'' Self Help for Your
Written by Gareth Milner BSc. (Hons) Osteopathy
10 Minute Read
Back Pain
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This Blog post gives you a summary of effective self-help strategies for your Back and Neck Pain.
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1. Physical Therapy​
Physical Therapy uses manual mechanical force and movements to promote musculoskeletal mobility and function. Through physical examination, diagnosis, prognosis and physical intervention, Physical Therapy (including Osteopathy, Chiropractic and Physiotherapy) is highly effective in clinically treating Back and Neck Pain, both acute and chronic in nature.
Osteopaths, like myself, qualify through a 4 Year Bachelor of Science Degree in Osteopathy (see Video below). If an Osteopath lives in the United Kingdom and practises Osteopathy they have to register with the general osteopathic council (gosc).
Chiropractors qualify through a 5 Year Bachelor of Science Degree in Chiropractic. If a Chiropractor lives in the United Kingdom and practises Chiropractic they have to register with the General Chiropractic Council (GCC).
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Physiotherapists qualify through a 3 Year Bachelor of Science Degree in Physiotherapy. In the UK (outside of the National Health Service) Physiotherapists who work in private Clinics are registered with The Chartered Society of Physiotherapy.
Similarities & Differences in Osteopathy, Chiropractic
& Physiotherapy in the Clinical Treatment of Back Pain
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Osteopaths and Chiropractors essentially use the same manual techniques, including Joint Articulation, High Velocity Thrust Manipulation, Soft Tissue stretching and Massage. Most back pain presentations are due to mechanical joint dysfunction and these manual techniques aid the realignment of the spine improving joint mobility. Through the Patient’s Case History and Physical Examination an Osteopath and Chiropractor can diagnose if the back pain is more serious (e.g. a spinal disc prolapse or a kidney stone), and decide whether referral to a medical Doctor is needed or not.​​
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Even with chronic presentations including spinal joint arthritis and spondylosis (‘wear and tear’), regular Maintenance Treatment with an Osteopath or a Chiropractic every 3-4 weeks is highly effective at maintaining a good range of spinal mobility, holding of spinal posture improvements and management of chronic pain.​​
Although generalisations, Osteopaths tend to provide 1 hour for initial consultations and 30 minutes for subsequent treatments. Chiropractors tend to provide 30 minutes for initial consultations and 20 minutes for subsequent treatments. There are a lot of myths about the therapies like Osteopaths treat the muscles and Chiropractors treat the joints. Many like these are incorrect and the therapies are basically the same.
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Physiotherapists use Joint Articulation, Soft Tissue Stretching and Massage to treat musculoskeletal disorders including back pain. Exercise therapy, Electrotherapy (including Ultrasound and Interferential) and Dry Needling (basically Acupuncture) are common techniques used by Physiotherapists. Some Chartered Physiotherapists take post graduate courses in spinal High Velocity Thrust manipulation, i.e. the techniques that underpin Osteopathy and Chiropractic. These 'Courses' taken by Physiotherapists can be as short as a weekend. Osteopaths and Chiropractors learn to be safe and effective in these techniques throughout their 4 or 5 year Degree.
Many Osteopaths and Chiropractors use Electrotherapy including Ultrasound and Interferential, as well as Dry Needling (see Photo Gallery to the right). If they are honest, this is to make the treatments easier on their hands, as manual therapy as a Profession is physically punishing on the Therapist. However Electrotherapy and Dry Needling are useful and have their place in treating musculoskeletal disorders including back pain, however nothing beats Manual Therapy Techniques.
2. Exercise Therapy
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Exercise has long been known as a healthy practice, however many exercise forms can aggravate back pain or even start it. The following are my recommended practices to reduce back pain or even get rid of it.
Stretching & Pilates. A combination of a mobile spine and a stable spine is optimum. Stretching reduces spinal muscle tension, restoring good mobility and posture. Pilates does the same but also strengthens muscles including the abdominals and the erector spinae, which gives stability to the spinal mechanics. The Video below features my ''Beat Lower Back Pain'' 30 minute daily routine.
''Beat Lower Back Pain''
30 minute Daily Routine Video
available here in March 2025
Swimming is a great way of removing the load of gravity on the back and allowing the spine to decompress. A great way of keeping excessive weight off the stomach area also and with it improvement on whole spinal posture. Breast stroke should be avoided due to the extension (backward bending) of the neck and the strain this can cause on the neck muscles and joints.
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Weight Training. As an Osteopath, my advice to my Patients is always remove or reduce your Manual Handling of inanimate loads. However controlled and coordinated, lightweight Weight Training is an excellent way to provide spinal stability.
After you have finished reading this Blog, check out ''Preventing Back in the Gym'' and ''Deadlifting, A Best Practice or Hazardous Lifting Exercise?''.
Walking & Running. Firstly a quality pair of trainers are needed. It is best to spend around £100-£500 on a pair. Altra and Saucony are my go-to brands.
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Walking is a great way of getting oxygen into us, stimulating blood to move, and reducing stiffness in the sacro-iliac joints (shown below). In chronic lower back pain, dysfunction in the sacro-iliac joints is always present.
Running should be performed with caution. It should only be practised when you are back pain free, and my recommendation is no more than a 1-hour run, preferably on grass, or better still on the beach.
3. Working at the Desk
As many of us work at desks using computers it is essential that we minimise the cumulative strain that seated postures can have on the back. If you suffer from back pain, have you had a Display Screen Equipment (DSE) Assessment? An online assessment is simply not enough if you suffer from back pain. Request from your Occupational Health or HR Department for a 1-2-1 DSE Assessment from a competent person.
As shown in the Photo Gallery (to the left) hazardous postures for the back at the desk include slumping in the chair causing a C-shape to the spine; leaning on an elbow on the desk; leaning on the arm rest; tucking the feet under the seat. The first three directly cause spinal muscle tension and compromise the spinal discs and joints (especially in the neck and lower back). Tucking the feet under the seat can lead to contracture (shortening) of the hamstring muscles which can lead to stiffness in the lower back. There is now a lot of available equipment for sale that can aid your DSE Posture and Desk Ergonomics.
I find this also makes me work harder with a standing posture. Obviously standing up this much is not for all but with a chronic neck injury myself I find this reduces my neck pain and headaches (for more information google cervicogenic headaches).
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I have a left hand Evoluent mouse and a right hand Evoluent mouse. The Evoluent mouse places the forearm in a better biomechanical position which not only reduces the chances of Upper Limb Disorders (e.g. Tennis Elbow and Golfers’ Elbow), the Evoluent mouse also reduces tension in the latissimus dorsi muscle that originates in the lower back and moves the shoulder joint, therefore reducing back muscle tension. I use each mouse 50% of the day. It takes a bit of learning to use the weaker arm but is perfectly achievable.
The following are my recommendations. A desk that can go up and down. I bought mine from IKEA and stand up around 80% of the day. When my legs and/ or back get tired I then push the digital down button to sit down on my saddle chair.
Learn to touch type. This avoids holding the head down, reducing neck and lower back tension. I learnt from a free BBC online course.
Use a narrow keyboard (shown photo above right) which doesn’t have the numbers on the right hand side. This allows for less strain on the neck and shoulder as the arm is held closer to the body. If you suffer from neck pain, your Trapezius muscles (shown below) will be part of the pain causation and use of a narrow keyboard will reduce the muscle tension in this muscle. If you need to type numbers regularly, you can get a separate number keyboard and alternate its position of use.
Keep the phone close to your keyboard and use a Wireless headset (I recommend www.jabra.com or www.grandstream.com. Many people have the phone too far away on their desk. With the use of a narrow keyboard you can keep the phone nearer.
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When I am seated I prefer a saddle chair. It does need a good amount of core stability to use one; achieved through daily practice of Pilates. Check out www.bodycontrolpilates.com. For those who find a saddle chair uncomfortable, I recommend a chair with a good lumbar support. If the chair doesn’t have a built in lumbar support, you can buy lumbar D-rolls from www.performancehealth.com Having a lumbar support reduces the strain on the lower back discs.
Get your eyes checked at an Optician. You may not be aware that your vision is not what it was. Wearing glasses at the desk definitely improves my neck posture, reduces headaches, and tiredness from eye strain. ​Concerning the ideal position of the screen, the top of the screen should be level with your eyes and the distance away from you when you stretch your arm out in front of you when you are standing at the desk. For more information about desk set up please refer to the DSE Regulations written by the Health and Safety Executive.
4. Keeping Hydrated
For chronic disc and osteoarthritic joint related back pain, water can be one of the most effective pain killers. With degenerative disc disease the spinal nerves become compressed, giving localised pain in the lower back and down the leg (s), and localised pain in the neck and down the arm (s).
Drinking lots of water can pump up the discs giving the spine more shock absorption, directly taking pressure off those sensitive spinal nerves. I aim for around 3 litres a day and when achieved I notice a significant improvement in my neck symptoms and reduced headaches. Being well hydrated also improves circulation, improving healing, and allows the kidney and liver to get rid of those harmful toxins. Drinking lots of water also reduces the need for those caffeine drink fixes, like coffee and tea, as tiredness is commonly due to dehydration. Caffeine increases muscle tension and high amounts of coffee and tea will dehydrate you and your discs.
5. Nose Diaphragm Breathing & Meditation​​
Very few of us actually use the lower ribs to really breathe properly. The worst are people like me who suffer from Asthma. We shallow breathe mainly through the ineffective upper ribs. This can lead to a brought forward neck position and resulting lower neck and shoulder pain. For people with acute neck or lower back pain, as an Osteopath I recommend for at least 2 weeks they practise daily nose diaphragm breathing for 2 x 30 minute sessions. The body calming, muscle relaxing and pain relieving benefits are huge; costing nothing and is as natural as you get reducing the need for harsh on the stomach anti-inflammatory pain killers. Couple nose diaphragm breathing with www.calm.com​
6. Supplements
If you suffer from osteoarthritis in the back, taking a high potency Chondroitin, Glucosamine and MSM supplement is highly recommended. Holland & Barrett can be expensive, but they do run regular offers and remember Essay 24 from Sorry! We're Closed ... You Get What You Pay for! (www.hollandandbarrett.com). In most Health Food Shops, Glucosamine is generally sold on its own, but it is essential to get one that contains Chondroitin. These organic chemicals give the lining of the joints, called cartilage, its shock absorbing abilities. Taking a high dose Omega-3 Oil has long been known as good for your joints, as well as being good for your heart and brain function. The best forms are Fish Oil Concentrate and Krill Oil. Flax Seed Oil is another great way of getting a range of those healthy Omega oils.​
​To aid a restful and healing night’s sleep, before bed time I sometimes take a course of 5-HTP, magnesium and tryptophan. With any of these supplements, always take the recommended daily amounts on the bottles, and from time to time give yourself a break in taking them. I use Holland & Barrett for my supplements as I trust the quality.
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7. A Balanced Diet
Eating your 5 a day of fresh fruit and vegetables is essential for many vitamins including Vitamin C. With regards to the joints, Vitamin C is needed for cartilage production. Eating fish high in Omega-3s can help reduce joint inflammation. The best sources are Salmon and Mackerel. Many of us are deficient in magnesium. Eating a handful of nuts (be careful on allergies!) and seeds can provide this all important nervous system mineral. My recommendations include unsalted almonds, cashews, pumpkin* and sunflower seeds (*I roast these in the oven, much nicer!).
Beat Back Pain with Curry! Yes, an Indian. Having a spicy fish curry with onions is a great way of giving your body natural anti-inflammatories and pain killers. Quercetin in onions, Turmeric (curry spice) and Omega-3s in fish are all anti-inflammatory and capsaicin in chillis has long been known as a pain killer. Best to avoid too much Cobra Beer though! Maybe ... just one?
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Keeping your weight down through a balanced, healthy diet (and not eating too much) is also important if you suffer from back pain. Having a ‘spare tyre’ causes a sway back lordotic posture (shown to the right) which instead of loading the lumbar discs (as is good biomechanics), this unhealthy posture loads the spinal joints and especially the L5/S1 joint (as an Osteopath the most common joint we manipulate). Loading the lumbar joints over time will cause osteoarthritis in these joints and chronic back pain. Having a sway back also compromises neck posture leading to lower neck pain.
8. Manual Handling.
Whether at work or at home, performing Optimal Manual Handling practices and techniques as much as possible will reduce the strain on your back. Of course avoiding Manual Handling completely is recommended but we all know this is not possible.
At work, have you had Manual Handling Training? I am talking about practical training, not online, tick the box, Jack of All Trades Training Provider, negligent techniques stuff.
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Even if you have, watching Osteopathic Solutions' Train In 15 Video is a must and Guess what? You can download it for FREE! Click the Black Tab to the left.
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This 15 minute, #Osteopath written and produced Video teaches Optimal Handling Techniques and Practices including Squat Lifting and Lowering, Lunge Lifting and Lowering, Carrying, Pushing and Pulling, and Team Handling including Team Pushing and Pulling and Team Lifting and Lowering.​
If you suffer from chronic back and/ or neck pain, actioning ALL of the above will reduce your pain levels, significantly. Get to work!
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For much, much more on Self-Help for Your Back Pain check out ALL Episodes of The Pain Free Podcast.
Thanks for reading.
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Gareth Milner BSc. (Hons) Ost. ... Osteopath for life #gosc
