Back, neck and shoulder pain: what osteopathy can do

Where the pain comes from

The spot that hurts is rarely the one that started it. Pain that lasts usually tells a story of habits: the same position, held for a long time, always on the same side, replayed day after day. At the practice I call this the frog’s legs.

Persistent low back pain can come from a hip that has stopped turning freely, from a diaphragm held tight by months of shallow breathing, or from a foot that has loaded unevenly since an ankle sprain that never fully settled. The body has no compartments. It redistributes.

What I look at

I start by listening. How long, in what circumstances, what eases it and what makes it worse, what you have already tried. That time is not politeness, it is what directs everything else.

Then the examination: mobility of the pelvis, spine, ribs, shoulders and the way you load the ground. I look less at the painful area than at the areas that have stopped moving and force the first one to work for two.

Then treatment, with techniques chosen for your build, your age and what you can tolerate. And finally what you can do at home, because a session that changes nothing about your habits will not hold.

Neck, back and limb pain

The lower back

Low back pain, acute locking episodes, pain running into the buttock or thigh. By far the most common reason people come.

The acute locking episode is the most dramatic: an ordinary movement, usually straightening up or turning, and the back seizes. It is alarming and it is rarely serious. The locking is a protection, not an injury.

Low back pain that lasts looks less like an accident. It settles in, tolerates walking, and returns after a long spell sitting or a bout of lifting. I look then at the pelvis, the hips, the play of the lower ribs, and the way you get up out of a chair.

When the pain runs down the leg, the first job is to work out what is running down. Pain following a precise path to the foot, with pins and needles or loss of strength, needs medical advice before it needs me.

The neck and upper back

Neck pain, tension between the shoulder blades, screen-related discomfort. These are not bad postures in any moral sense. It is stillness that hurts. The body does not hold any position for eight hours.

This one rarely arrives on its own. A stiff neck comes with a clenched jaw, shoulders that no longer drop, sometimes a late-afternoon headache starting at the base of the skull. These things hold each other, and treating them separately explains why some neck pain always comes back.

Screen work adds two precise demands. The head moves a few centimetres in front of the shoulders, which multiplies the load the neck carries all day. And breathing rises into the chest, because a concentrating body stops letting its diaphragm drop.

What I look at: the movement of the upper and lower neck, the play of the first ribs, where the shoulder blades sit, and how supple the jaw is. What I ask of you afterwards comes down to two things to change, not a list of ten.

The shoulder

Loss of range, movements that become awkward, waking at night when lying on the wrong side.

Pelvis and knee

Sacroiliac pain, discomfort on walking or climbing stairs, long-term consequences of an old ankle sprain.

The limbs

Elbow, wrist, hand, hip, ankle. Limb pain often comes from somewhere else: a wrist that has been pulling for months can turn out to be a shoulder story, and a stiff ankle ends up being read in the knee.

A check-up, with no particular pain

You can come without hurting. It is the appointment I prefer, in fact, because there is nothing to put out before I can look.

What I look for then is different. Areas that have lost movement without yet causing pain, footings that have shifted, compensations taken on after an old injury and never given back. The body tolerates them perfectly well for years, until the day one more demand tips the whole thing over.

That day tends to come at a bad moment.

It is a useful appointment after taking up a sport again, after a pregnancy, on changing desk or workstation, or simply once a year when you know your back has a memory. The session ends with two or three concrete things to do at home, not with a list nobody keeps.

What I will not do is promise that it prevents pain. Nobody can promise that. What I can say is that I almost always find something, and that finding it without pain beats finding it with.

What osteopathy does not do

It does not act on organic disease and replaces no medical care. It works on functional disorders, meaning mobility and tension, not on illness itself. When what I find goes beyond that, I say so and refer you on.