[SA Chris]

Had a deepish pain across the top of the right of my arse for about a week and a half now and getting a bit concerned, as font is looming fast, so going to get someone to look at it. Not really got time to see a GP and get a referral, so will need to spend my own cash, but make sure I get to see the right person. Last time I knackered my back (about 2002) I saw an Osteo in Bristol, and he was really good, but not sure about what to do in this instance?

Any advice before googling to see what's available locally?

Thanks

[Houdini]

You give next to nothing away at all.  If you've got time to quiz the net see your GP first.

[GCW]

If it's muscular see a physio.
Osteopathy and chiropracters are not something I (personally) have faith in, but a lot of people (anecdotally) say it helps.
A decent GP should have a bit of a clue and should be able to guide you and maybe recommend someone to visit.

[SA Chris]

You give next to nothing away at all.  If you've got time to quiz the net see your GP first.

You miss the point entirely. I can get an appointment with my GP for monday morning, "quizzing the net" takes a few minutes, and there are some people who are capable of giving an opinion.

[SA Chris]

If it's muscular see a physio.

Thanks will do. Will track down a physio now, and see what the GP says when I eventually get to see one.

[lagerstarfish]

Sounds like a pain that I had that was associated with various back damage and posture problems. A physio sorted me out with the McKenzie exercises to manage it myself. I also got a book about managing one's back pain from the McKenzie people - google might show something up about it?

I felt the pain at the top R of my buttock, but the damage was at the spine. The main excercise was the prone back extension. Hope you get yours sorted

[carefultorque]

Hey Chris,

In a way, these aren't mutually exclusive. 

As far as I understand it from a chiropractor that I've seen a few times, the treatment is partly based on the theory that 'maintenance' by a chiropractor keeps the major nerves radiating from the spinal cord in good condition, by ensuring that they're not impinged, and that their blood supply is what it should be.  If, the theory continues, these nerves are in good nick, then the major organs work better and we feel healthier all round.  Ta da!  (I know it sure looks like it, but this isn't my pseudo-science: it's a paraphrase of what he told me underpins the theory of chiropractic).

Physiotherapists, as we all know, look at the muscles and their attachments to joints as well as functional strength.  There's nothing to say that if money were no object, you wouldn't benefit from seeing both at the same time. 

Osteopaths I don't have any experience of.

[GCW]

chiropractor keeps the major nerves radiating from the spinal cord in good condition, by ensuring that they're not impinged, and that their blood supply is what it should be.  If, the theory continues, these nerves are in good nick, then the major organs work better and we feel healthier all round. 

Load of arse.

My humble opinion, please feel free to ignore it

[carefultorque]

Load of arse.

An orthopaedic surgeon I was talking to recently put it quite diplomatically.  'My friend X takes the piss out of what I do and I take the piss out of what she [a chiropractor] does.'  He was good enough to overlook the 15 year difference in professional  training in her favour.

I'm a natural 'show me/prove it to me' pain in the arse.  But I've managed to keep an open (-ish) mind about the mediaeval-sounding theory-of-chiropractice expounded to me. 

I think even the medics are coming round.  Not sure quite how it works, they seem to be saying, but if the punters like it and it appears to have some theraputic affect, what's the harm?
 

[jfw]

i would ask people local to you (who have had the most similar type of problem) to get personal recommendations

someone could have done masses of research and an outstanding degree - and still have all the empathy and deftness of touch of a bucketful of nails - i am not saying training/a qualifications is irrelevant, just that its not the be all and end all

i'd be prepared to keep an open mind - especially if i got a rave review from a friend

i guess you also have to ask what do you really want? the real solution to your problem might be in doing tedious exercises for ages to correct your posture - what you might want right now is some immediate relief (and attention) by having a good old massage

[GCW]

I think even the medics are coming round.  Not sure quite how it works, they seem to be saying, but if the punters like it and it appears to have some theraputic affect, what's the harm?

I'm not disputing that people get benefit, only the daft explanation.

[carefultorque]

I'm not disputing that people get benefit, only the daft explanation.

Well, actually there was more!  He said that one or more of these major nerves, radiating from the spinal cord, may atrophy when there's a joint problem, unless properly maintained [i.e, by a chiropractor]

Once again, I'm just reciting exactly what he said without saying that I agree or that I'm qualified to agree.  I'm not.

[SA Chris]

i would ask people local to you (who have had the most similar type of problem) to get personal recommendations

i guess you also have to ask what do you really want? the real solution to your problem might be in doing tedious exercises for ages to correct your posture - what you might want right now is some immediate relief (and attention) by having a good old massage

I have asked about, made an appointment with someone local wo someone at work said was good.

I am quite prepared for both. Like most climbers I am sure my posture is awful.

[butters]

As far as I understand it from a chiropractor that I've seen a few times, the treatment is partly based on the theory that 'maintenance' by a chiropractor keeps the major nerves radiating from the spinal cord in good condition, by ensuring that they're not impinged, and that their blood supply is what it should be.  If, the theory continues, these nerves are in good nick, then the major organs work better and we feel healthier all round.  Ta da!  (I know it sure looks like it, but this isn't my pseudo-science: it's a paraphrase of what he told me underpins the theory of chiropractic).

Having had extensive chiropractic treatment in the past for a neck injury (a rather fetching kink in my neck that was causing the nerves to my shoulders to get trapped with extremely painful consequences) your first sentence pretty much matches up with what I would say that a chiropractor does but it also corrects the problem to a large degree as well if my understanding of it is correct. Your use of the word mediaeval is also rather accurate in my opinion - the first time I had treatment I did seriously wonder if I was ever actually going to be able to get off the table again after hearing the crack/pop that my neck and lower back made.

Got to say that the second sentence really does sound as bad as you think it does but I can see a certain correlation with living with less or no pain making you feel a whole lot better though the corresponding beating your wallet takes off sets this some. 

bluebrad

[Johnny Brown]

I've had some really worthless treatment from physios and some very worthwhile from chiros,  osteopaths and acupuncturists. If folk want to diss alterantive therapies stick to reiki and homeopathy.

[Jaspersharpe]

  Apart from the worthless physio treatment as I have a good one. Chiropractic treatment can be extremely effective.

[GCW]

If folk want to diss alterantive therapies stick to reiki and homeopathy.

Homeopathy is OK, it dispels all the evil humours and rebalances the chyle.
I'm a believer in the "no harm, no foul" principle.  Just don't support it with pseudoscientific explanations.

[Houdini]

Voodoo and harming fowl all the way for me these days.   

[Jaspersharpe]

Is that why you keep trying to hack your finger off? Wondered why I saw Lagers sticking pins in a doll the other day.......

[Houdini]

Nah . . .   Just a bad tipsy multi-tasker.

[carefultorque]

If folk want to diss alterantive therapies stick to reiki and homeopathy.

Homeopathy is OK, it dispels all the evil humours and rebalances the chyle.

I remain undecided about crystals but have taken to standing under a pyramid at dusk, inhaling dew from the wing of a ladybird. It rebalances the humours.

[Obi-Wan is lost...]

Osteopathy and chiropracters are not something I (personally) have faith in, but a lot of people (anecdotally) say it helps.
A decent GP should have a bit of a clue and should be able to guide you and maybe recommend someone to visit.

I find it incredible that Chiro's are still considered as outside standard medical circles.

For christ sakes you can get bloody aromatherapy on the NHS in Sheffield but not chiro.

I see a chiro who was president of the UK chiro association a couple of years ago. A no-nonsense Scot who doesn't feed me any mumbo jumbo. All I know is I walk in there with back pain, and walk out with less or on occasion zero back pain. There's no 'belief' or 'faith' involved. It is certainly evidence enough for me, anecdotal or otherwise. Personally I have never walked out of a GP surgery instantly feeling physically better.

Whilst we are being sceptical about interventions, reserve a healthy scepticism for some things that your GP tells you, remembering that they are told much by the pharma industry and relate it to patients as fact. Take for example the seroxat farce, it was known for years that smarties would provide better anti-depressive qualities, but GSK sat on the results and manipulated the studies until they got one that they wanted to publish. Unbelievable. How many young people's depression has been worsened to the point of suicide by taking sugar pills?

study 377 showed that the placebo was "actually more effective than the anti-depressant."

http://www.bmj.com/cgi/search?fulltext=seroxat&x=0&y=0

[fatdoc]

Osteopathy and chiropracters are not something I (personally) have faith in, but a lot of people (anecdotally) say it helps.
A decent GP should have a bit of a clue and should be able to guide you and maybe recommend someone to visit.

I find it incredible that Chiro's are still considered as outside standard medical circles.

For christ sakes you can get bloody aromatherapy on the NHS in Sheffield but not chiro.

I see a chiro who was president of the UK chiro association a couple of years ago. A no-nonsense Scot who doesn't feed me any mumbo jumbo. All I know is I walk in there with back pain, and walk out with less or on occasion zero back pain. There's no 'belief' or 'faith' involved. It is certainly evidence enough for me, anecdotal or otherwise. Personally I have never walked out of a GP surgery instantly feeling physically better.

Whilst we are being sceptical about interventions, reserve a healthy scepticism for some things that your GP tells you, remembering that they are told much by the pharma industry and relate it to patients as fact. Take for example the seroxat farce, it was known for years that smarties would provide better anti-depressive qualities, but GSK sat on the results and manipulated the studies until they got one that they wanted to publish. Unbelievable. How many young people's depression has been worsened to the point of suicide by taking sugar pills?

study 377 showed that the placebo was "actually more effective than the anti-depressant."

http://www.bmj.com/cgi/search?fulltext=seroxat&x=0&y=0

Oh God, the poor lad just wants his back fixing!!, now look what we've done!

In essence some very interesting points on here.

I'm not biased (much  ), I'm a pain Dr and I do acupuncture...


My triathlon Orthopeadic surgeon mate until 6 weeks ago was the MOST sceptical dude however... shame he a had a 6 month history of classic piriformis pain (in arse, tight hamstrings... classic cycling problem) and was now 10% off usual times for 10KM. which were declining...


After a HUGE amount of badgering... he went to see the massage therapist i go to. 1 hr of agonising therapy later he books another appt on leaving..... 2 sessions later he feels fine, 3 weeks after he beats his 10Km PB by a big margin. He's converted. 

Biomechanics  / massage therapy / chiro are not available on the NHS.

Whether this sort of therapy to allow peeps to continue to engage in sport should be free is a bit difficult.... is that the role of the NHS??? This could explode into the worth of the individual vs society and health rationing.... e.g: treating lung cancer in smokers, treating DVT in the morbidly obese or not giving an ITU bed to an overdose patient...

I'm of the opinion these musculo-skeletal therapies should be on the nHS with a nominal fee... acute back pain is now a chiro referable treatment option in the notts area on the NHS, their result for back to work rates are better then physio (I was told this by the chiro that has helped organise the NHS contract... i doubt he's fibbing)....


bottom line is: who pays. mostly it works

[duncan]

Biomechanics  / massage therapy / chiro are not available on the NHS.

They are, just called physiotherapy (substitute manipulation for chiro).  I try and avoid becoming embroiled in these kind of threads, but I am slightly disappointed that a pain doctor is not aware of this.

The traditional philosophy behind chiro. is clearly wrong, especially including the 'bones out of alignment' stuff, as most chiros. I have spoken with agree.  Equally clearly, manipulation is very helpful for many people with back pain but the brand of the manipulator does not matter (UKBEAM trial: 1000 people manipulated by physios., chiros or osteos.  All treatments equally effective, all a little better than good GP care).

To the OP: there are good 'uns and bad 'uns of all stripes and my advice is to go to whoever comes well-recommended locally, once your GP has cleared you for take-off.  Whoever you see should be giving you advice on how to look after yourself and exercises to do, not just clicking your spine, taking your money and telling you to come back next week.  There is no evidence that 'preventative' manipulation decreases the chance of a recurrence.

I've written a spiel on back pain, aimed at doctors and clued-up patients here.  It has some (basic) exercises that might be worth trying.
 

[duncan]

.

[Obi-Wan is lost...]

I've written a spiel on back pain, aimed at doctors and clued-up patients here.  It has some (basic) exercises that might be worth trying.

I love this forum! Even our lurkers have MSc's! Good work Duncan.  Interesting stuff.

[Johnny Brown]

Ditto - very good. Reassuring to know that the 'management' I've stumbled into over the last three years is pretty much exactly what you recommend.

I can add that the best way to get me going on a bad morning is ibuprofen, strong black coffee and yoga.

[Stubbs]

I can add that the best way to get me going on a bad morning is ibuprofen, strong black coffee and yoga.

I wonder if there are any gastric specialists lurking 

[Houdini]

Too right.

I would be very afraid of such an early AM diet.  Ulcers/stomach cancers.  I hope you take them after food.

[Johnny Brown]

Jeez! This is only very occasionally, and yes its with breakfast. Which bit is going to give me cancer/ ulcers?

[Houdini]

Ibuprofen is bad shit.  Nasty for your stomach lining (but I believe OK w/ food).  Anything that forces your stomach to produce XS HCL may result in ulcers.   

Coffee - very acidic on an empty stomach.  Ever wondered why you'll shit after an espresso on an empty stomach?  It's poison; albeit a cool one.   Rather like magic mushrooms: brain says wooooooo - guts say poooooo.

Too much chilli is linked w/ oesophagal cancer . . .    You can't win.

(Incidentally, I have occassional trouble keeping XTC in my tummy.  Insto-boff!  I shelve it now  )

[Houdini]

I shelve it now 

No I don't 

[Johnny Brown]

Hmm, cancer is chillis, who mentioned chillis? Bit alarmist there Houd...

[butters]

Coffee - very acidic on an empty stomach.

Too much chilli is linked w/ oesophagal cancer . . .    You can't win.

I think you are in serious danger of sounding like a Teutonic version of the Daily Mail here Houdini... 

Still by eating all the chillis at least you don't have to worry about stomach ulcers before you die!

bluebrad

[fatdoc]

Biomechanics  / massage therapy / chiro are not available on the NHS.

They are, just called physiotherapy (substitute manipulation for chiro).  I try and avoid becoming embroiled in these kind of threads, but I am slightly disappointed that a pain doctor is not aware of this.
The traditional philosophy behind chiro. is clearly wrong, especially including the 'bones out of alignment' stuff, as most chiros. I have spoken with agree.  Equally clearly, manipulation is very helpful for many people with back pain but the brand of the manipulator does not matter (UKBEAM trial: 1000 people manipulated by physios., chiros or osteos.  All treatments equally effective, all a little better than good GP care).

To the OP: there are good 'uns and bad 'uns of all stripes and my advice is to go to whoever comes well-recommended locally, once your GP has cleared you for take-off.  Whoever you see should be giving you advice on how to look after yourself and exercises to do, not just clicking your spine, taking your money and telling you to come back next week.  There is no evidence that 'preventative' manipulation decreases the chance of a recurrence.

I've written a spiel on back pain, aimed at doctors and clued-up patients here.  It has some (basic) exercises that might be worth trying.
 

Hello mate... good info

But: try to get seen quickly enough for acute sports injuries to get back to sport rapidly and effectively via the NHS.
 Post code lotterys may get you good service, more often than not though.

 I've no issue with physio.. in fact I see various physios for my ailing body. What the therapist is called (massage therapist, physio or chiro) means nothing, getting rapid access means everything. The NHS as a rule does not offer the sort of care that sports peeps need, whether it should do is another matter.

In more instances than not you'll have to pay for prompt, and thus more effective therapy.

[Jaspersharpe]

The way I see it, bouldering is not an expensive sport at all and physio costs (or whatever treatment you choose to pay for) are just an incidental expense of the sport. And, as discussed on other threads, if you have a good physio then it's not exactly a big expense for the benefit you receive from it either.

Sorry, that's terribly written but you get the idea.

[fatdoc]

The way I see it, bouldering is not an expensive sport at all and physio costs (or whatever treatment you choose to pay for) are just an incidental expense of the sport. And, as discussed on other threads, if you have a good physio then it's not exactly a big expense for the benefit you receive from it either.

Sorry, that's terribly written but you get the idea.

i agree, bouldering is basically free

[Houdini]

Coffee - very acidic on an empty stomach.

Too much chilli is linked w/ oesophagal cancer . . .    You can't win.

I think you are in serious danger of sounding like a Teutonic version of the Daily Mail here Houdini... 

Still by eating all the chillis at least you don't have to worry about stomach ulcers before you die!

bluebrad

Blah blah

Researchers at The Yale University of Medicine concluded in 1994 that Chilli Pepper consumption may cause increased risk of stomach cancer. Compared to nonconsumers of Chili Peppers, consumers had an increased risk of stomach cancer (odds ratio 5.49; 95%). Among consumers, there was a highly significant trend of increasing risk with increasing self-rated level of Chilli Pepper consumption (high, medium, or low). That said, the study found that "definite conclusion is not warranted" because there was no assesment of dose relationship.


Another recent study by The Mexico National Institute of Public Health found higher rates of gastric cancer in people with high Chilli intake (9-25 Jalapenos a day!). However no clinical evidence was found that it was the Chillies that were causing the increase in cancer.


Excessive consumption of anything, especially cock, causes cancer.  It's a fact.  I can't be arsed to provide a link for that shit there, google yourself. One day all anecdotal evidence will be eliminated by thorough research.

[Houdini]

I know a man who drinks 2L of coke a day.  He also takes prescription antacid tablets/chalk.

[Houdini]

Sorry.  Physio, Osteo or Chiro?

Physio, for me (Chiropractors are sadists).

[guru]

physio, osteo or chiro?
i personally prefere osteo (i work with too) but the difference is often due to the person not ever to the qualification (even if they are not equivalent). so, it's a double problem 
i suggest to trust to the person you go to and simply verify the results. finding the reason of body problems is not an easy question. you sometimes feel better after a treatment, but you come back to pain in a few days. this is like take a pill.. but much more expensive!

[SA Chris]

So. Been to two physio appointments. Went to same practise, but saw a different person each time (not a good sign?). First lass was pretty vague in diagnosis, saying I had "pulled something" in lower back, and then proceeded to run the whole host of treatments; acupuncture, heat (lamp), ultrasound, Electric Shock Treatment (or whatever that machine is called), massage etc. and gave me some exercises to do, which I have done. The one I saw on Tuesday gave a bit more specific diagnosis (although I can't remember what she said it was!) and also said I stand too straight and overtension the muscles that run up next to my spine (name of these eludes me too). She also opted for acupuncture and heat treatment (electric blanket) and gave me some different exercises to do. I have been doing them for two days now, and to be honest it doesn't feel much better.


I did go and see a GP, not expecting much, but he managed to surprise me as to how unhelpful he was. He said I should "see somebody". I asked him who was best and what he would recommend? He said either an Osteo or a Chiro, whichever I preferred. He also said I can get an NHS Physio for treatment. The earliest appointment I could get was 1st June.

Have now made an appointment with a recommended osteo at lunchtime tomorrow in a last ditch attempt to get it sorted.

Thanks for all the help and advice all.

[Johnny Brown]

In my experience you can tell very quickly if they're any good or not, whatever the discipline, by their touch. Unfortunately you're generally committed by then.

[Jaspersharpe]

They do sound fucking useless. Hope you have more luck with the osteo.

[SA Chris]

Just got back from the osteo. He took my back like a concertina, but produced impressive glockenspiel noises from it. Feels loads better now, much looser and not hurting as much, but proof will come in the morning.