Category: Pain Medicine & Treatment

A Good Night’s Sleep is Necessary for Your Health & Wellbeing

October 11, 2011 by Peter Green

The human body has incredible healing powers. One of the best ways to make sure your body can maximise its power of self-healing is to ensure it gets enough sleep. If you’re like the vast majority of people, you often sacrifice sleep for your to-do list. You’ll get through your to do list easier if you’ve had enough sleep.

Less sleep equals less ability to deal with physical and mental stress. Sleep doesn’t just help your body rest; it helps your brain take on some important maintenance tasks as well.

If you’re feeling generally run down, it might be prudent to look at your sleeping habits.

Do you regularly get less than 7 hours of sleep at night?
Do you try to play “catch-up” on the weekends to make up for lost sleep?
Do you struggle to get up in the morning and hit the “snooze” button far too often?

You might not be getting enough sleep and might not be getting enough sleep cycles each night. Sleep isn’t just one long continuous period of rest. Sleep stages include: transition into sleep, sleeping lightly, deeper sleep, and REM sleep stages. Your body doesn’t just need to have a single instance of each stage per night. In fact, you’ll go through several sleep cycles each night — which is necessary for restful and restorative sleep. Too few hours equals too few sleep cycles.

Make Sleep a Priority

Making sleep a priority is important. A lot of people don’t do this and suffer from lack of restorative sleep. Some don’t allow themselves enough sleep and others have trouble getting enough sleep.

Having trouble sleeping?

Lack of sleep can happen for a number of reasons and it can create a bit of a vicious cycle where you begin to suffer from health problems that make sleep even more difficult.

Here are some tips to help you:

Establish a bedtime routine. Your body will become accustomed to it and you’ll start to find sleeping and waking up at scheduled times easier. Follow your bedtime routine on weekends, too, especially when first starting this new regimen.
Eliminate bad nighttime habits, such as eating junk food and drinking caffeine.
Make a to-do list at night for the next day. Do this well in advance of bedtime routines so that you won’t start to think about things once your head hits the pillow.
Make sure you’re sleeping ergonomically. If you’ve got a lumpy mattress, a drafty bedroom, a lot of noise to content with, or other disturbances, perhaps it’s time to do a Feng Shui, of sorts, to make your sleeping area an oasis that helps lull you to sleep.
Aches and pains keeping you up or waking you up in the middle of the night, robbing you of precious sleep cycles? Make an appointment for a physical. If you haven’t had a physical checkup lately, there could be physical reasons why you’re having trouble sleeping. Consider making an appointment with the osteopath. Contact Peter Green Osteopath if you’re looking for a Bondi Junction or Sydney Osteopath. Get help with back pain, neck pain, repetitive strain injuries, sciatica, and other problems that could make a positive difference.

“Sweet Dreams” is a kind greeting to give to others. And when you learn how important your sleep cycles are, you’ll know that sweet dreams aren’t just nice; they’re vital for overall health and wellness.

The Osteopath, Back Pain, and Internal Disc Disruption

September 3, 2009 by Peter Green

One of the common causes of low back pain is due to minor damage to the disc known as Internal Disc Disruption (IDD). It is believed that around 40% of low back pain is caused by IDD.

Damage to the disc can be caused by a number of factors from overload and injury to long term poor postural habits and the degenerative nature of the disc itself.

Any factor that creates undue load on the spine can lead to injury and back pain. Too much mechanical stress or dysfunction may occur due to repetitive strain of the spine leading to fatigue, one very large strain, or unexpected strain. Poor technique in physical activities or poor body mechanics may lead to disc
injury. Unexpected loading can result from falls, collisions or poor technique.

You will remember from the last blog that the discs are mainly avascular and the nucleus and inner 2/3 of the annulus have no nerves. The outer third of the disc does, however, contain tiny pain-carrying nerve fibres (nocioceptive C-fibres) that, when irritated, have the capacity to cause pain and disability.
When a tear of the annulus spreads to the outer third of the disc, these nerve endings (known as sino-vertebral nerve endings) are exposed to material leaking out from the nucleus of the disc which will lead to pain from the chemical irritation of these pain-carrying fibres.

Mechanical pain can occur when the functional abilities of the annulus are compromised. When the nuclear material invades the annulus, it will destroy annular collagen fibres. The mechanical forces spread across the remaining fibers and overwhelm the disc’s normal ability to support the weight of the body and the strong compression and rotation forces placed on the spine. The excessive strain transmitted to the highly nerve sensitive outer third of the disc results in mechanical pain signals on normal movements.

Tears can occur from the inner part of the disc outwards but also from the outer part in. there is also a relationship between a disc that has lost some of its water content and become increasingly brittle (part of the degenerative disc process) and disc tears

In a degenerative disc you can also get radial tears running circumferentially around the brittle annulus itself. These are known as concentric annular tears, or radial tears, and will weaken the disc and create an irritation of the nerve fibers within the annulus of the disc.

The symptoms of back pain due to disc disruption are of chronic duration and typically worse with any loading of the disc or activities that increase the intradiscal pressure. Such activities often include bending, lifting, sitting and, sometimes changes in posture.

This pain is not a result of disc compression upon the nerve root, which is the case in a disc herniation, but rather, it is due to the damage of the internal structure of the disc itself. The resulting changes to the nuclear material and internal radial fissures lead to a pain that does not usually radiate into either leg past the knee and there are not usually classic neurological findings. In other words, there is generally no weakness or sensory loss, no loss of deep tendon reflexes or root tension signs.

Most people who suffer back pain from IDD will obtain relief with time and conservative treatment. IDD can take up to 18 to 24 months to heal and patience is, obviously, an important factor here. The other important factor is to reclaim mobility as early in the healing process as possible, without exacerbating the pain. Conservative osteopathic approaches include gentle traction and mobilisation treatments and spinal stabilization training exercises.

Anti-inflammatory and analgesic medications will also aid in the early part of the healing process.

To get a visual sense of this process go across to http://www.bayareapainmedical.com/disruption.html and click on their animation

A little bit about our discs

June 10, 2009 by Peter Green

I see a lot of people coming through my clinics in the city at Sydney Osteopathic Medicine and at Harley Place Health in Bondi Junction with back pain problems arising from their discs, so I have decided to write a little about discs to help inform you about these irascible parts of our back and the nature of damage to them. I will also talk about how an integrative osteopathic approach can help you manage these conditions or where other approaches may be advised.

Today I am going to talk a little about the basic anatomy of the intevertebral discs.

The intervertebral discs are soft but tough cushions lying between the spinal vertebrae, with the exception of between the first and second cervical (or neck) vertebrae.

They have a threefold function:
1) They form a cartilaginous joint between each vertebra and act as the spine’s shock absorbing system.
2) They are anchored to the bony vertebra via the cartilaginous end plates of the bones. In this way the discs act as ligaments holding the vertebra of the spine together.
3) They also help promote some vertebral movement acting as a pivot point. While movement between individual vertebra is limited, the motion of a region is increased when the action of several discs combine together.

The vertebral body is composed of hard cortical bone on the outside and less dense cancellous bone on the inside. The top and bottom of the vertebral body are called the end plates. The intervertebral disc, sandwiched between two vertebral bodies, is attached to these end plates. Changes in the disc may be accompanied by changes in the end plates.

The disc contains a tough outer layer known as the annulus fibrosis and the soft jelly-like inner nucleus pulposus.

The annulus fibrosis consists of 15-25 concentric collagen, or fibrous, sheets wrapping round the outside of the disc a bit like the layers of an onion. The fibres of one layer are at 90 degrees to the adjoining layer. This configuration makes them very tough and able to contain the pressurized inner nucleus and helps distribute pressure evenly across the disc.

The nucleus is the softer water-rich central portion which has a gel like consistency and is roughly spherical in shape. It is placed under very high pressure when we are upright, especially in the sitting position. It acts to support the downward weight of the body and to allow the bones to pivot around its shape. It acts as a shock absorber, taking on the impact of the body’s activities.

The pressure in the nucleus is 5 – 15 times higher than blood pressure. As a result, blood cannot reach the nucleus; Also, there are no nerves in this central nucleus or even in the inner two thirds of the annulus. The nerves are only found in the outer one third of this fibrous ring. This explains why the disc can degenerate without pain until it affects this outer layer. While the disc may wear out, there are no nerves to receive and transmit pain.

There are a number of conditions that are affected by the wearing down and damage to the discs including degenerative disc disease, disc bulge, disc herniation and internal disc disruption leading to a variety of presenting symptoms. I will go on to talk about some of these and how an osteopathic approach may help you in further blogs.