Musculoskeletal mythbusting

What is the correct way to treat musculoskeletal issues? Let’s take a look at common misconceptions and what you should really be doing.

Your back isn’t “out”.

This is something I hear almost daily: a patient presents to me after lifting something heavy and feeling a “ping” or “crack” in their back, followed by pain. A lot of people think that this means one of their vertebrae has moved out of place and is what’s causing their pain.

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Our bones and joints are held together by very, very strong ligaments. While these bones and joints need to be able to move (or else we’d be very rigid!), the movement at each joint is very well controlled and reinforced by those ligaments. It’s almost impossible to have a bone or joint “move out of place”. If they did, it would be called an acute dislocation and you’d be on your way to hospital in an ambulance!

What usually happens to our bodies when people experience this type of pain is that they have overstretched a muscle or ligament, causing muscular spasm or inflammation. Everything is still “in place”, it’s just a bit inflamed and sore!

It can’t be “cracked back in”.

If it’s not the bones that are out of place, manipulation is certainly not putting a bone back into place. I do use spinal manipulation on some patients where it’s necessary, however not on the pretense that I’m moving a bone back into place.

The cracking sound is a gas bubble forming in a joint (see this link for more info) and can sometimes be used in conjunction with massage and stretching to improve flexibility in the area.

Manipulation has also been shown to affect the natural “pain killing” nerves in the area, so it can assist with temporary pain relief in some people.

It’s probably not a migraine.

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Migraines are a very particular type of condition. When people have thumping headaches that aren’t getting better with pain killers, they often assume it must be a migraine. The differentiation is important, as severe headaches and migraines are managed differently.

Migraine refers to a condition where the nerves and blood vessels in our brain become hypersensitive or inhibited, causing a myriad of symptoms.

Some people might get tunnel vision, blurry vision, nausea, sensitivity to light, sensitivity to sound, dizziness or numbness in the face or extremities. These symptoms will often appear just before or in conjunction with a headache of varying severity. Because migraines affect the brain and nervous system, it’s important to have them investigated to rule out any sinister causes of the symptoms.

Severe headaches can be absolutely debilitating, however they are often caused by things other than the brain’s vascular or nervous systems so are treated differently.

Bed rest isn’t best.

The attitude of most manual therapists, specialists and doctors has completely changed in recent years about bed rest and musculoskeletal pain.

We know now that a lack of movement and exercise will actually worsen most musculoskeletal aches and pains.

If you can’t exercise due to pain, have a chat to an osteopath, physiotherapist or exercise physiologist as they are skilled at finding things that you can do or helping you to alter technique to allow you to continue exercising without hurting yourself, thus improving your prognosis and shortening your recovery time.