The Little
Book of Pain

A handy guide to understanding and managing different types of pain from simple sprains to back ache and mild arthritis

How to avoid and manage muscular and joint pain

How to warm up

Top tips to avoid injury

What to do if you still feel pain

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Back Back
pain
Neck Neck and
shoulder pain
Rheumatism Rheumatism and
mild arthritis
Sprains Sprains/
bruising
Muscular Muscular pain
and stiffness
What is back pain?

Back pain is a common problem that affects nearly everyone sooner or later. The pain most commonly affects the lower back, but can also affect the middle or upper part of the back. It can also be acute in nature where it presents a sudden and severe pain, or chronic if it lasts for more than six weeks. Often it is difficult to pinpoint the exact cause of back pain.

What are the symptoms of back pain?

You may have one or more of the following symptoms with your back pain:

  • Pain across the lower, middle or upper part of the back
  • Pain that starts in the back but then moves to other areas such as the neck, shoulder, buttocks, thighs or groin
  • Pain that is worse with movement
  • Difficulty moving your back - particularly bending forwards and leaning back
  • Stiff back from tense spasms of the muscles around the spine
  • Tilting of the back to one side when the pain is severe
  • Occasional tingling sensation or numbness in the back, buttocks or leg, which may travel down to the foot (a condition called sciatica, where the sciatic nerve that runs from the spine to the feet is affected)
  • Remember to always consult a pharmacist or GP if your pain is severe or constant
What are the causes of back pain?

For most people it is often impossible to pinpoint the exact cause of their back pain, and it may simply be related to strains, sprains or minor injuries, or a pinched or irritated nerve, triggered from the following:

  • Physical effort - heavy or incorrect lifting or carrying, twisting, bending awkwardly, over-stretching, or overuse of muscles from sport or repetitive movements
  • Prolonged bad posture while sitting, standing or driving
  • Or more generally a part of ageing

Sometimes there is no apparent reason for the back pain - people just wake up one day with a bad back.

For a few people, there may be a specific reason that may have caused the back pain - for example from the following conditions:

  • Mild arthritis
  • Slipped disc
  • Sciatica
  • Frozen shoulder
  • Collapse or fracture of one or more vertebrae (often the result of osteoporosis or brittle bones in older people)
  • Deformation of the spine's natural curve
  • Back pain is often experienced during pregnancy
How to treat back pain?

Acute back pain can be treated with pain relief medications and anti-inflammatories, and hot or cold compression packs. It can help you stay active and able to continue with your daily activities, in order to keep the muscles that support the spine strong, and prevent stiffness to help your recovery.

Chronic back pain that persists for longer periods, more than six weeks, requires consultation with your doctor, who may suggest the following treatment options:

  • A combination of pain relief medications
  • A structured exercise programme tailored to your needs
  • A course of manual therapy (such as physiotherapy, or treatment from an osteopath or chiropractor)
  • A course of acupuncture
What is neck and shoulder pain?

Neck and shoulder pain is a common problem, and the two are frequently connected - pain in the shoulder may arise from a neck problem, or vice-versa. The pain can range from niggling pain, to severe, burning pain. For most people, the pain and stiffness usually gets better within a short time, but occasionally the pain can become chronic, where it lasts several months. Neck and shoulder pain can often develop from the simplest of things - like sleeping in an awkward position - or even from anxiety and stress where tension builds up in the neck and shoulder region.

What are the symptoms of neck and shoulder pain?

You may experience one or more of the following symptoms with neck and shoulder pain:

  • General pain in the neck and shoulder area, and stiffness in the neck and shoulder muscles
  • Pain that starts in the neck and/ or shoulder and moves to the arm, hand or head
  • Muscles in the neck and shoulder that feel tense, sore and hard when touched
  • Acute pain and twisting of the neck to one side - this is known as torticollis
  • Weakness or fatigue in the shoulders and arms
  • Tingling sensation in the arm and fingers
What are the causes of neck and shoulder pain?

Often neck and shoulder pain can result from strains or sprains from simple things like:

  • Sleeping in an awkward position
  • Bending or moving the neck or shoulders into an abnormal position
  • Using a computer keyboard for a prolonged period of time
  • Poor posture whilst sitting or standing
  • Even from sitting in a draught
  • Anxiety and stress that causes tension in the neck and shoulder muscles
  • Pain that has radiated out to the neck or shoulder from each other, or from back problems

For others, there may be more specific reasons like injury to the neck from:

  • Trauma or injury to the shoulder, collarbone or arm from dislocation or fractures
  • Frozen shoulder - thickening, swelling and tightening of the flexible tissues that surrounds your shoulder joint, that makes the joint stiff and painful
  • Shoulder joint, muscle or tendon instability or inflammation
  • Mild arthritis
  • Slipped disc
  • Osteoporosis (brittle bones)
  • Misalignment of the spine's natural curve

For some people there simply is no obvious cause of their neck or shoulder pain.

How to treat neck and shoulder pain?

Neck pain can be treated with pain relief medications and anti-inflammatories, and applying warmth through hot water bottles or hot compression packs. Sleeping on a low, firm pillow at night and correcting your posture can all help. It is better to keep your neck mobile - so the use of a neck collar is not advised for more than a couple of days, and generally you should try to stay as active as you can. Some gentle exercises can help to strengthen your neck muscles and range of movement.

Shoulder pain can also be treated with pain relief medications, anti-inflammatories, and hot or cold compression packs to reduce inflammation and relieve pain. There may be certain activities that should be avoided to prevent aggravating your symptoms.

If you have had neck or shoulder pain or stiffness for more than a few weeks, your doctor may suggest a combination of pain relief medications, or try you on corticosteroid medications and refer you to see a physiotherapist.

In more severe cases, you may be referred to an orthopaedic surgeon (a specialist in conditions that affect the bones or muscles) or a rheumatologist (a specialist in conditions that affect the muscles and joints).

Mild ARTHRITIS

There are many different types of arthritis. Movelat can provide relief of pain due to mild arthritis.

TYPES OF ARTHRITIS

  • Milder types of arthritis are associated with persistent or recurring mild-to-moderate joint pain and can often be self-medicated without the need for regular supervision by your GP
  • Although Osteoarthritis is the most common form of arthritis, severity of the condition may vary. It is caused when wear and tear of the joint wears away the cartilage which covers the bone at the joint. It usually affects older people and develops over time. Common symptoms include pain, stiffness and swelling of the joint, which is most evident on waking in the morning. People with more sever arthritis will often be treated by a doctor or rheumatologist.
  • Rheumatoid arthritis is much rarer than Osteoarthritis, affecting about a tenth of the number of people. Although some symptoms can be similar, the two are very different. Rheumatoid arthritis is an autoimmune disease, which means your body attacks itself; it comes on quickly, rather than over many years, often affecting a number of joints and should be treated by a specialist rheumatologist
RHeumatism

Rheumatism is a general term used to describe a number of painful conditions of muscles, tendons, joints, and bones. Movelat can provide relief to rheumatic conditions.

What are sprains and bruising?

A sprain causes pain, swelling and loss of movement of around the affected joint. Bruising may also arise and show as blue discolouration of the skin. Sprains and bruising are very common injuries that affect many joints and ligaments (the bands of tissue around the joints that connect bones to one another).

Sprains occur when one or more ligaments are damaged - usually the result of stretching or twisting of the joint, for example the knee, ankle, wrist or thumb when you fall and land awkwardly or collide with an object. Bruising occurs from an excessive force applied on the skin or tissue that in turn causes blood vessels to break or burst.

After the trauma or injury, the swelling from a sprain will occur soon after, but the bruising may take longer to appear and sometimes not show at all if the blood vessels damaged are not close to the skin's surface.

What you might experience with sprains and bruising

You may experience one or more of the following symptoms with sprains and bruises:

  • Pain, swelling and inflammation around the affected joint
  • Loss of movement around the affected joint
  • Tenderness of the joint or skin to touch
  • Black-and-blue discolouration under the skin
What are the causes of sprains and bruising?

Sprains and bruising often occur as a result of playing sports or when there is a fall or collision. They are most likely to occur when you over reach, change direction or speed suddenly, fall and land awkwardly or collide with an object or person. You can be at increased risk if you do not regularly exercise, your technique is poor, there was inadequate warm up, or you are feeling tired.

How to treat sprains and bruising?

The pain of sprains and bruising can be treated with pain relief medications and anti-inflammatories to reduce inflammation and relieve pain.

With sprains, the injured area should be kept still to prevent further damage to the joints, ligaments and surrounding tissue. The recommended treatment is: protection, rest, ice, compression and elevation (PRICE):

  • Protection - protect the injured area from any further damage
  • Rest - rest the injured joint or muscle for 48-72 hours
  • ICE - apply ice regularly until the swelling reduces, but for no longer that 2-5 minutes at any one time. This will avoid the possibility of 'cold burns
  • Compression - compress or bandage the injured joint or muscle, to limit further swelling and prevent movement of the damaged area
  • Elevation - raise the injured area to help reduce swelling

Bruises are best treated with cooling through the use of regular ice or cold compression packs.

You should consult a doctor if the sprain is accompanied by severe pain and severe swelling, or one of your joints gives way and is unable to support your weight, or if the pain does not improve after several days of treatment at home. For bruising, consult a doctor if you seem to bruise easily or without any apparent reason.

What is muscular pain and stiffness?

Muscular and joint pain causes discomfort in various muscles, tendons and ligaments. Also referred to as Musculoskeletal pain, it can sometimes affect the bones.

What are the symptoms of muscular pain and stiffness?

The symptomatic profile of muscular pain varies from one individual to the other. Sometimes, people may feel as though their muscles have been pulled or overworked. This may cause them to twitch or experience a burning sensation. The three most common symptoms however are:

  • Exhaustion
  • Aches
  • Disruption to sleep patterns
What are the causes of muscular pain and stiffness?

There are several causes of muscular pain. It can arise due to general wear and tear of muscle tissue resulting from daily activities, continuous application of excessive pressure to a particular area, and as a result of sustained injury to a body part or overexertion of the muscle. The following damage to an area can also cause you to experience muscular pain:

  • Direct blow to the muscle
  • Straining of muscle
  • Displacement of a joint
  • Overuse
How to treat muscular pain and stiffness?

For more serious or severe muscular pain, a physical examination will need to be carried out by a doctor or physiotherapist before commencing treatment. This will involve a full physical examination and discussion of your medical history.

The most common treatment option for muscular pain is anti-inflammatory drugs. In extreme cases however, such as for people with acute muscular pain - it may be necessary to perform various kinds of manual therapy or mobilisation techniques, which have been shown to aid recovery.

The following treatment options may also be recommended depending on the severity and type of muscular pain:

  • Acupuncture
  • Therapeutic massage
  • Occupational therapy
  • Physiotherapy
  • Chiropathy
  • Osteopathy
  • Relaxation/biofeedback techniques