Do you have back or neck pain you are concerned about?
Do you have back or neck pain that is affecting your work or sporting performance?
Danger signs include...
• Leg pain
• Arm pain
• Headaches and migraines
• Pins and Needles
• Hot or Cold sensations
• Weakness and loss of strength
You require the Right Assessment, Diagnosis & Treatment ... We Can Help You!
Our total assessment includes 2 separate visits:
1. Initial Consultation
- Detailed health history
- Comprehensive Physiotherapy, orthopaedic and neurological exam
- X-ray / MRI analysis if required (not included in fee)
2. Report Consultation (which you must attend)
Written report detailing:
- What you need to do to change your current symptoms
- What we can do to help
- How long it will take
- How much it may cost (you may have to pay part if you are insured)
- Treatment can begin immediately
To book call 0870 240 4667 to arrange a consultation with Dr Mike Squirrell
Mike Squirrell Physiotherapy is one of the UK's leading Back Pain specialists in the W1 area of London at 76 Harley Street W1G 7HH.
About Back Pain
Back Pain is one of the most common problems in the UK and more than people suffer from back pain.
Mike Squirrell Physiotherapy Harley Street have the answers to all of your back pain problems. Don't take the pain, seek treatment at our Harley Street back pain clinic.
Types of Back Pain
Chronic pain is defined as pain that persists longer than the temporal course of natural healing, associated with a particular type of injury or disease process.
The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." Pain is subjective in nature and is defined by the person experiencing it, and the medical community's understanding of chronic pain now includes the impact that the mind has in processing and interpreting pain signals.
Pain may be a response to injury or any number of disease states that provoke nociception. Advances in imaging studies and electrophysiological studies allow us to gain a deeper insight into the characteristics and properties associated with the phenomenon of chronic pain
Chronic Back Pain Rehabilitation
As alluded to earlier there are other modalities used in the treatment of chronic pain. These include: physical modalities such as thermal agents and electrotherapy. Complementary and alternative medicine, therapeutic exercise and behavioral therapy are also utilized autonomously or in tandem with interventional techniques and conventional pharmacotherapy. This is most often structured in a multidisciplinary or interdisciplinary program. Return to types of back pain
According to the most widely accepted definition, neuropathic pain is "initiated or caused by a primary lesion or dysfunction in the nervous system." Neuropathic pain cannot be explained by a single disease process or a single specific location of damage.
Neuropathic pain may be associated abnormal sensations called dysesthesias which occur spontaneously and allodynias that occur in response to external stimuli. Neuropathic pain may have continuous and/or episodic (paroxysmal) components. The latter are likened to an electric shock. Common qualities of neuropathic pain includes burning or coldness, "pins and needles" sensations, numbness and itching. nociceptive pain is more commonly described as aching.
As much as 7% to 8% of the of the population is affected and in 5% it may be severe.Neuropathic pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). Thus, neuropathic pain may be divided into peripheral neuropathic pain, central neuropathic pain, or mixed (peripheral and central) neuropathic pain.
Central neuropathic pain is found in spinal cord injury, multiple sclerosis, and some strokes. Fibromyalgia, a disorder of chronic widespread pain, is potentially a central pain disorder and is responsive to medications that are effective for neuropathic pain.
Neuropathic pain is common in cancer as a direct result of cancer on peripheral nerves (e.g., compression by a tumor), or as a side effect of chemotherapy, radiation injury or surgery.
Treating Neuropathic Pain
Neuropathic pain can be very difficult to treat with only some 40-60% of patients achieving partial relief.
In addition to the work of Dworkin, O'Connor and Backonja et al., cited above, there have been several recent attempts to derive guidelines for pharmacological therapy. These have combined evidence from randomized controlled trials with expert opinion.
Determining the best treatment for individual patients remains challenging. Attempts to translate scientific studies into best practices are limited by factors such as differences in reference populations and a lack of head-to-head studies. Furthermore, multi-drug combinations and the needs of special populations, such as children, require more study.
It is common practice in medicine to designate classes of medication according to their most common or familiar use e.g. as "antidepressants" and "anti-epileptic drugs" (AED's). These drugs have alternate uses to treat pain because the human nervous system employs common mechanisms for different functions, for example ion channels for impulse generation and neurotransmitters for cell-to-cell signaling. Return to types of back pain
Acute Back Pain is the term to describe how long the painful symptoms last and not to describe the severity of the pain itself.
Acute pain usually lasts no longer than six weeks. Return to types of back pain
Mechanical Back Pain is also called by a number of other medical terms. These are:
- Non-specific back pain
- Osteoarthritis of spine (without neurological changes)
- Simple backache
- Back strain or sprain
- Lumbar spondylosis or spondylitis
- Spasm of back
- Back pain
- Degenerative back problem or disease
- Chronic back pain
- Muscular back pain
Most people (60-80% of the world’s population) will experience back pain at some point in their lifetime. 85-90% of all episodes of back pain are non-specific or mechanical in nature.
Mechanical means that the source of the pain may be in the spinal joints, vertebrae or soft tissues. However, in the vast majority of cases of mechanical back pain it is not possible to identify a pathologically definable problem. That is, no structural abnormality of the back can be found on examination or x-ray to account for the symptoms.
Multiple studies have shown that spinal abnormalities are as common in symptom free individuals as they are in those who have back pain. These incidental findings may include:
- Non-specific degenerative changes
- Bulging inter-vertebral discs
- Desiccated discs
- Soft tissue and/or bony abnormalities
Specialised investigations such as Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI) scans have also failed to identify a cause for MBP.
Many alarming abnormalities in the lumbar spine and associated structures have been discovered in symptom free people with normal back function on MRI/CT imaging. Mechanical back pain is therefore best described as non-specific.
Once an individual has experienced their first episode of mechanical back pain, although the episode itself is usually self-limiting and resolves quickly, there is an increased risk of further back pain episodes.
Risk factors for recurrent back pain include:
- Previous pain syndromes (e.g. Fibromyalgia)
- Poor socio-economic status
- Psychological distress at presentation
- Dissatisfaction with employment
- Heavy manual work
Courtesy of www.dwp.org.uk
Sciatica is a set of symptoms including pain that may be caused by general compression and/or irritation of one of five nerve roots that give rise to the sciatic nerve, or by compression or irritation of the sciatic nerve itself. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.
Although sciatica is a relatively common form of low back pain and leg pain, the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve, causing the pain. This point is important, because treatment for sciatica or sciatic symptoms will often be different, depending upon the underlying cause of the symptoms.
Return to types of back pain
Low back pain (sometimes referred to generally as lumbago) is a common symptom of musculoskeletal disorders or of disorders involving the lumbar vertebrae. It can be either acute, subacute or chronic in its clinical presentation. Typically, the symptoms of low back pain show significant improvement within two to three months from its onset. In a significant number of individuals, low back pain tends to be recurrent in nature with a waxing and waning quality to it. In a small proportion of sufferers this condition can become chronic. Population studies show that back pain affects most adults at some stage in their life and accounts for more sick leave and disability than any other single medical condition.
An acute lower back injury may be caused by a traumatic event, like a car accident or a fall. It occurs suddenly and its victims will usually be able to pinpoint exactly when it happened. In acute cases, the structures damaged will more than likely be soft tissue like intervertebral discs, muscles, ligaments and tendons. With a serious accident, osteoporosis or other causes of weakened vertebral bones, vertebral fractures in the lumbar spine may also occur. At the lowest end of the spine, some patients may have tailbone pain (also called coccyx pain or coccydynia). Others may have pain from their sacroiliac joint at the bottom of the lumbar spine, called sacroiliac joint dysfunction (see sacroiliac joint for more information). Chronic lower back pain usually has a more insidious onset, occurring over a long period of time. Physical causes may include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae, or a spinal disc herniation, a vertebral fracture (such as from osteoporosis), or rarely, a tumor (including cancer) or infection. Return to types of back pain
Upper back pain, also called middle back pain or thoracic pain, is pain that is felt between the bottom of the neck and top of the lumbar spine. The upper spine is very strong and stable to support the weight of the upper body, as well as to anchor the rib cage which provides a cavity to allow the heart and lungs to function and protect them.
The word “thoracic” means pertaining to the chest, and the thoracic spine comprises the upper portion of the spine that corresponds to the chest area. The upper spine includes twelve vertebrae, and each of the upper nine vertebrae in this section attach to the a rib on either side of the spine. Each of the ribs then curves around the side of the body and attaches to the breastbone in front. This forms a sturdy structure (the throracic cage) that supports and protects the internal organs - the heart, lungs and liver.
The most common cause of upper back pain is believed to originate from muscular irritation or other soft tissue (e.g. ligament) problems. These can arise from lack of strength, poor posture, overuse injuries (such as repetitive motion), or a trauma (such as a car accident or sports injury). Muscular strain in the upper back is usually treated by one or a combination of the following:
- Exercise/Active and passive physical therapy
- Joint manipulation, as commonly performed by chirpractors or osteopathic physicians
- Deep massage or massage therapy
- Ice and/or heat therapy
- Analgesics such as non-steroidal anti-inflammatory drugs
If there is a specific tender spot, then trigger point massage or injections can be helpful.
Another cause of upper back pain is problems with the joints that connect the vertebrae and the ribs. Treatment for joint problems such as this usually includes:
- Manual manipulation (with an osteopathic physician or chiropractor)
- Exercise and physical therapy
- Pain medications such as anti-inflammatory medications
A compression fracture of the vertebra can also cause acute and/or chronic pain in the upper back. Especially for women over age 50 with complaints of upper back pain, a vertebral compression fracture due to osteoporosis should always be considered a possibility. A painful vertebral compression fracture may be treated with pain medication and rest, or with vertebroplasty or kyphoplasty surgery.
Other, less common causes of upper back pain include a spinal disc herniation, degenerative disc disease, or some type of trauma (such as a fall) that may have fractured a vertebra in the thoracic spine. Return to types of back pain