UKC

I've had a bad back for three weeks. I couldn't get to see a doctor and all I got from the surgery staff was "have you taken paracetamol?"

The trouble with pain killers, I believe, is that you're merely treating the symptoms and not the cause and I don't like the thought of becoming dependent on them.

On the recommendation of Mrs. B I went to an osteopath this morning. She pinpointed the problem and gave me a 40 minute treatment session. I already feel it was £50 well spent.

Does amyone else use osteopath?

I have done in the past and agree, I have thought it was money well spent, but generally only as a one off.

Hi,

I’ve found it’s worthwhile using pain killers for a couple of days if it can get you moving. With me it’s generally my muscles being very tight and stressed that causes the problem so easing this with drugs for 48 hours can work well.

I see a physiotherapist quite a bit for some ongoing issues and it's worth every penny. Physio is the evidence based medicine approved version of all the osteapath chiropractor stuff. Some of the osteo/chiro stuff seems to work, but those bits have been subsumed into modern medicine.

Painkillers have their place.

What was the diagnosis?

Stiffness of mid/lower spime probably caused by "overdoing it"/awkward movement

I agree with what you say there.  When I have random aches and pains, more often now I'm in my early 60s, not taking anything makes me move in not normal ways to try to alleviate them, but it just makes it worse.

Pop a few pills and a night's sleep and I'm invariably 'cured'.

I used to use osteopaths for back pain, but found they were very good a curing the sort term problem, without highlighting the long term issues that would cause a relapse down the line.

In the end, a couple of physios helped me get to the bottom of the problem and I never had to visit an osteo or physio (for my back) again 🙂

Back pain is a perfectly normal thing to experience, 97% of which is classed as non-specific, meaning there isn't a structural cause of your pain. It comes and goes, in a similar timescale to the duration of chiropractic treatments.

Regarding the "stiff spine" diagnosis, how did they measure this? And what's a normal level or rating of stiffness? There's no medical research that has ever found a link between back pain and posture, stiffness, shape of spine, kyphosis etc. Be very wary with any healthcare professional (do osteopaths have to practice under the HCPC?) who use dangerous language such as this.

Any weird symptoms in the legs or unremitting pain, get to your GP. Otherwise, keep things moving gently (any stretchy type of exercise/walking/movement that feels comfortable and helpful, no research supports any specific exercise) and build your activity levels back up. It will improve and you can learn how to self-manage along the way, saving yourself £50. Back pain should not be a financial burden.

Solely on the drugs I would take ibuprofen rather than paracetamol or failing that diclofenac. I have used both of the latter. I have no medical experience. 

Additionally, I would advise against following pharmaceutical advice from non-pharmacy/medical trained people on the internet, especially for prescription analgesia. 

Healthcare and medical professionals know what they're talking about and are held accountable by their professional body, so they can't give you advice out with current best practice and evidence. Experts who aren't professionally accountable, can say what they want and are immune to any repercussions. 

Hope your back pain settles quickly!

Why would you suggest NSAID prescription for what appears to be Low Back Pain? Genuinely interested in your clinical reasoning.

Wouldn't be my first port of call. No way would I let anyone start manipulating my spine without some diagnostics first.

https://edzardernst.com/2019/03/new-review-confirms-osteopathy-is-not-evide...

First a disclaimer, I've a couple of friends who are oesteopaths and have only met physios in a professional capacity. Then an observation that like any profession teachers, doctors, police, many are brilliant a minority are sh*t.

My simplistic understanding is that an oesteopath is more likely to "do" something that improves your condition, a good one should then give you exercises/stretches to stop the problem reoccurring, but this isn't always the case. Physios are less likely to do something that improves the problem dramatically in one session, but are much more likely to give a patient exercises/stretches to follow before the next session. I think, generally people who post on UKC would genreally follow those protocols and consequently see the benefits . Parents/grandparents/guardians of kids I've taught generally expect to be "fixed" without having to put any effort in themselves. I think that goes some way to explaining their respective preferences 

Isn't that a US study, that points out that things are very different in Europe? 

As Rob says, some are good some aren't .  Like all professions.

I used to get bad backs when I was doing more walling and both the osteopath and the chiropractioner  I used were really good at sorting my back out when I had problems.

Pretty much what Rob says. I've had good results with diclofenac, but the doctor won't prescribe it any more. One osteopath did a good job, the rest were rubbish. Physiotherapy (choose your practitioner carefully) does work and they will recommend pilates, which has made more improvements for me than any form of manipulation.

I found moderate short term relief of lower back pain from visiting a osteopath through a work based occ health scheme. But this could just be explained by having a chance to lay down in a nice calm and warm environment and relax for a hour in the middle of a stressful work day.

That’s surprising. Some workplaces put quite a bit of effort into ensuring that people who sit at computers all day have the right posture to reduce occurrence of low back pain. But there’s no research to back this up? How about this kind of thing:

https://www.sciencedirect.com/science/article/pii/S000368700900132X

Genuinely interested. 

Osteo- and Chiropractors will inflict ABH, relive you of £50, and have you coming back for more. Side effects include cracked vertebrae and death.

Physio will give you a realistic diagnosis if there is one, and a load of exercises you have to put the effort into yourself. This will be hard work but the most likely to be effective.

Some people's arrogance about painkillers can be so unproductive.

What do you have?

Pain.

What do you want?

Relief from your pain.

What does paracetamol do?

Relieve pain.

It's not Sophie's choice. If you are in less pain you can move more. If you move more, you might be able to actually do some of the exercises a physiotherapist (not an osteopathic quack) prescribes, rather than be in pain and avoid them (compliance is the biggest issue in any physical rehabilitation program). 

In this country, osteopathy is licensed and you need to be registered with the GOsC to practise, which essentially means you need a degree.  There are NHS osteopaths https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/... and it's fair to say that osteopathy is becoming accepted as a branch of mainstream medicine.  To the best of my knowledge there's never been a UK death. 

Chiropractic, OTOH, is witchcraft and occasionally kills people; if you google for osteopathy deaths you find reports about chiropractitioners...

I am a physicist, and I'm naturally sceptical.  I've had a problem with the base of my neck and right shoulder for more than 20 years.  I've spoken with my GP many times, had repeated NHS physio, and I am the kind of person who actually does the exercises like they tell you.  I have learned to manage it but I accept that I am always going to have an issue there - our best bet is that it came from a scrum collapse (I was a flanker drafted into the front row when we lost our hooker) at university.

When I have an attack (usually because I've pulled it, or occasionally just slept wrong!), the only thing that helps is a visit to an osteopath.  There's a particular manipulation that will free it back up.  Within ten minutes the range of movement is greatly improved, and a day later I'm back to normal.  

Nothing else fixes it.  If I can't get to an osteo then it just goes one and on.  I've tried massage therapists, who do everything an osteo does but without the manipulation, and they reduce the pain but don't remove the lock in my neck.  Data is not the plural of anecdote, but in my case I am quite convinced that the manipulation is what fixes me.  Placebo - maybe?  But I don't think so.

Pilates, physio  and exercises make it less likely that I get into trouble.  But they seem unable to permanently fix the issue.

Some osteos still come with a large dose of 'woo' and I try to avoid them.  Younger ones tend to be better.  My regular is a physio as well as an osteo and that seems like an excellent combination.

I with you on this.

 Early days for me I know but last night I had my best night's sleep for a while and I definitely have felt some benefit today. The only negative aspect at the moment is that the osteo has "banned" me from hill walks for the time being. She is also confident that I won't need too many sessions.

I'm afraid GPs no longer give me much confidence in such matters. They are, after all, not specialists. This was brought home to me some time ago when I was having what turned out to be iliotibial band problem when walking down steep hill. The GP advised me not to walk down hill! A visit to tbe boot department of Cotswold resulted in the recommendation to use contoured in soles - problem solved.

I have used both Physios and Osteopaths and it is pretty much a mixed bag. I've had physios use accupuncture which did bugger all for me and osteopaths who used manipulation which did a great deal of good. I've also had the reverse. Recomemdations from friends I trust (and personal experience) go further with me than titles. I understand that physios are generally more science based but that hasn't stopped a few going woo on me. I've had Osteopaths who are fantastic at the manipulation as long as you ignore the leaflets saying it will cure cancer, baldness and the commone cold.

Experience and exercise has also kept me out of the hands of both for the past few years. Still get the occasional bad back but know how to treat it.