Our bodies are not badly stacked towers of Jenga which is liable to “fall out of place” at the slightest knock or bump; nor are we clunky bits of machinery constantly needing to be “adjusted and realigned”. Our bodies are highly robust and adaptable! We can cope with an awful lot and our bodies get stronger to accommodate the demands we place on ourselves; we are also remarkably adept at healing and repairing!
Our bones never dislocate or ‘pop out’ and to do so would require substantial force or us to have an underlying genetic condition which affects our tissues (1). Let's take the pelvis as an example; I have lost track of how many people have told me their “hips are out, pelvis is twisted or tilted” and it’s a shame these messages are perpetuated by the health and fitness industry, despite being implausible. Firstly, if you dislocate a hip, you would most likely be in hospital so lets discount that notion, the pelvis is formed from
strong bones and supported by several very strong ligaments. It is an incredibly robust structure (1,2).
Posture has normal variations and we are all slightly different shapes this is all within a normal range. Pelvic postures are not linked with back pain nor are variations in the size of normal spinal curves (3,4). The negative imagery created by these incorrect statements may actually cause needless worry and worsen back pain (2)!
We know stress is linked to back pain as is sleep and many other factors; pain is much more complex than simply the positions of joints! These theories are fairly old fashioned and most professionals are moving away from these inaccurate descriptions of the past. Some of these notions about pain date back hundreds of years and frankly things have moved on a fair bit.
Our backs are not “out” or vulnerable but they may be painful; commonly when in pain we become more sensitive and things which normally would not be painful become bothersome (2,5),. Think of a time you had sunburn after the damage occurred normal sensations are painful whilst you recover. I think of this like sensitive teeth, they hurt when I eat ice cream but they are not harmed by it or if I stand for a long time my legs ache but are not injured.
Osteopathy can be helpful in recovering from back pain with gentle hands on treatment to reduce pain. We will also explain what has happened and reassure you about how long you can expect it to take to recover, what things you can do yourself to aid healing and prevent future issues from recurring.
Blog by Andrew MacMIllan MOst, PGCME.
Sources: Williams PL, Bannister L, Berry M, Collins P, Dyson M, Dussek E, Ferguson MW. Gray’s anatomy. Churchill Livingstone, Edinburgh. 1998 Darlow B, Dean S, Perry M, Mathieson F, Baxter GD, Dowell A. Easy to harm, hard to heal: patient views about the back. Spine. 2015 Jun 1;40(11):842-50. O'Sullivan K, O'Dea P, Dankaerts W, O’Sullivan P, Clifford A, O’Sullivan L. Neutral lumbar spine sitting posture in pain-free subjects. Manual Therapy. 2010 Dec 1;15(6):557-61. Laird RA, Keating JL, Kent P. Subgroups of lumbo-pelvic flexion kinematics are present in people with and without persistent low back pain. BMC musculoskeletal disorders. 2018 Dec;19(1):309. Testa M, Rossettini G. Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes. Manual therapy. 2016 Aug 1;24:65-74.