AREAS WE TREAT
Areas we Treat
As Osteopaths we don't just treat back pain, we treat a wide variety of musculokeletal complaints. From sports injuries and repetitive strain injuries to postural problems and headaches.
To find out a little more about common injuries we see in our clinic and how treatment may help just click on the area of the body below!
Headaches, Jaw and Sinus Pain
'Cervicogenic headache' is a term used to describe headaches arising from abnormalities in the joints, muscles, fascia and neural structures.
Typically cervicogenic headaches are described as constant, steady dull ache, often one sided but can be both sides. It can feel like a tight band around your head. Many people feel the tension at the base of their neck, it can also refer to the temples and forehead. Usually the onset is gradual and the headache can be present for days, weeks, even months! There is sometimes an acute trauma, for example a road traffic accident or it can be related to repetitive trauma associated with some sports or work related posture/poor posture. The posture adopted by many desk based workers of rounded shoulders and an extended neck puts tension through these muscles making them a prime candidate for cervicogenic headaches!
Pain is usually associated with neck stiffness and aggravated by neck movements and/or sudden jolting. Associated symptoms such as light headedness, dizziness and nausea are common. Your Osteopath will take a detailed case history and perform a physical examination to determine the cause of your headache, if appropriate they will proceed to treat you manually and provide advice and exercises.
Jaw pain is often be a symptom of temporomandibular disorder which is commonly multifactoral in origin and typically involves dysfunction of the muscles and joint/s. Displacement of the joint can occur causing wearing of the internal structures. Grinding and clenching teeth, trauma and osteoarthritis can all cause the movement of the joint to be disturbed.
After careful history taking and examination if appropriate your Osteopath will work to help to improve the function of the joint and relieve tension around the jaw. They will also be able to offer advice and in some cases exercises.
Sinus pain or sinusitis is inflammation of the lining of the sinuses, caused by viral or bacterial infections. The sinuses are small cavities behind the forehead and cheekbones, which drain mucus into the nose through small channels. These channels can become blocked when the sinuses are infected and inflamed.
The most common cause of sinusitis is the common cold, a viral infection spreads from the upper airways to the sinuses. All age groups can be affected and it often clears by itself within a week or two. Alternatively, bacterial infections can develop lasting for longer periods and may require antibiotics. If the episodes are severe or reoccurring you will be referred to a GP to determine any underlying factors.
Osteopathic treatment aims to relieve the symptoms and speed up recovery by massaging the local glandsand muscles, which drain the sinuses. Draining the sinuses often eases the feeling of compression in the head and subsequent pain.
As pain in this area can be caused by a multitude of factors it is important that you consult a medial professional. Headaches, jaw and sinus pain can sometimes be symptom of a serious underlying medical condition.
Neck pain is one of the most common musculoskeletal complaints, around 2 in 3 of us will experience neck painat some point. There is a huge range of reasons as to why someone may experience neck pain, most commonly it is due to injury to the apophyseal joints (small articulating joints in the neck) and intervertebral discs.
The discs between each vertebrae can become damaged, traumatic onset can occur with a whiplash type injury, in this case the onset may be sudden. Pain can also arise as a result of degeneration of the disc, the space between the discs will narrow as a result and can lead to formation of boney growths within this space called osteophytes. Both of these can cause acute as well as chronic pain. The small joints in your spine (apophyseal joints) are also susceptible to damage, again this can be traumatic or degenerative. In all these cases pain is often exacerbated by long periods of sitting, changing position, walking, bending and lifting and is usually worse in the morning and relieve by gentle activity. Occasionally nerves can be compressed as a result, depending on the area of the injury this can cause symptoms into the legs, including weakness, tingling and numbness. In a small number of cases pain in the lower back and legs can be a medical emergency so please consult a medical professional.
Trigger points within muscles can often make a significant contribution to the level of pain felt, it is less common for muscle pain to be the original problem but they can become the main source of pain and can contribute length of recovery time.
By taking and detailed case history and carrying out some clinical tests your osteopath will be able to establish the root cause of your pain and any contributing factors. If suitable, your osteopath will carry out treatment as well as offer advice. When appropriate exercises will be given to initially help manage the pain and the rehabilitate your back.
Neck pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.
Mid Back & Rib Pain
The most common cause of musculoskeletal pain in the thoracic spine are due to disorders of the intervertebral joints and rib articulations. This includes damage to the discs, facet joints (apophyseal joints), muscle strain and rib joint sprain (costovertebral joint sprain).
Disorders of the intervertebral joints can occur suddenly or gradually and can include inflammation, such as ankylosing spondylitis, degenerative change, such as osteoarthritis and mechanical joint sprains. Injury to facet joints (small articulating joints in the spine) is more common than disc injuries in the thoracic spine. Facet joint injury will produce localised pain and occasionally refer pain into the arms, chest or abdomen. Often there is associated muscle spasm, classically extension (bending back) will be more painful than flexion (bending forwards).
Pain is the most common symptom of a disc herniation, movement may become limited and coughing and sneezing may increase the pain. Depending on where the injury is pain can be referred to other areas including the arms, chest and abdomen. Muscles in the surrounding area may become stiff and painful also.
Rib joint (costovertebral and costotransverse) injury is associated with localised tenderness and restricted movement of the joints. Pain can be felt locally, it may also radiate around the chest or shoulder blade. Coughing, sneezing and deep breathing can cause sharp pain. All movements can be affected especially rotation.
Scheuermann's disease is the most common cause of back pain in adolescents. It is caused by differing growth rates in the front and back of each vertebral segment, resulting in wedge shaped vertebra - This causes a rounded back (kyphosis). It more commonly affects the lower portion of the mid back. Depending on the severity it can cause significant back pain, often aggravated by activity or long periods of sitting or standing.
By taking a detailed case history and performing an examination your osteopath should be able to determine the cause of your back pain and provide appropriate treatment and management.
As with all musculoskeletal pain it can be a symptom of an underlying medical condition always consult a medical professional.
Lower Back Pain
There is a very wide variety of reasons as to why someone may experience lower back pain, the most common causes are due to injury of the apophyseal joints (small articulating joints in the spine) and intervertebral discs. Trigger points in the gluteal muscles can also cause pain around the lower back. Pain can also refer to the lower back from the hip or sacroiliac joint (SIJ). Back pain is thought to affect 85% of the population at some point in their lives, there are a number of different factors which are associated with an increased risk of back pain. Below highlights a few of these risk factors;
The discs between each vertebrae can become damaged, traumatic onset often occurs when bending and twisting as this is when the discs are under most pressure. In this case the onset may be sudden and many people can record "feeling their back go". Pain can also arise as a result of degeneration of the disc, the space between the discs will narrow as a result and can lead to formation of boney growths within this space called osteophytes. Both of these can cause acute as well as chronic pain. The small joints in your spine (apophyseal joints) are also susceptible to damage, again this can be traumatic or degenerative. In all these cases pain is often exacerbated by long periods of sitting, changing position, walking, bending and lifting and is usually worse in the morning and relieve by gentle activity. Occasionally nerves can be compressed as a result, depending on the area of the injury this can cause symptoms into the legs, including pain, weakness, tingling and numbness. Pain radiating down the back of one or both legs is often reffered to as Sciatica as this is usually caused by irritation of the Sciatic Nerve.
Trigger points within muscles can often make a significant contribution to the level of pain felt, it is less common for muscle pain to be the origin of the problem but they can become the main source of pain and can contribute length of recovery time.
The sacroiliac joint (SIJ) is a large joint between the iliac bones (hips bones) and and the sacrum (triangular bone at the base of the spine). It is held together by very strong ligaments so as a result has very little movement in it, however, a great deal of force goes through these joints to hold us upright which can lead to wear and tear and arthritis.
Pregnancy can be another cause of sacroiliac pain, during pregnancy the body releases hormones to relax ligaments in preparation for child birth. This allows for increased range of movement through the sacroiliac joints leading to increased stress and abnormal wear. The additional weight and altered gait (walking pattern) adds further stress to the joint. Any condition which may alter normal gait will have an impact of sacroiliac function, this includes injury to the ankle, knee and hip. In these cases it is especially important to perform a full analysis of biomechanics as treating the underlying condition will most often result in SIJ pain reducing.
The most common symptom of SIJ disorders is pain, this can be in the lower back, hips, groin or thigh. This is typically worse with standing/walking and relived by rest, although sitting in one position for a long period can also be uncomfortable.
By taking and detailed case history and carrying out some clinical tests your Osteopath will be able to establish the root cause of your pain and any contributing factors. If suitable, your Osteopath will carry out treatment as well as offer advice. Where appropriate exercises will be given to initially help manage the pain and eventually to rehabilitate your back.
Lower back pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.
Whilst one of the more common causes of musculoskeletal chest pain is due to referral from the mid back (thoracic spine), pain can also be due to injury of the rib joints at the front of the chest, muscle strain, shoulder injury and collar bone injury (sternoclavicular).
Inflammation can occur at the joints between the sternum and ribs, this will cause activity related pain and tenderness over the area. The condition is sometimes referred to as Tietze's syndrome. Your Osteopath will be able to carefully assess the area and decide on the appropriate course of action to take. If appropriate this will usually include a combination of treatment, advice and rehabilitation exercises.
Chest pain can indicate a serious underlying medical condition. Please always consult a medical professional.
The shoulder is a complex joint and pain can occur due to injury of many different structures. One of the most common muscular injuries in the shoulder is to the rotator cuff. The rotator cuff are a group of muscles which stabilise the shoulder joint, they can become easily injured in sports or repetitive movements of the arm. Alongside pain people often experience weakness and limited movement in the shoulder, you may find it difficult to perform activities involving raising the arm or simple movements such as putting a coat on.
Occasionally ligaments or the capsule around the shoulder joint (glenohumeral joint) can become damaged, this can often be due to a traumatic onset such as a fall on an outstretched hand. It can be very painful and people will often notice 'poping', 'clicking' or painful catching in the shoulder. This type of fall can also typically affect a small joint called the acromioclavicular joint (ACJ), pain is often felt over the ACJ at the tip of the shoulder. Movements involving reaching across the body can be painful.
Frozen shoulder (adhesive capsulitis) occurs in about 3-5% of the population. It is a very painful condition and can be classified into three stages. 'Freezing', this is the first stage characterised by progressive loss of shoulder movement and an increase in pain (especially at night). The shoulder still has some range but is limited by both pain and stiffness. 'Frozen', this is the second stage where one has a greatly decreased range of shoulder movement. During the early part of this stage, there is still a substantial amount of pain. Toward the end of this stage, however, pain decreases. 'Thawing', in the final satge there is a big decrease in pain, especially at night. There is still a limited range of movement, but ability to complete daily activities involving overhead motion is improving at a rapid rate. The cause of frozen shoulder is not well understood, there is an increased incidence with conditions such as diabetes, hyperthyroidism and hypothyroidism.
With careful examination and testing, Osteopaths are able to determine the cause of your shoulder pain and if appropriate will be able to treat the condition accordingly with manual therapy and exercise prescription.
One of the most commonly known conditions affecting the elbow is 'tennis elbow' or lateral epicondylitis. Although, it's not always racket sports which cause the injury! Those of you who spend a lot of time using a computer can also be susceptible due to the repetitive movements of using a mouse or keyboard. Pain is often felt on the outer part of the top of the forearm but it can radiate down the arm to the wrist as well.
'Golfers elbow' or medial epicondylitis is a very similar condition but occurs less often and affects the muscles originating from the inside of the elbow. Golf isn't the only sport to cause excess loading of this area, activities involving throwing or using hand tools can also cause damage to these tissues. Pain usually starts on the inside of the elbow and can radiate down the forearm, you may find it hard to grasp objects.
Another condition which may cause pain on the inside of the elbow is cubital tunnel syndrome. This is compression of the nerve which runs down the inside of your elbow. As well as localised pain you may feel pain and/or numbness down the inside of your forearm and into your 4th and 5th fingers.
With careful advice, treatment and excises Osteopaths are able to treat and manage such conditions.
Common injuries of the wrist include wrist ligament sprains or tears, tendinopathies (damage to the tendons of the muscles in your forearm and hand), fracture of the radius or scaphoid and compression of the nerves in the wrist (carpel tunnel syndrome).
Injuries in the wrist can often occur due to a fall on an outstretched hand. Occasionally this results on dislocation of one of the carpel bones (wrist bones). Symptoms include, significant pain in the wrist and palm of the hand, swelling and limited movement. People may also experience symptoms of carpal tunnel syndrome.
Carpel tunnel syndrome is the name given to compression of the median nerve in your wrist. Burning pain is commonly felt over the wrist with numbness or tingling in the thumb, index and middle finger. The numbness often occurs at night.
Many of the tendons around the wrist can become painful with excessive activity, this is termed tendinopathy. There is often tenderness over the area and occasionally swelling and crepitus. Gripping and lifting objects may become difficult.
An Osteopath should be able to determine the cause of your wrist pain and whether you are appropriate for treatment by performing a series of physical examinations and taking a careful case history. Treatment will usually involve a combination of manual therapy, advice and rehabilitation exercises.
Common causes of hand and finger pain include fracture of the metacarpals, dislocations and ligament sprains. Fractures can occur with trauma to the hand, people will experience significant pain, swelling, loss of grip and loss of mobility.
Ligament sprains can occur for a variety of reasons. Forced hyperextension (bending back) of the fingers can damage the ligaments on the palmer aspect and again cause swelling, pain and loss of mobility. 'Skiers thumb' is the term given to damage to one of the ligaments over the thumb, it's an injury commonly seen in skiers as it often occurs during a fall on an outstretched thumb especially when gripping (ski pole). Gripping and pinching will often become painful and range of movement will be limited.
By performing a series of physical examinations and by taking a careful case history an Osteopath should be able to determine the cause of your hand/finger pain and whether you are appropriate for treatment. Treatment will usually involve a combination of manual therapy, advice and rehabilitation exercises.
Hip and Groin Pain
Adductor muscle and hip flexor strains are a common cause of groin pain, these are the muscles which attach at the top of you thigh and on your pelvis. Injury to these is common in sports where there may be sudden changes of direction or repetitive kicking movements. Pain can be very acute and is usually well localised to the area. Recurrent adductor and hip flexor strains are common for a number of reasons its therefore important to carefully analyse why someone developed the initial injury, this often involves looking at biomechanics and running technique.
Bursa in the hip can sometimes become inflamed (bursitis), bursa are little fluid filled sacs which act as a cushion between tendons and bones. Hip bursa can become inflamed with repetitive hip movement or trauma to the area. Bursitis usually cause pain and localised swelling and tenderness.
The tissue around the hip joint called the labrum can become torn, this may be due extrinsic factors such as trauma to the hip, excessive loading or repetitive activity both active (dancing, martial arts) and passive (cycling, driving for long periods) and intrinsic factors such as poor postural tone and abnormalities in the hip joint. Pain is usually dull and 'nagging' and often accompanied by 'clicking' or 'catching' sensation in the hip.
After taking a case history from you, your Osteopath will perform a series of simple test to gain a complete picture of which structure/s have been injured and then provide appropriate treatment and management. Treatment usually consistis of manual therapy, advice and exercise rehabilitation.
Hip and groin pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.
Quadriceps muscle strains are the most common cause for local pain at the front of the thigh. Pain can also be referred to the front of the thigh from the lower back, hip or SIJ so these are also important considerations. Quadriceps muscle strains often occur during sprinting, jumping or kicking. Like all strains they can be of different severities, it may be a sudden injury during activity where there will be acute pain, localised tenderness and if severe swelling and bruising. More minor strains may not even be noticed until the following day.
Similarly, pain at the back of the thigh can potentially also be referred pain from the lower back, SIJ or hip. However hamstring muscle strains are very common, sports involving sprinting and jumping have an increased incidence of hamstring injuries. Symptoms are similar to quadriceps injuries. There are number of factors which have been found to predispose to hamstring injury such as, flexibility, strength, lumbo-pelvic stability, joint dysfunction, fatigue and training modalities.
Your Osteopath will carefully assess you in each of these areas to provide an individual and effective treatment and rehabilitation programme.
Thigh pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.
The knee is a very complex joint and there are a wide number of structures which can become damaged causing pain in and around the knee. Acute knee pain can be most often attributed to damage of the meniscus (cartilage inside the knee) or ligaments around/inside the joint. Damage to the meniscus can be due to trauma or simply degenerative. Traumatic onset can typically involve twisting through the knee whilst the foot is grounded. This can be associated with a 'clicking' or 'popping' noise, people often will feel 'catching' in the knee or report it to 'lock' or 'give way'. Swelling with traumatic onset is usually rapid, with degenerative tears this may happen very slowly. Meniscus injury is often accompanied by a tear of the anterior cruciate ligament (ACL) inside the knee. This commonly occurs in sports when jumping, pivoting or decelerating. Symptoms are much the same as meniscus injury. The medial collateral ligament (MCL) on the inside of the knee is also vulnerable to injury, again often in conjunction with meniscus and ACL injury. All three of these structures can suffer damaged isolated as well as together.
Patella tendinopathy, patellofemoral pain and fat pad impingement can all cause pain over the front of the knee. Pain caused by damage to the patella tendon (Patella tendinopathy) is usually felt just under the knee cap (Patella), there may be slight tenderness over this area. It can be aggravated by squatting and climbing stairs. Swelling is rare but the tendon can become thick. Patellofemoral pain is caused by altered movement of the patella over the femur (thigh bone) it is common amongst runners, pain is vague and there may be slight swelling. 'Creaking' and 'clunking' in the knee is often reported. This is often associated with abnormalities of biomechanics so it is important to address these factors. Fat pad impingement is associated with repeated extension of the knee, pain can be very acute. There is usually tenderness just under the patella and it may appear 'puffy'.
Iliotibial band (ITB) friction syndrome (ITBFS) effects the outer part of the knee, it is caused by friction between the ITB and the femur often reffered to as 'runners knee'. An ache will be felt over the outer part of the knee which will be aggravated by running, longer or downhill runs tend to aggravate the pain more. There is usually localised tenderness over the area alongside trigger points in the TFL and gluts. Abnormalities in biomechanics are strongly associated with ITBFS so it is important that the practitioner performs a gait analysis.
Your Osteopath will take a detailed case history and use a variety of clinical tests to diagnose which structures are damaged, then treat and manage appropriately using a combination of manual therapy, advice and exercise rehabilitation.
Knee pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.
Lower Leg and Calf Pain
Shin pain can often arise due to a combination of factors such as; muscle and tendon injuries/strains, inflammation where muscles attach onto the shin bone (tibia), bone stress fractures, raised pressure inside the lower leg and nerve entrapment. All of these conditions can be linked to one another and will sometimes lead to one another.
Abnormalities in biomechanics when exercising can lead to muscle fatigue and failure to adequately shock absorb, leading to 'shin splints' (medial tibial traction periostitis). In chronic cases this can then lead to stress fractures and deep compartment syndromes (raised pressure inside the leg).
Pain at the back of the leg in the calf can be due to muscular strains or cramps, again biomechanical factors may predispose to this. Pain in the calf can be quite acute and occasionally 'stabbing' in nature, if it is a muscular injury it is likely to be exacerbated by activity. With careful advice, treatment and rehabilitation exercises your Osteopath will be able to provide effective treatment.
Your Osteopath will be able to assess the cause of the problem including any biomechanical abnormalities and provide effective treatment and management. Treatment usually consists of manual therapy, advice and exercise rehabilitation.
Calf pain can sometimes be a symptoms of an underlying medical condition and can be attributed to vascular or neurological abnormalities. Please always consult a medical professional.
Ankle and Foot Pain
Ligaments are the most commonly injured structure in the ankle, the ligaments on the outer part of the ankle are weaker than the ones on the inner side and therefore more commonly injured. Injury to these ligaments can often occur in activities which require a sudden change of direction, especially on uneven surfaces. People often recall an audible 'snap', 'crack' or 'tear' accompanying the sprain. Swelling usually occurs rapidly, although occasionally it can be delayed by a few hours. The pain is acute and weight bearing and walking will often exacerbate the pain.
Tendonopathies, tendon ruptures and fractures can also cause acute ankle pain, although are less common. The mechanism of injury and symptoms are similar to ligament sprains.
A condition of the foot which is commonly seen by Osteopaths is 'plantar fasciitis', pain is felt along the sole of the foot and can be often focused around the heel. Classically the onset is gradual, pain if often noted to be worse in the morning and relieved by gentle activity during the day. As the condition becomes more severe pain may be present when weight bearing and worsen with activity. Development of this condition can often be attributed abnormalities of biomechanics which can be carefully assessed by your Osteopath.
Tendinopathies and joint sprains can also be causes of foot pain. With careful examination and sometimes gait analysis the cause of the injury can be determined by your practitioner along with factors which may be affecting recovery time.
After careful examination your Osteopath will be able to determine the cause of the pain and will be able to provide appropriate treatment and rehabilitation. Treatment usually consists of manual therapy, advice and exercise rehabilitation.
Foot and ankle pain can sometimes be a symptom of a serious underlying medial condition, please always consult a medical professional.