Philip Bayliss Body Work

A Good Exercise Program

This Pilates exercise program could help you be pain free. If you currently have more than mild back pain, discus it with your health practitioner first.

Warm Up Exercises

It is important to warm up before sport. This program was made by ACC:

If you have an injury, remember RICE:

R.I.C.E.

It is essential to apply the R.I.C.E method in the 24 hours immediately following injury in order to relieve pain and reduce the extent of swelling (inflammation)

R=Rest
I=Ice
C = Compression
E = Elevation

Rest

Stop activity. With an injury to the leg, this may mean having to use crutches.

Ice

Apply ice for 10-15 minutes every 1-2 hours initially and then gradually reduce the frequency of application over the next 24 hours.

Methods of applying ice:

• Ice bucket.
• Instant ice packs.
• Crushed ice wrapped in wet towel.
• Packet of frozen peas wrapped in wet towel.

Compression (Use of compression bandage)

Compression of the injured area also helps to prevent or reduce swelling. The bandage should be applied firmly but not so tight that the blood is cut off. If applied to a limb, the fingers or toes should remain pink and not become ‘tingly’

Ice can be used over the bandage. Remove the bandage every 3-4 hours and reapply.

Elevation

Raise the leg above the level of your hip e.g. lie down with your leg propped up on a chair and/or pillows, or the arm in a sling or with the hand on the opposite shoulder.

The R.I.C.E method should not be applied to anyone with Raynaud’s disease (poor circulation), diabetes, or peripheral vascular disease.

Causes of back pain:

Every year half the adult population report getting back pain for at least 24 hours. About 80% of adults experience back pain at some point in their life. About 40% will relapse in the year of the initial injury and 5-10% will become chronic. A previous history of back pain doubles the chance of future episodes. Low back pain causes 40% of missed days of work, second only to the common cold. Additionally, it is the single leading cause of disability.

The spine is a complex interconnecting network of bones, facet joints, sacro-iliac joints, discs, ligaments, tendons, fascia, muscles and nerves, all of which are capable of producing pain. Sometimes the cause of pain is in a different part of the body than the symptoms. Nerves from the spinal cord go between the vertebrae and on to the arms and legs. Pressure on these nerves may cause pain, tingling, weakness or numbness in the arms and hands or the legs or feet, the location depending on which nerves the pressure is on. This is called referred pain. Sometimes the body will adapt or compensate for an injury so that the pain disappears, only to return, sometimes years later, when the compensation breaks down. This occurs when cumulative stresses of daily life or a sudden severe stress compromise the bodies adaptation abilities. Sometimes severe or chronic pain can create a tissue memory that persists even when the cause of the pain has gone, but the person continues to experience pain.

Tips on the Prevention and Self-Care of Back Pain

• Total bed rest should be avoided. Severe pain limits movement, which can slow the healing process and can lead to the development of chronic (persistent) pain. Pain relief may allow more movement, lack of which can delay recovery. Sections below have information on both pharmaceuticals and natural remedies for pain relief. However, care must be taken do to overdo activity, and often certain activities should be avoided. Your health practitioner will advise on these.

• A good exercise program can help back pain and help prevent a re-occurrence. Philip may prescribe you specific exercises based on your personal bio- mechanics and injured tissues. An exercise that benefits one person with back pain could harm another person with similar symptoms.

• Posture and gait. With some back injuries you will find that you can't stand or walk straight. This is the bodies intelligence taking the weight off inflamed weight bearing tissues. Go with it and do not try to force yourself to be straight as this can aggravate things. You may find a walking stick helps. You will become straighter as your back heals.

• Sitting can aggravate some types of back pain. If this is the case, keep sitting and driving to the minimum and use a firm chair with lumbar support. When possible rest lying down with your knees bent.

• Ice is not recommended for low back pain. Although ice can help reduce inflammation, it also increases muscle tone, which is not helpful.

• Heat, such as a hot water bottle, heat pad or wheat bag, can be useful to help relieve tight painful muscles, but it should not be too hot, or applied for too long, as heat can increase inflammation, causing an aggravation of the underlying injury. As a guide, the temperature should not be over 60 degrees, and should not be applied for more than 30 minutes, with a 30 minute break between applications. Alternating hot and cold has been proven to be ineffective.

• A warm bath with a handful of Epsom salts is very relaxing and can give relief from back or neck pain. Epsom salts can be purchased from a pharmacy. They are magnesium sulphate. Some of the magnesium is absorbed into your muscles and helps relax them. Dissolve a couple of handfuls of the salts in some hot water in the bottom of the bath and stir until dissolved. Then add both hot and cold water until you have a warm but not too hot bath, and lie back and have a soak for twenty minutes. After your bath drink plenty of fluids.

• If you are overweight, loose weight. Being overweight affects the alignment of your spine and puts extra pressure on your discs. The more overweight people are, the more likely they are to have back pain. At any one time, 2.9% of adults of normal weight will have back pain. This rises to 5.2% in the overweight and 11.6%in the obese.

• Lifting: Don't lift objects that are too heavy for you. If you attempt to lift something, bend your knees and your hips, keeping your back straight, and lift with your knees and your hips with your stomach muscles tight. Keep the object close to you, don't stoop over to lift. Don’t twist while lifting.

• Beds: Individual needs vary. If the mattress is too soft or too hard, many people will experience backache. A mattress needs to allow the more prominent parts of the body to sink in and support the more hollow parts. If the mattress is too hard the person will have to sleep twisted in order to present a flat surface to the mattress. A worn or poor quality mattress will sag. A firm base is preferable. If you have a box spring base, a piece of plywood between the base and mattress will help. A mattress pad will help soften a mattress that is too firm.

• Stretching exercises such as yoga have been shown to decrease the incidence of back pain. A supple spine is less likely to be strained. Stiff joints will degenerate more quickly. Stretchable hamstring muscle give good hip movements, which save the back when bending and lifting.

• Exercising on an unstable surface helps strengthen the stabiliser muscles, which are also the muscles that help prevent injury. Examples are exercise balls, skateboards, surfboards, snowboards and skis. If resistance training in a gym, it is best to sit or lie on an exercise ball rather than be supported by a bench, and to use free weights, or to move weights via a cable, as then the stabiliser muscles will be used. To strengthen large muscles without also strengthening the stabilisers is to invite injury.

Natural Remedies

Natural Anti Inflammatories

These taken orally may help reduce inflammation:

• Turmeric (curcuma longa)
• Frankincense (boswellia serrata)
• Ginger (zinzibar officianale)
• Devils claw (harpagophytum procumbens)
• Protolytic enzymes such as papain and bromelain
• Omega 3 fatty acids (fish oil/marine lipids, flax oil)

Muscle Relaxants

Magnesium is a natural muscle relaxant.

• In a warm bath: Epsom salts
• Orally: chelated magnesium such as magnesium glycinate

Joint Repair Supplements

These supplements may help repair damaged joints:

• Chondroitin sulfate
• Glucosamine sulfate
• Hyaluronic acid
• Collagen (type 2)
• Methyl sulfonyl methane (MSM)

Herbs for Massage

Essential oils or tinctures made from the following herbs may be added to massage oil or cream:

• Lavender (lavendula angustafolia)
• Marjoram (origanum marjorana)
• Chickweed (stellaria media)
• Comfrey (symphytum officinale)
• Chili pepper (capsicum frutescens)
• Leopard's bane (arnica montana)
• Common rue (ruta graveolens)

Non-Prescription Medicines

Paracetamol (Panadol, Paracare) can be taken at the same time as an anti-inflammatory such as ibuprofen (Nurofen, I-Profen, Act-3) or diclofenac (Voltaren). You can buy paracetamol combined with ibuprofen (Nuromol, Maxigesic).Do not exceed the recommended dose and talk to your GP if you are pregnant, taking other medicines, still in pain after one week, or have any side effects.

Persistent Pain

Pain killers do not give effective long term relief for persistent (chronic) pain. All of them can cause hyperalgaesia, which is when all pain is amplified, and some are addictive. Read either of these PDF's to learn how to manage persistent pain without drugs:

Philip Bayliss, 43 Thames Street, St Albans, Christchurch. Phone: 03 356 1353