In November last year the National Institute of clinical excellence (NICE) updated its recommendations for Lower Back Pain and Sciatica in an effort to re-evaluate best practice for treatment of these conditions. The summary of this is a combined management of your symptoms with a manual therapy package, some forms of anti-inflammatory medication in the short term, psychological therapy and exercise. To a very large degree this is something that Osteopathy has been offering and or recommending to patients for many years.
Lets be clear on a few things first. What do the guidelines mean by lower back pain? Well they use words like ‘non specific’ and ‘not long lasting’ with improvements within weeks to months. But many people suffer from ‘non specific’ lower back pain for much longer periods and NICE do accept that the important issue is trying to reduce risk of a poor outcome i.e. non resolving. There are many differing causes of lower back pain from direct injury to muscles and joints caused by lifting something heavy or twisting, to long term repetitive less specific causes such as sitting in an office for long periods which cause stiffness and aching and we haven’t even considered wear and tear to the joints and the effects that that can cause – all of which can be either prevented or managed with Osteopathy.
And what about Sciatica? I see many people who self diagnosed themselves with ‘Sciatica’ without really knowing what it is. NICE define Sciatica it as ‘neuropathic leg pain secondary to compressive spinal pathology’. For most laymen it seems to have become a term for any leg pain, whereas in reality it is a quite specific set of symptoms which often include a sharp shooting pain tracking down the back of the thigh to the ankle, with or without lower back pain. Sciatica is caused by compression of the sciatic nerve and the most common cause of this is bulging disc, however some symptoms of sciatica can be present without this and just to confuse you even more approximately 30% of the population have been found to have some form of disc pathology without any back or sciatic symptoms at all. What you need to know is that your sciatic leg pain symptoms are more likely to be coming from your back than from your leg even if you don’t have back pain.
The much more important thing to understand is what you as a sufferer can do about it. Rest and doing nothing certainly will not help in the long term. Your can visit your GP who will probably give you some form of medication to help ease the symptoms and some exercises or refer you to a physiotherapist, but the appointment may take a while to come through and what do you do in the mean time. Visiting an Osteopath can help in offering a manual treatment of your symptoms, offering you an initially gentle exercise package and suggest some life style choices that will also help you to further reduce symptoms and prevent them from coming back. Whilst Osteopathy cannot prescribe medication the NICE guidelines recommend certain anti-inflammatory medication such as Ibuprofen as long as they do not cause you any side effects and are only for a short period of time.
So if you have a long standing or even a recent bout of lower back pain then book in for a 15 minute free consultation to see if I can help in any way. Osteopathy has used principles for treatment of lower back pain for years that are now being recommended for GP’s to advise you on. By far the most important person in successful resolution of lower back pain is you, whatever treatment type you decide to take.