Why does raising my arm cause pins and needles in my hand?

The neck has muscles that cross both the blood supply and the nerve supply into the arm. Raising the arm tightens those muscles that can put pressure on the nerves or arteries. This causes the pins and needles.

Why does my back hurt only in the morning/evening?

It depends on the cause of the pain. In some cases the back is being stabilised by your muscles, and as the day wears on and the muscles tire the pain will become more apparent. People with inflammatory arthritis notice the stiffness and pain more in the mornings so getting out go bed can be quite painful, but once the blood starts moving mobility is restored.

Why isn’t what you do available on the NHS?

Osteopathy is available on the NHS in some areas. People from Richmond and Twickenham may see me by referral from their GP on the NHS for back pain and neck pain.

Can laser help my foot pain?

There are lots of different reasons for foot pain: plantar fasciitis, arthritis, diabetic neuropathy. Many of them can be treated with laser.

How long before my back pain gets better?

How long is a piece of string? But seriously, all but the most serious problems are resolved with appropriate treatment within a month and mostly quicker.

My physiotherapist gave me exercises for my back pain. How is what you do different?

Physiotherapists are highly trained allied health professionals. Despite this we see a lot of people who have been given written instructions for exercises that may or may not have been appropriate for their back pathology. Before any treatment modality should commence you require a good diagnosis. Diagnosis isn’t a mystery and many common cases are easily identified. However, everyone is different and unless someone has had a good look at where your pain is and how the condition came about exercise is inappropriate. We use www.exerciseprescriber.com to support the rehabilitation of our patients. We use exercise to reinforce the process and prevent a return of any dysfunction that could cause pain.

The last therapist cracked my back. Is that what you do?

Manipulation is only one tool in the box for us. Manipulation may get a good result for many conditions. However, it is not the be-all and end-all of manual therapy.

What are you trying to do when you crack my back or neck?

It has been clinically observed that manipulation causes the normalisation of neuromuscular tone of the muscles that cross the joint that cavitates. The crack causes relaxation or increase in tone so that the structure becomes functional and balanced, preventing painful spasm.

Is cracking (manipulating) my neck dangerous?

There are many occasions where spinal manipulation of the neck is inappropriate. We are intensively trained to be cautious and conservative in it’s use. I always discuss the issues with patients. Because my practice isn’t just manipulation, if the patient doesn’t want manipulation for any reason I have more than enough other techniques and modalities to normalise a dysfunctional painful neck.

Osteopath? That’s for backs isn’t it?

Osteopathy was originally envisioned as a complete medical practice in the USA. To this day in the US it is a prescribing medical practice. When osteopathy was brought to the UK in 1902, the medical establishment weren’t willing to recognise it as a full medical practice so it became an allied health profession focused solely on manual therapy with a slightly adversarial attitude to medicine. Today we retain our entire body focus with an interest in all aspects of our patient’s health. So its not just backs. That being said if someone presents to me with a fracture I’ll send them to A&E and if someone has for example hypothyroidism I’ll send them to their doctor for levothyroxine.

What’s the difference between an osteopath and a chiropractor?

Chiropractors are manual therapists like osteopaths. I think as a whole osteopaths are gentler, have more tools in the box and more likely to get you better faster and not have you come back.

What’s the difference between an osteopath and a physiotherapist?

There are many justly famous physiotherapists delivering world-class manual therapy in the UK. There are also many of my patients arriving with badly photocopied stick-man drawings of generic exercises.

What is sciatica?

Sciatica is pain from irritation of the nerve that comes from multiple levels in the lumbar spine and fuses together in the pelvis. The sciatic nerve travels down the back of the leg between the hamstrings. Technically it changes name behind the knee and becomes the tibial nerve. However, pain below the knee from the irritation of the nerve is still called sciatica. The cure of this pain involves finding out where and how the neural pathway is being irritated and stopping the cause. Often the spine is involved, but it is possible to have sciatica with no direct trauma to the spine.

Why does my back hurt more when I have a period?

This is surprisingly common. It can be explained if you understand three things. First, visceral pain, in this case an inflamed uterus, is poorly localised neurologically. That means that the brain has difficulty localising the pain signal and pain referral is common. Second, an increase in inflammation anywhere in the body will increase underlying musculoskeletal pain, so easily ignorable aches and pains become more intense. Third, there is a shared innervation between regions of the back and the pelvic organs. Increase in nociceptive (pain) nerve signals in the pelvis will lead to an increase in muscle tightness at corresponding areas with the same spinal innervation. Muscles can become so tight as to create a lack of sufficient blood supply which leads to pain. You may be interested to know that because your menstrual cycle repeats, the neuro-musculoskeletal system develops a stereotypical response to the visceral pain. In other words the body learns the pattern of pain in response to your period and when it receives the same stimuli. You can get back spasms even when your period is mild.