors to tighten up which is going to cause you even more pain. Set yourself a timer and stand up every 30-60 minutes, go for a walk and make a joke about Monday being a real pain in the butt.

  1. Take a dip in the pool

Apart from offering a place to escape the scorching heat, the pool is the perfect place to ditch sciatica. Once you’re feeling up to it, swimming slow and relaxed laps is a great way of easing pain, nerve spasms and relaxing the stiff muscles surrounding the painful area.

  1. Get a massage

Not just any massage, you need a physio skilled in the treatment of the pelvis and lumbar spine to give you a good working over. A titled musculoskeletal physiotherapist will be able to identify the root causes of your nerve pain and give you a massage that stimulates circulation through the affected area and helps to relax any muscle spasms.

  1. Strengthen your gluts

Strengthening the gluteal muscles (yes – the gluteus maximus is your big butt muscle!) is a great way to help prevent flare ups in the future. Many issues that affect the back and cause constant pain can be relieved by strengthening the hips and the core. Don’t go pumping out thousands of deadlifts, squats and crunches while you’re still in the primary phase of pain though, as that’s only going to hurt you more. Your local Dee Why physio will be able to conduct a full examination of your body and movements to give you the best core exercises for your body type and condition.

  1. Stretch

While you work with your physio to strengthen your core, increasing flexibility through your hips and lower back will be a key factor in keeping sciatica away. Muscular tension is a key trigger for sciatic pain, and having a daily routine of stretches will help build the resilience of your muscles, release the tension and prevent recurrence. Speak to your physio about the benefits of functional training on your body and the ways it can be used to strengthen the vulnerable areas of your body and protect them from everyday movements that cause pain. Clinical Pilates is also a proven avenue for painful conditions that affect the lower back and body, it’s certainly not just for middle aged mums and Instagram models!

WORD OF WARNING! Don’t sit on your sciatica pain! If left to its own devices, sciatica may go away on its own. Yet on the other hand, if left to it’s own devices the sheath of protective coating around the nerves (think of the plastic coating that is around all power cords) may whither away and die. It is much easier for us physios to fix a problem that has been there for a few weeks than a few months!

Get in contact with your local Fixio Northern Beaches physio and arrange an in depth treatment plan if you are experiencing sciatic pain, don’t let it restrict you from doing the things you love.

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