How could meditation possibly cure my pain? That’s impossible, isn’t it?

Channel Nine news in Brisbane recently ran a story about using “mindfulness” to treat back pain. A couple of patients have since asked me about it, so I thought I’d use that story as a catalyst for this month’s piece.

What is “mindfulness”?  Mindfulness is a form of brain exercise in which you try to keep your thoughts only in the present. While doing this meditation you attempt to let go of worries, thoughts and judgments, and concentrate only on observing yourself; most people find it easiest to focus on the inward and outward flow of their breath. Once you have achieved this state of mindfulness, you can then add other mental techniques such as progressive muscle relaxation and positive thinking.

But, I hear you wondering, how could such a simple technique help overcome back pain? Surely fixing my bulging disc, relaxing my tight muscles or loosening my worn out joints have more to do with curing my pain than some silly meditation?

"Back Pain: How to get rid of it Forever"

I pondered this question myself at length many years ago when researching for my book “Back pain: How to get rid of it Forever'”.

I spoke with psychologists and doctors, and examined a lot of research, including some very interesting work done on chimpanzees. I gradually realized that psychological approaches to pain are one of many tools that you have at your disposal to help you improve your health. Just like stretching and strengthening exercises, physio treatment, good nutrition and keeping fit are all a part of the holistic treatment of conditions such as back pain, having the correct mental approach is another weapon that you can use to cure yourself. Even better, once you master the meditation techniques they are free!

As a result of my studies into the psychological aspects of back pain, I expanded the relevant chapters into a separate booklet entitled “Using your Brain to get Rid of your pain”. (Keep reading for free gifts at the end of this article!) This booklet explains how your mindset can either cause or help to cure physical ailments such as headaches, back pain and even arthritis.

It’s a very complex subject, but the summary is as follows:

Stressed mum

Modern day stress can arise from many sources

Stress from any cause – not enough money, fighting with your partner, or just being too busy with a young family etc etc – induces a reaction in your body known as the fight-or-flight response. In this state your body releases hormones and other chemicals designed to help you fight (to save your life) or to run away from danger. In ancient times this response was useful, but nowadays, when our worries are often more prolonged than being attacked by a dinosaur, the fight-or-flight response gets in the way. Ultimately it can cause pain and other physical symptoms.

How does the fight-or-flight response cause such pains and problems? First, the released hormones change your bodily systems so that blood flow and energy are diverted to your muscles in preparation for battle or escape. To facilitate this it shuts down or minimizes background systems such as repair and maintenance. This state is fine for a few minutes, but if maintained through a long stressful period then damage will eventually accumulate due to the low background rate of your body’s repair systems. This can cause many symptoms such as stomach problems, skin conditions, artery damage and even physical joint pain.

Second, the constantly heightened state of muscle activity causes them to become tight and overactive. Other muscles, especially the deep core muscles that are of little use in a fight-or-flight situation, become weak. This imbalance then causes joints and tendons to be moved incorrectly, and slightly out of alignment. When this faulty movement pattern is repeated thousands of times the joint, tendon or disc becomes worn out, inflamed and painful. Voila! Your mind has caused you pain!

muscle imbalance

Muscle imbalances cause injury!

Third, if your mind is in a heightened state of stress then it is far more susceptible to sensory input. For example, imagine you are sitting around a campfire in a completely relaxed frame of mind and you hear a twig break. You’d probably ignore it altogether. But now imagine that you’re stressed and anxious and hear that same sound – you’d probably jump and startle. Why? You’re anxious mind is in a flight-or-flight state, and is searching for any sign of danger. When in this state, all sensory input is heightened – including pain. So the same injury will feel worse when you are stressed compared to when you are relaxed.

So there are many well-established pathways by which your frame of mind can directly cause or heighten injuries and wear-and-tear. By learning mindfulness and other relaxation techniques you will have another method with which to help yourself feel better.

Old version - isn't that cover just awful?

Old version – isn’t that cover just awful?

To finish this article I have two special offers! First, to all readers of this blog I would like to offer a complimentary copy of an audio MP3 entitled Using your brain to get rid of your pain. To use this file simply follow the link to our publishing web site, download the file and transfer to your phone or MP3 player. You can use this track to help you master the skills of meditation and mindfulness.

The second gift is an offer to Bulimba and Mansfield PhysioWorks patients ONLY. I have recently released a new version of the booklet “Using your brain to get rid of your

The new edition of "Using your brain..." Available as e-book or in print form amazon.

The new edition of “Using your brain…” Available as e-book or in print form amazon.

pain.” However I still have some old copies of the first edition in stock. So if you would like a complimentary copy of the original booklet (it’s the one pictured here with that awful yellow cover) , please simply contact your nearest PhysioWorks centre and let us know.

Other readers can purchase the new edition of the booklet (as an e-book or in print) at a very low price from Amazon or your favourite online book store.

So start relaxing now and reap the benefits, not just for your mind, but for your physical pain and problems as well!

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A ride on a 25-year roller coaster

It was 25 years ago this Monday – 9 May, 1991 – when a much younger, slimmer and darker-haired version of John Perrier first opened the doors to Bulimba PhysioWorks. It’s been a roller-coaster ride for the ensuing 2½ decades, so I’d be pleased if you spared five minutes for a wander though the memories with me.

The original practice site was at 124 Oxford St, next to the Commonwealth Bank – Grill’d Burgers operates there now. I had spent weeks painting, carpet laying, buying equipment and networking with local doctors. I turned the key, opened the door, and then waited nervously by the phone for …well, nothing.

It took all day, but eventually the phone rang and I had my first booking – a young swimmer named Nathan – and my life as a private physiotherapist was underway. I’m pleased to say that I still occasionally treat Nathan (and his mother) to this day.

original bulimba practice 01

The original Bulimba Physiotherapy Centre. Luxurious, isn’t it?

From these undoubtedly humble beginnings, the practice grew to provide a very busy first few years. I had taken out a big bank loan to start up at 17% interest – the going rate at the time. I had heard multiple warnings about how many small businesses closed in the first two years, so I was determined not to fail.  Working alone, my tasks rapidly expanded beyond what my inexperienced mind had imagined – I had thought that being my own boss would give me control over my time. Ha! I couldn’t have been more wrong.

Besides treating patients, taking payments and answering the phone, I had to squeeze the accounting, cleaning and admin into my lunch breaks. Three nights a week after work I would head off to the local AFL club for sports physio from 6-8 pm. On Saturday morning I would spend a few hours in the clinic and then try (but usually fail) to complete the financials and marketing. I’d sleep in on Sunday morning – that was my only real time off – before heading to the AFL to work the afternoon as the strapper and on-field physio. I’d love to have just a fraction of that energy now – I don’t – but in its place is hopefully a little more wisdom.

Because the rooms were next to the bank, break-ins were frequent in those first few years. The thieves’ usual plan was to bust open my back door and then smash through the adjoining wall into the bank. It never seemed to occur to them that the bank’s vault would be locked anyway. The first time I walked in after a break-in I was horrified. After the sixth such burglary, I barely paused to sweep up the rubble before registering the intrusion with the police and calling my plasterer, who by this stage I had on speed dial.

original bulimba practice 02

The practice location, right next to the bank. This picture was taken about 1995 after a modest renovation.

Much has changed since then, not just with physio, but with the local and wider world. Bulimba has undergone a complete makeover. Its primary characteristics in 1991 were dilapidated old Queenslanders and dozens of industrial factories.  It’s hard to imagine now, but many large companies, including Telecom, Rheem and Lloyd’s ships, all had major manufacturing facilities in Oxford St.  There was barely a coffee shop nor a restaurant in sight. True.

The Balmoral Pub, then known affectionately as the “Balmongrel”, was not a place for the feint-hearted, with a motley collection of out-of-work tradies and old punters being the main clientele of its smoke-filled public bar. There were no TAB outlets in pubs in those days, and the nearest outlet was further down Oxford St (where Woolworths now stands). So many of the punters would wander down the street, beer in hand, to place a bet.

Unfortunately there was a brick bench directly outside my practice door, where they’d regularly stop for a breather or a cigarette. (You can see it in the photograph above, by which time it had been converted into the garden bed behind the lamp post.) At times their arguments would get quite rowdy, and I had to break up more than one fight.

As Bulimba’s old houses were renovated and the industrial land was snapped up for units, the suburb’s working class persona steadily disappeared. In the meantime, land values and rents soared: our yearly business rent is now eight times what is was in 1991.

Technology has also completely transformed the way we do business. My first computer in 1991 had a hard drive capacity of only 512 Mb (that’s megabytes). I recall paying extra to upgrade to a top-of-the-range RAM chip, which was 64 Kilobytes. Yes, kilobytes – you may have to google that term if you’re under the age of 35. To put this into perspective, you would have to link 250 similar computers to match the capacity of a single modern smart phone.

My original business card includes only the shop address and a phone number: 899 1226. (Note the missing initial ‘3’, which was not introduced until eight years later.) There were no other contact methods; faxes were the domain of big business and hot-shot lawyers, while electronic communication was still a few years away.

By comparison, we now have three phone lines (including the fax line), multiple email addresses, mobile numbers, EFTPOS and HiCaps payments, text out services, Skype contacts, a 200-page web site, e-commerce capability, online booking systems, this blog and a Facebook page. Of course most of these things come with a monthly account fee….

original business card

The last surviving copy of an original business card. Sometimes I long for these simpler times…

Thankfully, one thing that hasn’t changed much in all those years is the human body. In hindsight, I was fortunate to choose a profession that is amenable to accumulating skills and experience over time. Things that I learned way back in 1991 are still 100% relevant today – backs, knees and shoulders haven’t changed at all. By contrast, the knowledge gained in 1991 by say, a computer programmer, would now be largely worthless.

But of course treatment methods have progressed. In 1991 most joint surgery was performed by the old “open ‘em up” method that more resembled carpentry than the surgical precision of a modern arthroscopy. MRI scanners and the like weren’t invented yet, so we had to diagnose injuries with scant help from technology. This was sometimes like a mechanic trying to pinpoint your engine problem without opening the bonnet, but at least it gave us a solid grounding to develop diagnostic skills.

In this matter I’d particularly like to thank those patients who trusted me and persisted when things didn’t always improve as they’d hoped over the first few sessions. Sometimes it was only after we changed diagnosis or treatment that results flowed, and my physio bag of tricks subsequently grew each time. So thank you for your patience, patients!

At last count, our Bulimba practice has now helped about 117,000 clients – I’d like to think we’ve learned something from every one of you!

We physios are also fortunate that we have plenty of time to talk while we’re working. Can you think of any other occupation in which you can chat for 20 minutes or so to every client without impeding your time or theirs? Even better, our patients are from all walks of life: both blue and white collar workers, kids, stay at home parents, retirees, elite sports people, soldiers, you name it; everyone gets sore sooner or later. So we are exposed to a variety of problems, ideas and opinions, all of which provide for an interesting and varied work day.

The internet didn’t exist in 1991, and Google was still eight years away, so finding information was far more difficult than today; you couldn’t just type a search phrase into a computer. For most people this meant either a trip to the library or just asking around until you found someone who knew that subject.  But we physios had a big advantage: with about 100 people per week coming in for treatment, it was only a matter of time until an expert on gardening, car engines, mountain climbing or whatever came through the door. We had our own ‘mini-internet’.

We’ve also expanded our staffing levels over the years. Obviously the enterprise began with just one inexperienced soul. IN 1994 I married, and my wife started helping out in the office; she would work her day as a schoolteacher, and then come in to help with the admin until late. We ate a lot of take-way for a few years! In 1997 our first baby daughter came along, and we took the big step (well, it seemed like a big step at the time) of employing a part time receptionist. After opening a sister practice at Mansfield  we employed another physio, and have been slowly expanding since.

We now employ five physios, two practice managers and three casual receptionists. Many co-workers have come and gone, but I’m grateful that I still count most of them as friends. I’m even more proud that my daughter is now studying physio as well. Her probing anatomy and physiology questions certainly stretch my memory.

With the enormous changes that have taken place in just 25 years, it’s hard to imagine what our working lives will be like in another decade or two. But it should be fun finding out.

Yes, it has been a roller coaster ride, but one with far more ups than downs. Thank you again to everyone for your support, and I hope you continue to trust us at Bulimba PhysioWorks to help you feel better for many years to come.

“Is stretching before sport a waste of time? Er, yes, probably.”

Do you need to stretch before and after exercise? Some people believe stretching reduces the risk of injury, reduces soreness experienced after exercise, or enhances sporting performance. But is this true? Despite what you’ve been told over the years, the answer is “probably not”.

The only way physios can get a really clear idea of the effects of stretching is to review randomised trials, in which a lottery is used to allocate each participant to either receive the treatment (in this case, stretching) or not. Then the outcomes (injury, muscle soreness or sporting performance) of the participants who stretched are compared with those who didn’t. The difference in the two groups tells us about the effects of stretching.

The first two trials of the effects of stretching on risk of injury, conducted on 2,631 army recruits, showed three months of routine stretching before exercise did not appreciably reduce injury risk. A more recent trial on 2,377 active people had very similar findings: three months of regular stretching had little or no effect on risk. Together, these trials strongly suggest stretching doesn’t appreciably reduce injury risk.

A number of other trials have investigated the effects of stretching before and after physical activity on the soreness experienced after exercise. A review of these trials concluded that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness in healthy adults.

Flexibility and strength

The effect of stretching on sporting performance is less clear, or at least more complex. Not many trials have measured sporting performance as an outcome. Instead, most have studied the effect of stretching on two factors that are likely to affect sporting performance: flexibility, and the ability of muscles to generate force.

Ballet dancers and yoga teachers, who stretch a lot, tend to be more flexible than the rest of us.

So the first question is: does stretching actually increase flexibility? In the short term, yes. After just a few seconds or a few minutes of stretching, joints move further and resist movement less. But this effect is transient. Once the stretching stops, flexibility returns to pre-stretch levels. And recovery is largely complete within a few minutes of finishing the stretch.

It’s possible, but less certain, that stretching also has long lasting effects on flexibility. Everyday observations suggest that’s true, because ballet dancers and yoga teachers, who stretch a lot, tend to be more flexible than the rest of us. But, while it seems obvious that regular stretching makes people more flexible, it has proved remarkably difficult to demonstrate that in controlled experiments.

Either way, the effects of stretching on flexibility – short or long term – could be exploited to enhance performance of some sports. It seems likely that hurdlers or gymnasts, for instance, could perform better if they were more flexible. i.e. stretching could increase performance in sports that require flexibility.

Many sports require great flexibility to perform at a high level.

To stretch or not to stretch?

For recreationally active people, these research findings suggest stretching is unlikely to have much benefit, although it probably won’t do you any harm. If you like stretching, stretch. If you don’t like stretching, don’t do it, but don’t feel guilty about not doing it.

For high-level athletes, stretching might increase performance in sports that require lots of flexibility; it makes more sense to stretch if you’re a hurdler than if you’re a weightlifter.

Similarly, good evidence of the superiority of one method of stretching over another, or of the long-term effects of particular kinds of stretching, doesn’t exist.

To finish on a more positive note: while it appears that stretching doesn’t appreciably reduce risk of injury, there’s good evidence that warming up does. An intensive, well-structured, active warm-up can substantially reduce risk of injury, so try doing that the next time you exercise.

I acknowledge the work of Senior Principal Research Fellow at Neuroscience Research Australia, in preparing this article.

Why a Mutant Fish is Responsible for Your Sore Back

Why a Mutant Fish is Responsible for Your Sore Back

If you asked an inventor or an overpaid corporate engineer to design a gadget, the first thing that they would want to know is what it was supposed to do. No sensible person would design an object and then assign it a use when they had finished.  Usually, the design of something depends upon its purpose. Function dictates structure.

Your spine is no different.  Its myriad of strange shapes and complex joints serve very worthwhile purposes. Those funny little pointy bits on the bones did not appear by accident. If you understand the function of your back, and how those demands evolved, then you will find it far easier to appreciate its bizarre structure. Later, armed with this knowledge, you can confidently tackle tasks such as diagnosing and preventing your own back pain.

The Evolution of your Spine

Mother Nature designed your spinal column over a very long period. Helped by her design team of natural selection and evolution, she gradually fashioned the extremely complex systems that form the human spine.

The process began about half a billion years ago when an otherwise inconspicuous ocean-dwelling animal called an Elasmobranch developed a spine. The Elasmobranch’s spine was a flimsy affair: its chief function was to provide protection for the bundle of nerve fibres that ran down the creature’s back. Despite this inauspicious beginning, the vertebral column had arrived.

Over the next lazy 100 million years or so, other sea life such as primitive fish slowly evolved spines. These spines were also very simple, and made from soft cartilage rather than bone. They gradually assumed another job besides protecting the nerves: to provide an attachment for the fish’s muscles. This extra control allowed them to swim, and thus survive, more efficiently.

Then, about 400 million years ago, the fish did something that had a huge effect on our spinal development: they migrated to land. With this audacious move came a new problem for the spine. Gravity.

Helped along by the very small changes that are evident from one generation to the next, these early amphibians gradually developed newer, different models of the spine.  The quality control manager, natural selection, tested each new design. Those animals with more efficient spines had a better survival rate, meaning that their descendants, the reptiles, inherited better backs.

By the time mammals arrived about 250 million years ago, the vertebral column had developed many desirable characteristics:

  •  The individual building blocks of the spine were now constructed from dense bone rather than cartilage. This change allowed them to bear more weight.
  •  The vertebrae—the back bones—developed joint structures that allowed extra movement.
  •  Shock-absorbing mechanisms evolved that helped to protect the bones from fracturing in the rough-and-tumble of prehistoric Earth.
  •  Strange lumps and bumps of bone developed on the vertebrae. These protuberances provided leverage for muscle attachments, allowing more precise movement control.

For a time, everything went smoothly in Mother Nature’s spinal design department.  She had an efficient, working model that allowed good movement, offered a firm attachment point for both muscles and ribs, while offering vital protection to essential nerve structures.

Then about fifteen million years ago, probably on an otherwise ordinary Tuesday or Wednesday afternoon, all that contentment dramatically changed. Something happened that would alter the requirements of the spine, and therefore its structure, forever: an apelike creature began to walk on two legs.

Why did the ape do this?  Well, nobody knows for sure.  However, scientists and anthropologists suspect that the motivation was so that the creature could use its front legs—its arms—for tasks such as using crude tools, or brandishing weapons for self-defence. The two-legged stance also liberated the front legs for the useful purpose of carrying objects, like food. Or beer cans.

 

Why we evolved onto two legs?

Why we evolved onto two legs?

Mother Nature and her design team now had to enable the spine to cope with a new functional requirement: to support the trunk in the upright position. Suddenly, the architecture of the lower back needed a drastic overhaul. Undoubtedly, the first versions were poor.  Any decent spinal health practitioner would have made a fortune had they been around during these early reformative millennia.  However, as the centuries ticked by, evolution again provided gradual improvements.  The pelvis and hips gradually changed their alignment so that the legs were roughly in line  with the trunk, rather than jutting out at right angles like a quadruped’s limbs.  The abdominal muscles also changed their function so that they supported the spine in an upright position, rather than simply being a sling for the stomach and intestines.

As we developed, tree climbing became an occasional diversion rather than a semi-permanent home. Our tails, which were no longer necessary, steadily disappeared … which I, for one, think is a bit of a shame. Imagine how much fun you could have at a party with a fully functioning tail.

Recently, only a mere two or three million years ago, we human beings emerged from the developing gene pool.  We now walked upright most of the time. In response, the spine made one further adaptation: it developed some inward and outward curves. Besides providing some extra leverage for the postural muscles, the curves had a springlike effect that helped the spine to absorb shock.

Finally, after a 500 million year journey that started with a mutant fish, the spine arrived at the current model.

Despite the miracle of design, I award Mother Nature only nine out of ten for her efforts in spinal architecture. Why the deducted mark?

The lower back is probably the weakest mechanical link in the entire human body. It is responsible for more musculoskeletal pain than any other area. Compared with other masterpieces like the eye, the brain and the hand, the lower back looks decidedly amateurish. Paradoxically, the probable reason for this weakness also lies in the mechanism of evolution.

In our earliest caveman days, health problems of all kinds beset the average human being. Even a simple cut or abrasion was often fatal, while the most common form of death was infection from tooth decay! Because of these appalling health problems, most human beings died at a very young age, usually less than thirty. Of course, most reproduction and parenting had to be completed by the early twenties to squeeze into this limited lifespan. Due to the early parenting age, the natural selection process had no chance to attack the residual problems in the lower part of the spine. Most people had already produced their offspring and/or were dead before they had even begun to develop a bad back, which, as we will see later, usually occurs first in early middle age.

So we passed this weak genetic link from one generation to the next, while it patiently waited to make its presence felt when the human lifespan elongated. Now, as the average length of life approaches eighty years, we are, as a race, suffering from far more back pain than our early ancestors could have imagined.

Yet for all its problems, our spine is an amazing and complex piece of machinery.  Try to envisage any other design that not only protects the nerves that carry signals from the brain to the limbs, but provides efficient attachment for both ribs and muscles. Of course, this design would also have to allow plenty of movement without being unstable or floppy, protect itself with shock absorption, and stay upright while being supported on only two legs.

The spine, despite its faults, is really very clever. We’ve got that mutant fish to thank!

This article is extracted from “Back pain: How to get rid of it Forever: Volume 1 – The Causes” by John Perrier. The e-book is available to download for FREE at amazon.com, along with it’s companion “Volume 2 – The Cures“.   For a complete list of retailers of both the paperback and e-book versions please see www.JPpublishingAUSTRALIA.com .

Not sure? You can browse the books online for free here for volume one and here for volume two.,

For more information on back pain, or to have your spine problem evaluated and treated, please contact us directly.

“Why does my back ache when the weather turns?”

Does it seem like your joints ache more when certain weather is approaching? There is one possible theory that supports your observation.

When rain is imminent, the extra water vapour in the air lowers the air pressure. Some academics have postulated that this lower air pressure is responsible for a minor increase in joint swelling. This occurs because the air pressure, which normally exerts a force on our bodies in all directions from the outside, is now lower, allowing the swelling to expand slightly. This extra fluid around the joint then leads to aching and stiffness.

weather cartoon

This theory explains the assertion of some arthritic sufferers that they can tell when it is about to rain because their back aches. However, this theory does not explain why the same people usually suffer from the cold temperatures in winter, the winds in autumn, and the humidity and storms in summer. Wouldn’t have anything to do with the condition of your spine, by any chance?

One study showed no correlation between weather patterns and the average pain level of a large group of arthritis sufferers (although my late grandfather would disagree…) So there is no hard evidence to support the air pressure theory above.

If you think the weather is affecting your joints, then you should work on the condition of your spine – do some exercise, use heat or ice, do some relaxation exercises or see your physio. Concentrate on the things that you CAN change, rather than worrying about things that you can’t affect, such as the weather.

“Driving through back pain”

Back pain is never pleasant. If you suffer from back pain while driving, it can be almost unbearable. It’s even worse if you’re stuck in heavy traffic, or have a dozen shopping bags loaded in the boot. The techniques and tips that follow tell you how to reduce the stress on your spine during these times.

Does driving cause you back pain?

Does driving cause you back pain?

How long do you spend sitting in the car each day? If you added every minute, you may find that you spend over two hours per day sitting while commuting – even more if your job keeps you on the road. Unfortunately, you spine was not designed for long periods of inactivity. If you wish to keep your back healthy, then you must ensure that your sitting posture is efficient. Luckily, with a little knowledge and effort, a good driving posture is easy to achieve.

Don’t bother sitting up straight

First, don’t have your seat back vertical. Yes, I know that you’ve been told that a straight, vertical backrest is better for your spine, but this just isn’t true. Instead, you should tilt the backrest backward as far as is comfortably practical. I suggest that about 20 degrees is a good starting point. Then you should ‘lie’ your whole spine against the backrest. Let the chair do the supporting work for you.

Tilt your chair back about 20 degrees and let the seat-back do the supporting work for you.

Tilt your chair back about 20 degrees and let the seat-back do the supporting work for you.

Of course, with the seat back tilted backward, your shoulders will be further away from the steering wheel. Compensate by sliding the whole seat forward a few inches.

Second, make sure that your bottom stays snugly at the back of the seat. If you let your bottom slide too far forward it will no longer be supported by the backrest. Keeping your seat belt firmly around your waist will remind you to keep your bottom back where it belongs.

Some car seats have in-built lumbar support, which may help to keep your spine from slumping. If not, you can make your own lumbar support roll. To do this, simply take an old towel, and fold it in half lengthwise. Then tightly roll the towel to form a cylinder about 3-4 inches (7-10 centimetres) in diameter and secure with tape or rubber bands.

002 make lumbar roll 2

A old towel can be used to make a serviceable support for your lower back. A short length of rope through the centre will allow you to tie it in the correct height on your seat.

Tuck the roll horizontally behind your lower back when you sit. It will maintain an inward curve in your lower back, which is usually better than is a rounded, slumped spine. Don’t worry if you feel slightly uncomfortable at first – you’ll soon get used to the new position. Leave the roll on your car seat, and you’ll never forget to use it.

Other tips for car-related back pain

The following simple tips may help to ease any pain that you experience while working on the car, or during long car journeys.

  • When loading parcels or boxes into the boot, place the heaviest items at the rear of the car. In this way you won’t have to lean too far in order to retrieve them.
  • When changing a tyre, don’t risk injury by pulling up on the wheel brace. Instead, use your body weight to your advantage by pressing down on the wheel brace. Use a length of pipe to increase leverage for tight wheel nuts.
  • Working on the engine often requires prolonged bending. To reduce this effect, lean a piece of ply-board, padded with a couple of old towels, on the fender. Rest your upper body against the board, minimising any harmful effects your spine.
  • When undertaking a long journey, stop the car and walk around every hour or so. A simple exercise that helps relieve the effects of prolonged sitting is performed as follows: Stand with your hands in the lower part of your spine, and gently lean backward. Hold this extended position for 5 seconds, then return. Repeat 10 times.

The lumbar extension exercise, which can ease the pain of prolonged sittingThe lumbar extension exercise, which can ease the pain of prolonged sitting

  • A hot water bottle is a good companion for a long car journey. It not only provides soothing warmth, but also doubles as an effective lumbar support.

If you continue to experience back pain while driving or lifting, then please come in and see us as you may have a chronic or serious problem. Good luck, and I hope you enjoy safe, pain-free driving!

Please look out for John Perrier’s book “Back pain: how to get rid of it Forever” coming in February 2015 to all good e-book retailers.

Arthritis: do I have it? What can I do about it?

What is Arthritis?

Arthritis is a group of musculoskeletal conditions in which there is wearing and inflammation of the joints causing chronic pain, swelling and stiffness.  Nearly 3.3 million Australians have a disability due to arthritis and related conditions, and more than half of these have chronic or recurrent pain. Even though many different conditions are labeled as arthritis,they each have very different causes and so require different treatments. The most common forms of arthritis are:

  • Osteoarthritis (OA). This is by far the most common type. It is caused by wear-and-tear that grinds away at the smooth lining of cartilage that covers the joint surfaces, exposing the rougher bone underneath. This process causes pain, stiffness, creaking and sometimes swelling. osteoarthritis_diag
  • Rheumatoid arthritis (RA) This is an inflammatory disease that primarily attacks the small joints in the hands and feet. It is caused by a dysfunctional immune system in which your own cells attack the joint linings.

    rhematoid arthritis

    rhematoid arthritis

  • Gout is usually found in the big toe joint. It is caused by a build up of crystals within the joint.
  • gout

    gout

  • There are many other different but rarer types of arthritis such as Ankylosing Spondylitis, Juvenile arthritis and Systemic lupus erythematosus (lupus), just to name a few!

Is my sore joint arthritis?

There are many different reasons why your joints may be sore. Not all pain in your joints is caused by arthritis. It could be from an injury or using your joints and muscles in an unusual way (for example, playing a new sport or lifting heavy boxes). Talk to your physio if you have pain and stiffness that:

• starts for no clear reason

• lasts for more than a few days

• comes on with swelling, redness and warmth of your joints.

How can I find out if I have arthritis?

Your physio will ask you about your symptoms and examine your joints. They may do some tests or x-rays, but these can be normal in the early stages of arthritis.  Your physio may also send you to a doctor for blood tests, or to a specialist for a surgical opinion, if either is warranted.

The Role of Exercise

Moderate, regular exercise has been proven to aid in the prevention of arthritis, and offers you a host of side benefits.  Exercise can reduce your joint pain and stiffness, build strong muscles around your joints and increase your flexibility and endurance.

The Role of Physiotherapy

If you have OA you could benefit from physio work to loosen your joints, and electrotherapy to ease your pain and inflammation. We can also give you muscle strengthening exercises to realign your joints—almost like giving your car tyres a wheel alignment. Localized, specific massage techniques can also break up the ’rust’ from your affected joints, greatly reducing your pain.

hip stretch

Loosening a hip joint to lessen the effects of arthritis

Physiotherapy can reduce arthritic pain and reliance on drug therapy. Unlike pharmaceuticals, physiotherapy has few side effects or contraindications. So although arthritis is a chronic disease, treatment and management techniques can control and reduce the effects of the condition, and prevent further deterioration.

Almost like a miracle cure!