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Low Back Pain & Sciatica – The Latest NICE Guidelines

Posted on 20th January 2017 by

The National Institute for Health and Care Excellence (NICE) has recently published new guidelines on best management of low back pain. This includes both people with ‘simple’ back pain (localised to the back) and those with referred pain (sciatica) which can affect the nerves down one leg. These guidelines are based on latest evidence and expert analysis of what is the best course of action for people with low back pain.

Here’s how we’re putting them into practice at goPhysio

Assessment

When you come to see us with back pain we will do a thorough assessment by asking a number of questions to find out more about your pain and to rule out any ‘red flag’ conditions. These red flags can indicate serious pathology such as cancer, infection, trauma, inflammatory conditions or Cauda Equina Syndrome. Thankfully these conditions are rare but if we have any suspicion we will referral you on to the appropriate speciality for further investigations without delay.

We will do a complete back examination to assess how the joints, muscles and nerves are functioning. We know there are a number of factors that can influence your recovery both positively and negatively so our staff are undergoing further training on use of the STarT Back Risk Assessment tool. This will help us identify those who are at risk of poorer outcomes and ensure that we tailor our treatment to address these factors.

Treatment

Self-management education is a vital aspect of treatment for any patient. We help you to understand why you have pain and what steps you can take to reduce it – both during an acute flare up of pain but also long term strategies or simple changes you can make to your lifestyle which will help your back.

Your treatment will vary depending on the nature and cause of your pain, how severe it is and a variety of individual factors. Physiotherapy treatment may include manual therapy such as joint mobilisations or massage, alongside a personal exercise programme and advice on pain relief.

Research has shown that anti-inflammatory medications (NSAID’s) such as Ibruprofen or Naproxen are much better than paracetamol for back pain, however, for people that are unable to take NSAID’s or that find them ineffective, weak opioid medications such as Co-codamol can be recommended for simple back pain.

For acute sciatica your GP may recommend stronger ‘neuropathic’ pain medications which are much better for nerve pain (tingling/burning/shooting pain). Please note all medications have side effects and can interact with other medications you are already on or other conditions that you may have so please check with your GP or a pharmacist before taking any new medication.

What happens if you are not responding to treatment?

For acute sciatica you may be referred on to a spinal consultant, who in more severe cases can consider epidural injections or a spinal decompression surgery. However it is important to remember that this is never a first course of action as most episodes of sciatica resolve within 6-12 weeks. Your physio will help you decide when it is appropriate to be referred on depending on how you respond and recover.

Sometimes there are psychological factors affecting your rehabilitation such as depression, anxiety or other mood disorders. In this case your physio may recommend that you are referred on to a psychologist for cognitive-behavioural therapy. This is because we know that people with negative mood and health beliefs rarely respond well to usual treatment without first addressing these factors.

So if your pain is persistent or not responding to usual treatment it is important to seek professional help.

What about x-rays and scans?

X-rays are no longer routine for lower back pain unless there is the suspicion of a fracture (such as after a severe trauma or in people with osteoporosis). This is because it exposes you to radiation but does not often provide any useful information on how we should best treat your back. Likewise MRI’s are only needed to rule out serious spinal pathology or to help a consultant identify if a nerve in your back is being significantly compressed to warrant injection or surgery. The vast majority of this information your physio will be able to deduct from a thorough assessment.

Once an acute episode of back pain has eased off, we recommend continuing with exercise to help keep any further recurrences at bay. Research indicates that any form of exercise is great for people who’ve had back pain – being active and moving helps! many of our patients go on to our specialist Pilates classes. These are particularly beneficial as they are taken by our Physiotherapists, so they are well equipped to deal with any concerns or issues you may have with your back and can modify and progress the exercises for you individually. The classes are also small, so you aren’t lost in a sea of people struggling – you get individual care and attention. We run 16 classes a week, so there’s plenty of choice to fit in with your weekly commitments.

NICE back pain

If you’re suffering with back pain and want some peace of mind and reassurance that it’s nothing serious and help to get on the road to recovery, come and see one of our Physio’s at goPhysio. We make it easy for you, with appointments available 8am – 8pm and Saturday mornings, we can normally offer you an appointment within 24 hours, if not the same day. Just call one of our friendly Patient Services Team on 023 8025 3317 or book an appointment online.


Why Is Rehabilitation Pilates different to other Pilates Classes?

Posted on 12th June 2016 by

Pilates classes are a big part of what we offer here at goPhysio in Chandlers Ford. However, the Pilates classes we run at goPhysio are a little different to others you may experience in the area. Our Pilates is in essence ‘Rehabilitation Pilates’.

Rehabilitation Pilates is different to a traditional class you may attend at the gym or local hall.

Physio Pilates Chandlers FordRehabilitation Pilates has been specifically developed for use by physiotherapists.  All of our instructors are both Charted Physiotherapists and are trained by the Australian Physiotherapy and Pilates Institute (APPI), which is the world leader in rehabilitation Pilates.

Rehabilitation Pilates exercises target the deep postural muscles of the tummy and spine to improve central ‘core stability’ & posture. They also help improve spinal mobility, increase flexibility of the key trunk and leg muscle groups and improve body and postural awareness. This type of Pilates is particularly suitable for you if you suffer with back or neck pain or have suffered a specific injury. It is also a great way of preventing injuries or preparing for sport.

People who come along to our Pilates classes tend to fall into one of 5 categories:

  1. They’ve had an injury and have been seeing us for Physiotherapy. Once they are nearing recovery, they start with Pilates to both continue their recovery and help improve their physical ability to stop the injury coming back.
  2. They have been advised to start Pilates by another health care practitioner (e.g. Consultant or GP) and want to join a Physio led class to make sure they have the right support in the class and adequately experienced Instructor.
  3. They’ve suffered with back or neck pain (or other injuries) on and off for years and have heard Pilates is great to stop it re-occurring.
  4. They’ve been to another Pilates class elsewhere but felt that the class size was too big and they weren’t getting enough attention or support from the instructor. We even have people who’ve picked up an injury at other classes from doing Pilates incorrectly.
  5. They’ve just heard wonderful things about Pilates and want to experience the benefits too in a friendly, supportive environment!

As our instructors are also Physiotherapist, you have ‘on hand’ expertise ready to share their knowledge and advice at every class. They have such an extensive knowledge of the human body and also injury, so can tailor each class to the individual needs and make sure you really get the most out of it for you. The classes only ever have a maximum of 8 participants, so you are always under the watchful eye to make sure you’re doing the exercises correctly and be progressed when needed.

We also run 2 specialist Pilates classes for pregnant ladies and also new mums and their babies.

There is a real skill in getting the Pilates exercises right and this needs concentration, guidance and attention.

Take a look at our class timetable to see the classes we run at goPhysio.

Questions we’re often asked about our classes

How many people come to the Pilates classes? The numbers for each class are strictly limited to a maximum of 8. This is to ensure that we maintain a high quality class, with the instructor being able to give sufficient attention & support to each individual.

How do I book onto a Pilates class? If you want to join our classes you can give us a call at the clinic on 02380253317 or email us. We’ll help find the most suitable class for you, we’ll can chat through the booking process and organise payment for the class. Alternatively, If you are currently attending goPhysio, chat to your Physio or our Reception team, who can organise for you to attend a class.

How much do the classes cost? We normally run our courses in 8 week blocks. The cost of each 8 week course is £100.

Why do I need a 1-2-1 before I start Pilates? We do advocate that if you haven’t seen us at goPhysio before you have a 30 minute 1-to-1 pilates session, before joining a class. This will enable our Pilates Instructor to help you to get 110% out of your Pilates! This is norma;l procedure for anyone starting a Physio led Pilates course. These 1-2-1 appointments cost £35.

Pilates Classes Chandlers Ford