Are you suffering an episode of acute lower back pain? I encourage you to stay calm and don't panic. Lower back pain is common and it does heal, most of the time full activity is restored over a number of weeks.

There is a worrying trend to over-treat back pain with unnecessary and aggressive techniques while all that may be needed is rest and gentle manual therapy. An interesting article related to this issue is available on the Harvard Health blog and I encourage anyone who has had or is currently suffering from lower back pain to read.

Harvard Health blog excerpt:

Most routine back pain will improve on its own with conservative therapy in three months, often shorter than that,” says Dr. Bruce E. Landon, professor of health care policy at Harvard Medical School. “Even more importantly, when we do more aggressive things - such as injections, imaging, and surgery - the long-term outcomes don’t change at all. These things have very little impact on what is going on, and they have the potential to make things worse.

The effectiveness of acupuncture as a treatment for Fibromyalgia very much depends on the individual being treated. Factors such as how long the Fibromyalgia has been present, the state and responsiveness of the central nervous system, patient expectation and belief, levels of pain and physical activity, etc, can all have a bearing on how well someone may respond to medical acupuncture treatment.

The key to a successful course of treatment, from my own clinical experience, is getting the ‘dose’ of treatment correct. This usually means having to be careful not to over-stimulate and not cause too much sensation with the acupuncture needles. Given that individuals with Fibromyalgia are usually already very sensitive, much care is needed when needling to ensure that is is done comfortably. Sometimes this requires some trial and error in the first couple of sessions to discover the right dosage for the individual.

A combination of medical intervention and lifestyle modifications are needed in order to offer a cure for a repetitive strain injury (RSI).

RSI, also referred to as upper limb work related disorder, is a general term used to describe pain of muscles, nerves and tendons caused by repetitive movement and overuse (National Health Service). It most frequently occurs in those who work with computers or in repetitive manual labour. This condition mostly affects parts of the upper body including the neck, shoulder, elbow, wrists and forearm.

The best sleep position may be slightly different for each person but to avoid back and neck pain there are simple sleeping position techniques that are common for most. We spend about a third of our day sleeping in a mostly still position. This extended period of motionless can leave us feeling stiff the next morning and potentially cause or aggravate back or neck pain. Fortunately it is not difficult to achieve an aligned, pain free sleeping position with the help of some simple techniques and an extra pillow or two.

In my clinic I get asked regularly about what are the best sleeping positions and in fact it was just the other day a client queried specifically about neck pain and sleep positions which inspired me to write this post.

My first answer is usually to suggest finding a position which is most comfortable. From years of clinical experience and understanding sleep related pain issues I am usually able to offer some suggestions as to how best to achieve better sleeping positions for pain relief.

In the clinic we find medical acupuncture, when given at the correct dose, to be very effective in helping certain Fibromyalgia patients manage their pain better as well as help them move and exercise more comfortably. Unfortunately, treating Fibromyalgia is not a quick fix and requires a course of treatment of at least 6-8 weekly sessions, possibly followed by maintenance or top up sessions if it has been helpful.

There is no known cure for Fibromyalgia, but it is a condition that can be managed and medical research evidence has shown that medical acupuncture has a role to play (Berman et al, 1999, Martin et al, 2006, Harris, 2005).

Also referred to as dry needling, acupuncture is a technique of inserting very fine, solid, metallic needles into the body through the skin. The needles stimulate the nerves of the skin and muscle and increases the body's release of endorphin and serotonin (natural painkillers) in the pain pathways of the spinal cord and the brain.

The pain process is a complex and intelligent signalling system between the affected area of the body and the brain. This system is ultimately trying to protect us but it seems we can trick ourselves by making the pain sensation far worse relative to the injury.

In a recent article called "What happens when we feel pain?" I explored this pain process including questioning why pain can become persistent, how unhelpful thoughts play a role as well as best treatment and pain management techniques.

Here are two excellently presented, intriguing and entertaining videos by Professor Lorimer Moseley, a clinical scientist investigating pain in humans.

These are well worth a watch. Enjoy.

Sticking a needle into a tender muscle may sound like madness but it often does help! 

A very common condition we treat effectively with dry needling is pain and dysfunction within the muscle and connective tissue often centred around trigger points - a condition referred to as myofacial pain.

In this article I aim to describe why we use dry needling, how it works and the risks involved with some of the adverse reactions we may encounter.

Let’s take the tension headache for example, a common condition. There is some debate as to whether this type of headache is curable, or whether the best we can do is help sufferers manage their symptoms.

From my experience the extent to which a patient can manage stress, lifestyle factors and posture has much to do with how successful we are in in treatment as these are all known to drive tension headaches.

Firstly I want to explain here the three most common types of headaches. The cervicogenic (neck related), migraine and tension type headache.

Manual therapy is a term used to describe most techniques Chartered Physiotherapist do with their hands. There are techniques which are taught to us 'Physio’s' at University which take a lot of practice to perform correctly and effectively.

These include:

Pain relief for common running injuries begins with a little knowledge.

Runners often suffer niggling injuries over time. Many are not debilitating and with some determination won't prevent you from skipping your after work jog. However, if you can identify more accurately what the issue may be you are in a better position to self treat it so it doesn't get worse.