The Mechanical Picture

Sometimes when you visit your osteopath, you won’t leave with a diagnosis with a nice clean name. This may be because what’s going on is mechanical. This means that there are probably a few things going on, and the changes that they have caused are leading to your symptoms. It sounds complicated, but this kind of presentation can sometimes be the quickest to respond to treatment.

Osteopaths like to look at the body as a whole, so it’s not unusual to come and see us with pain in one place and receive treatment in other places as well.

This approach is actually present from the outset. We notice how you get out of your chair in reception and walk towards us. We ask about things that happened around the time your pain started, as well as things further back in your history. We ask if your asthma is well managed and whether or not your desk has been ergonomically assessed. Sometimes it seems like a bit much, until we uncover something that you hadn’t even considered might play a role in your pain.

One of the most common examples of this mechanical picture is stiffness in the upper back. Computer work tends to play a big role in this, and often the stiffness goes unnoticed until it’s treated. Asthma can tighten up an upper back too, as can stress.

There are twelve bones in the upper back and five in the lower. If everything is moving well, then the movement will be fairly evenly spread over the joints between all seventeen of these. But if a few of these upper back joints are stiff, you’re suddenly asking a lot more of the lower back. If the lower back can adapt to this, then you won’t have any problems; but if it can’t then you might find yourself with lower back pain for no particular reason. If you combine a week of coughing with a lower back that’s already adapting to its limit, then maybe it’ll just take bending down to pick a pen off the floor for a twinge to start. Often this will resolve on its own, but if the upper back stays stiff and the lower back has to keep working hard, then the problem isn’t solved and will likely return.

We can think about this mechanical idea from the bottom up as well as the top down. A twisted ankle from years ago that never got quite back to 100%, or the early stages of arthritis in the hip (as in the image to the right) can also manifest in the back. Knee and ankle pain are quite easy to compensate for with a slight limp, or by avoiding straightening the knee, but they have the same effect as a stiff upper back. They make something else work harder to achieve the same range of movement.

It’s not just the back that becomes a victim; often accommodating one irritated knee can lead to irritation in the other side. Typical early symptoms of something mechanical going on can include:

  • Persistent tightness in the same area
  • Clicking, or feeling the need to click a joint
  • Feeling like your posture has changed (“I feel like I’m walking like an old woman” is a common one)
  • Being told you’re walking with a limp

Nipping these things in the bud is exactly what osteopathy is made for! If you get to the point where you’re telling people that “my back just went- I didn’t even do anything!”, then it’s definitely time to get to the root causes.


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