Back Pain

Back Pain and Osteopathy

Back Pain: A Very Common Complaint

Back pain encompasses all pain felt along the spinal column, from the cervical spine to the sacrum. It is the primary reason for consulting an osteopath and one of the leading causes of time off work.

Three main regions of the spine may be the source of specific pain:

• Cervicalgia — neck pain, often linked to posture, stress or injury
• Dorsalgia — mid-back pain (thoracic spine), common among those working at a desk
• Lumbalgia — lower back pain, the most common and most disabling

Why Does Back Pain Occur?

• Poor posture — prolonged sitting, poorly positioned screen, ergonomically deficient work setup
• Sedentary lifestyle — lack of physical activity leading to deconditioning of spinal stabilising muscles
• Stress and psychosomatic tension — the back is a frequent site of stress somatisation
• Repetitive mechanical strain — heavy lifting, repetitive movements, vibration
• Inappropriate sport — training overload, incorrect technique
• Pregnancy and postpartum — postural and hormonal changes
• Poorly resolved past injuries — sprains, falls, old accidents creating compensations

Common Symptoms

• Localised or diffuse pain along the spine
• Morning stiffness or stiffness after sustained postures
• Pain radiating to the limbs (sciatica, cruralgia, cervico-brachial neuralgia)
• Feeling of tension, blockage or muscular spasm
• Headaches of cervical origin
• General fatigue associated with chronic pain

Osteopathic Approach

Treatment aims to restore mobility, release muscular tension and re-establish overall mechanical balance. The osteopath does not limit treatment to the painful area but assesses the entire body:

• Joint mobilisation of restricted spinal segments
• Muscular work on paraspinal muscles, psoas, trapezius, diaphragm
• Rebalancing of the pelvis and sacroiliac joints
• Cranial and cervical techniques where indicated
• Consideration of lower limbs and thorax in the global postural balance

When to Consult?

• Recent back pain with no spontaneous improvement
• Recurrent back pain, even if it resolves between episodes
• Stiffness or functional limitation affecting daily life
• Pain related to a change of workstation, return to sport or pregnancy
• Preventively, to maintain good mechanical balance

How Many Sessions?

1 to 3 sessions are generally sufficient for acute back pain. Chronic or recurrent cases benefit from adapted follow-up, with sessions spaced according to progress. Preventive follow-up (2 to 3 consultations per year) may be proposed for patients with persistent risk factors.

References

• Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. (2013). Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Annals of Family Medicine, 11(2):122-129. PMID 23508598
• Franke H, Franke JD, Fryer G. (2014). Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 15:286. PMID 25175885