About the Patient
Graham came to see me with a fifteen year history of lower back pain. Although he had managed his intermittent back pain with pain killers prescribed by his GP and the occasional massage – he had learned to live with it. That was until it affected him playing his beloved golf. When Graham had a particularly bad bout of lower back pain it had stopped him playing golf. He explained to me that golf was his only exercise and a social outlet for him and he needed to get it fixed. After a bit of nagging from his wife he booked into see me.
When a patient comes in with any kind of long chronic injury history I know it’s always going to be a challenge due to the joints and tissues having undergone a lot of change. However I am always optimistic with the right treatment and a sound commitment from the patient to do their exercises most patients will get better and learn to manage their body better.
Assessment & Diagnosis
I carried out a thorough assessment of Grahams spine and posture in the first assessment. Sure enough I found the expected spinal stiffness particularly in the lower lumbar joint at the base of the spine (L5-S1). There was a lot of tension in his muscles surrounding the spine and there was weakness in his core muscles and gluteal muscles.
When carrying out a postural assessment I noticed Graham had flat foot arches and so I carried out a Gait analysis to measure his foot function and foot biomechanics. To do this Graham walked across the pressure mat which recorded his timing sequences during walking. This confirmed that his walking pattern and in particular his lack of big toe movement was putting strain on Grahams back. I explained to Graham that the big toe forms the pivot for entire body movement, and a disturbance in function, when repeated thousands of times on a daily basis, can alter the way we move and put strain on the lower back. When Graham seemed perplexed that his feet would be aggravating his back I did explain that golf includes a 6 mile walk around a course.
The treatment plan for Graham consisted of:
1. Osteopathic Treatment – Graham came for 6 treatments in total to mobilise his lower back and relax tense muscles.
2. Exercise Rehabilitation – as discussed Graham had a role to play in helping his back get better in the short and long term. I gave him a set of daily exercises to maintain mobility in his back and improve core stability.
3. Orthotics – I prescribed orthotics to improve his foot function. As I explained to Graham – the good news is that when his foot type is treated specifically with an orthotic, over 77% people will get long-term relief from their back pain.
Road to Recovery
The good news is that Graham is now playing regular 18-rounds of golf with his friends pain-free for the first time in 15 years. He comes to see me every 6 weeks for maintenance to keep his back mobile and make sure he is doing his exercises. His has not had a back spasm in over 6 months.