Practitioners often offer a mixture of therapy using acupuncture, manipulation and/or exercise to combat pain in the spine. At Core Body Clinic we know how useful all of these are for rehabilitation of the spine and other types of body pain. We also know how important education and knowledge is when dealing with pain.
Therefore, by combining all of these therapies and using them in the right places we are able to offer a unique approach to spinal pain. We call it ‘Spinal Combination Therapy’ or SCT.
A machine gun approach to pain is often the mistake we make when dealing with back pain. Assessment is the key to understanding all types of pain and dysfunction. Assessment also allows clinicians to understand the ‘stage’ at which a dysfunction is at in terms of chronicity. Pain is a signal that the body is engaged in a defence mechanism. The brain has acknowledged a signal. The signal has been interpreted as threatening resulting in a reaction. This reaction is often pain, stiffness in the muscles and therefore altered movement patterns. Understanding whether this is acute, sub-acute or chronic/persistent helps to provide an indication of the appropriate dose, duration and type if therapy. Education is key. If we as clinicians do not tell the patient the correct diagnosis then the treatment can actually be less effective and even perceived as harmful by the brain resulting in greater reaction and therefore more pain. At Core Body Clinic we are meticulous in the understanding of pain and its drivers. This ensures we provide the most effective treatment plan.
Using (spinal combination therapy) SCT allows us to select or combine the most effective treatments for treating pain.
Spinal manipulation describes a treatment therapy where a carefully directed thrust is delivered to the spine at a specific region of the vertebral column, often at the level of dysfunction. It Is associated with an audible ‘cracking’. This noise is created by a change in pressure within the joint. It is not the sound of bones slipping back into place.
Manipulative therapy is used to reduce pain, restore normal spinal mechanics and reduce local muscle spasm. While spinal manipulation is not a panacea for all types of back pain, it is highly effective for non-specific back pain. At Core Body Clinic our physiotherapists are highly trained in the use of spinal manual therapies, clinical rehabilitation, Pilates, and dry needling (a type of western healthcare acupuncture).
Spinal manipulation helps reduce the sensitivity of the nervous system and therefore the degree of pain felt from the spine. The brain acknowledges this and reduces muscular spasm enabling pain free and guarded movement. In many cases this allows the brain to re-engage with pre- injury and non-adaptive movement patterns. When we are in pain the body moves in a compensated manner with inappropriate muscular firing. We often move in a contorted manner, further stressing the muscles and further causing pain. All of this is what we call ‘guarding’. It is the brain protecting you. Unfortunately, for all our intricacies of human anatomy and function, the brain is unable to diagnose the problem and therefore promotes an al- out protective movement pattern. Spinal manipulation works really well to break the pattern by reducing sensitivity. The therapy promotes the release of the potent cabinet of pain relieving chemicals stored in the brain. On occasions, the brain is unable to forget about the newly formed protective muscle movement pattern and continues to deliver signals to the muscle that maintain spasm. The muscles are unable to physically ‘let go’ of the spasm and remain in a shortened state. Dry needling is highly effective in reducing this spasm and shortened state. It acts directly on the muscle and muscle motor end plate – the neural sensory component of the muscle. Dry needling is different to acupuncture because we are directly stimulating the muscle or spinal nerve root associated with the level of pain. It is also based on Western concepts of healthcare and not the Holistic and non-medical style of healthcare practised by acupuncturists. Dry needling the muscle involves the careful placement of needles into selected muscles. We are unsure of the exact mechanism but the muscles appear to submit when the needle is inserted with the nervous stimulus supplying the muscle from the brain inhibited. Using dry needling in conjunction with spinal manipulative therapy reduces the likelihood of recurrent muscle spasm. We will often assess how appropriate it is to use both treatments during our assessment phase.
Quite often this is enough and the pain is reduced significantly with movement patterns normalised. However, we see time and time again pain recurring and patients re-visiting clinicians. The reason for this is because the brain has created a ‘memory of pain’ and unlike many of our memories our brains are fantastic at recalling pain – great! Not only do we remember the pain, we recall and recite the pattern of movement and the fear of movement associated with the pain.
The final phase of SCT is to ensure that those patterns of pain are firmly forgotten about. Clinical rehabilitation uses carefully selected patterns and sequences of movement that unlearn the inappropriate habits created during the period of pain. Once the pain has settled using dry needling and/or manipulation it is essential to reassess the pattern of movement and more importantly those movements associated with the initial onset of pain or the movement direction most likely to drive the recurrence of pain. People often describe recurrent ‘catching’ and ‘spasms’ associated with twisting and turning. These can often happen at random times during innocuous movements. This is often pain memory in full operation. Each time you twist and turn with pain you are reinforcing the inappropriate pattern of movement. Over time the pattern becomes more guarded, better established and occurs with greater propensity. Prevention is better than cure and the movement re-education component of SCT ensures the abnormal activity in the nervous system is removed. The unique patterns of movement are specific to your requirements. We don’t just lay you down and get you to stretch. Stretching is often part of it but only in a carefully sequenced manner and although strengthening is important, actually getting the muscles in the spine to contact and fully relax is the aim of re-education. This is what we call patterning. Often with recurrent back pain the nervous system signals to the muscles to behave in a guarded fashion so they never fully switch off and actually increase in activity in situations where they should actually be reducing……ie bending forward! SCT also provides a progressive program so that you stay engaged and continue the home management program after the acute episode.
SCT takes the evidence and combines it to deliver a highly effective and prescribed treatment strategy to combat your unique pain.
Call or email to discuss. If you have had physiotherapy, Chiropractic or Osteopathy before we would be happy to assess why your pain has yet to resolve. We offer 15 minute free chats to understand more about your pain and how we might help you to overcome it.