Welcome to the Back Pain Podcast with Rob and Dave!
We are researching the facts about back pain and bringing them to you in easy to understand format.
We are two Chiropractors who spend every day looking after people with back pain. It has become our mission to talk to the best in the business to get the facts that you need to hear. We interview everyone from surgeons, GPs, Physios, Chiropractors, consultants and more so that we can get you the answers to your questions, as well as actionable tips you can take away from each episode to start feeling better/regain your health/get back to life...
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This episode takes a look at scans, why scans might be needed and how they can help Scan.com was founded to make scanning accessible for clients and support earlier diagnosis making a positive difference in patient journeys and recovery Hear about the clinical pathway for getting a scan with Scan.com and why their process supports accurate and clear information along with the next steps through an integrated system and pathways that support the patient journey
KEY TAKEAWAYS
There is a clinical pathway that is followed alongside the option to be referred for scanning if appropriate
We use each process depending on the clinical situation, but the scans are complementary to each other
The patient won’t know necessarily know what the most appropriate scan will be, and when you have been screened you will be directed to the most appropriate appointment
With a scan, it’s important that it’s carried out as part of a process with a clinician
You can be a clinician and make a referral on the platform
Ultrasounds are an important scan for peripheral muscular-skeletal conditions
BEST MOMENTS ‘We now offer MRI, ultrasounds, X-rays and CTs’ ‘Lots of reports can be so confusing for patients and we make sure the patients understand and know what’s relevant’ There’s a whole package on offer’
ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram
Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter
Back Pain in Kids, Spondys, Spondylolysis & Stress Fractures With Angela Jackson
Épisode 130
jeudi 6 juillet 2023 • Durée 40:15
Angela Jackson, specialist paediatric muscular skeletal physiotherapist joins the podcast again to talk about all things spondy Spondylolysis is one of the most common back pain injuries seen in child athletes and although common it's vitally important that these injuries are picked up and The Back Pain Podcast is helping to raise awareness with Angela explaining how a stress fracture is very different to a full fracture and how they can be picked up along with the actions that need to be taken
KEY TAKEAWAYS
Lower back pain in a young athlete is an inconvenience that needs sorting out but the majority go back to sport without any problems
These injuries don’t occur in the non-athlete population. Whatever level it’s at, it needs checking
If you have an experienced clinician they should be able to manage it without imaging
A graduated return to activities is what’s required, we want to have an adult athlete who can withstand the demands of adult sport
We need to help them to see good credible role models who have come back from this injury
Working in phases helps young people see what the journey is back to health
It’s about getting them back into sport layer by layer, making them stronger and educating them
BEST MOMENTS ‘It’s not that kids are doing too much, it’s that they are doing too much too soon’ ‘We only get this opportunity to make you stronger once’ ‘Find a hero in their sport that you know has come back from this injury, loads of people have gone through this’
Relative Energy Deficiency In Sport (RED-S) With Dr Clodagh Dugdale
Épisode 121
vendredi 3 mars 2023 • Durée 54:30
Dr Clodagh Dugdale Consultant in Sports and Exercise Medicine working at the Spire hospital in Cambridge discusses relative energy deficiency in sport
Learn what RED-S actually is, the signs to look out for and how it’s a syndrome that affects not only elite athletes but also recreational athletes and other cohorts
This is a must-listen for anyone from professionals to weekend warriors in understanding the symptoms of RED-S and raising awareness
KEY TAKEAWAYS
It’s a mismatch of energy intake and energy expended, it’s a low energy availability status
There is a normalisation of certain symptoms such as a lack of periods and rates of depression and anxiety are much higher in those who have RED-S
Coaches and trainers are the key because they see people every week and would see the changes
A lack of periods can be an early sign of RED-S and should be investigated
It’s can be about both the workload and the dietary intake and a multi-disciplinary approach is the most effective way to treat RED-S
People with RED-S are often post viral most of the time and low in iron
Currently, it's about raising awareness about it with training and education
Any treatment must be bespoke as the time and types of food are also factors in taking in enough energy
There are many external factors as well as internal factors that need to be taken into account
BEST MOMENTS
‘We need to raise awareness of all the symptoms throughout all levels of sport’
‘If someone has reduced periods they should go and see someone as its most likely a result of low energy availability’
‘There are a lot of doctors who don’t know about this’
Do I Need an MRI for My Back Pain?
Épisode 31
vendredi 20 novembre 2020 • Durée 01:00:17
Dave and Rob are with physiotherapist Adam Dobson discussing scans and in particular how MRI scans can and are used in connection with back pain.
Scans are important but only for a small number of patients with back pain and Adam explains in detail the pathway and context that may lead to a scan being done along with reasons why a detailed clinical diagnosis is so important in this episode packed with great information and content.
Its ultimately about the right scan at the right time and this is a great opportunity to find out more.
KEY TAKEAWAYS
90% of back problems are not diagnosable on a scan and a scan will only be important for a small number of patients with back-related problems.
Scans can be used to rule something out such as a fracture, cancer or an infection and may open up a change of treatment plan.
If there is a good quality working diagnosis then imaging can create a potential additional step before treatment begins.
Patients should know what a scan is likely to show, the implications of the findings and what it might change.
Scans are highly detailed and show lots of things that may not be relevant and are common in lots of the population. These things are not predictors for pain or function in the future.
Patients should be prepared and educated to help them understand imaging.
If you’ve had a problem for less than 6 weeks, the nerves are working and there are no indicators for serious pathology there is a high chance your problem will resolve itself over time.
It’s about the right scan for the right person at the right time
The picture can change - If you are told you don’t need a scan it doesn’t mean you will never need one.
If you have persistent and disabling pain there is something wrong but it can be about the factors involved and where best to focus effort with therapy and support powerful options.
BEST MOMENTS
‘If it’s is unlikely to change the treatment plan and there is no evidence for serious pathology then there is a strong argument that imaging is not required’
Is Back Pain Stress-Related?
Épisode 30
vendredi 13 novembre 2020 • Durée 18:37
Rob and Dave come together to share great advice on a question that they are frequently asked ‘is back pain stress-related?’
Currently, there are lots of reasons why people feel stressed and in this episode, Rob and Dave share a range of different things anyone can do to lower their levels of stress. If you are able to decrease your back pain you will be able to lower your stress and the first thing you can do is listen to the Back Pain Podcast, a great source of information, content and advice all of which will help you to understand, decrease and manage any back pain and in turn lower your levels of stress.
KEY TAKEAWAYS
Exercise is a great way to relieve stress and vital if you want to lower your stress levels.
Try and remove yourself from the situation or environment that is making you feel stressed.
Getting outside and experiencing the natural world is a great way to de-stress.
Organise your thoughts to lower overwhelm, write down everything you need to do so that you can prioritise, delegate and outsource.
Take a step back and take a constructive overview, this can help to get things in perspective.
If you have a big task to complete break it down into smaller chunks.
Relieve your levels of stress through breathing – take 10 deep breaths slowly to calm yourself down.
Helping someone else is a good stress reliever and will also make you feel better.
Set yourself a challenge that can translate into a daily goal.
If you learn how to decrease your back pain then you will be decreasing your stress.
BEST MOMENTS
‘Listen to the Back Pain Podcast and learn how to decrease your back pain and lower your stress’
‘There is a little bit of self-gain in undertaking some selfless activities’
‘Try and find activities at home that you enjoy’
Discs Don’t Slip!
Épisode 29
vendredi 6 novembre 2020 • Durée 51:13
David Poulter is a physical therapist working out of Minnesota in the United States and shares great information about how dynamic our interbody joints, our discs, are effectively adapting to movement and load.
He explains how discs are structured and work with the interbody joint getting its nutrition from loading and compression.
With his extensive expertise and experience, David provides an in-depth and comprehensive explanation of both the construction and function of these interbody joints and shares why the truth is that discs don’t slip.
KEY TAKEAWAYS
The disc is the joint between 2 vertebrae. Where one vertebra joins another there are complicated structures.
It’s the bulging of the material in the disc that causes people to think its slipping.
The outer aspect of the disc conveys information about motion, position and space.
In the centre of the disc, there are no nerves because it’s all about compression but there are pain structures on the outer layers of the disc structure.
Injury can be caused by doing something too quickly or doing something for too long.
Treatment should be based on the patient and their individual history.
After an injury in rehab, you need to make sure you don’t back to something for too long, too strong or too quickly.
Rehab should follow the process of unloading, temporary rest then progressive loading to return people to where they were before.
Sitting, standing, bending are all normal and taking yourself away from your normal is more likely to result in harm to your discs.
Discs are developing and dynamic as we grow and if you do something long and often and the disc will adapt.
BEST MOMENTS
‘Symptoms are a warning system to tell us to change what we are doing’
‘These are just joints and they need to be returned to graded function’
Is YOUR Back Pain Serious?
Épisode 28
vendredi 30 octobre 2020 • Durée 46:07
In this episode, Rob and Dave talk to Laura Finucane and Sue Greenhalgh, consultant physiotherapists who are launching a video about when you should seek urgent help for your back pain.
The majority of back pain is not serious but it’s important to know what to look for, the red flags so that anything more serious is not overlooked and this episode has detailed advice on how and what to do and is an essential listen for anyone suffering from back pain.
KEY TAKEAWAYS
Serious pathology for back pain is rare but it’s important to look for and identify early on
The majority of back pain is not serious but it’s important to know what to look for so that anything more serious is not overlooked
There are risk factors that will raise the concerns of professionals but its dependent on the context.
If you experience back pain that is getting worse or you haven’t experienced before, pain that spreads from your back in a band around your body or odd feelings in your legs, feeling unsteady, pain that stops you sleeping or gets worse when you lie down then seek help immediately.
Early identification for serious pathology makes the difference in recovery and quality of life.
A change with the back pain progressing can mean it needs to be investigated.
As a patient, it can be frustrating to answer lots of questions but the detailed questions are what help the clinician with the subtle signs that can be important in understanding what’s going on.
Many people can present with worrying symptoms but it will turn out to be nothing to worry about.
BEST MOMENTS
‘If we can increase awareness people will get to the right place in a timely manner’
‘Our job is to put context around the questions being asked and empower patients to speak out about what’s going on for them’
‘The vast majority of back pain is nothing to worry about’
Ice or Heat Which One Should I Use?
Épisode 27
jeudi 22 octobre 2020 • Durée 17:11
Rob and Dave discuss one of the questions they are asked the most ‘I’ve got back pain should I use ice or heat?
There’s lots of conflicting information out there but the answer is it doesn’t matter, neither will cause you any harm it’s all about working out which one is best for you and will provide the relief you are looking for from your back pain.
Rob and Dave explain how often you should apply relief treatment in this reassuring episode that explains exactly how heat and ice work and why it’s all about working out which one is the one that works for you.
KEY TAKEAWAYS
Whatever makes you feel better is the treatment to continue to use and if it stops providing relief then try the other.
You should be trying either ice or heat to test it, moving about and continuing to use the relief treatment that is best for you.
If someone is suffering with severe pain and cannot move the recommendation could be for ice first.
Ice can help to numb pain and relieve sciatica if you apply it directly to the area.
The relief treatment can be repeated for 10-15 minutes up to every hour whether its heat or ice.
Topical heat from products can work but they will not have as much impact as ice and heat.
Reusable ice and heat packs can be helpful when you are at work or away from your home.
BEST MOMENTS
‘Try ice and if it doesn’t help then try heat’
‘Each to their own it’s about whatever works for them’
‘You can interchange between ice and heat if it works for you’
Many people (10% of the population) suffer from chronic widespread pain and in this episode, Rob and Dave share the best takeaways and nuggets of advice from previous interviews that they themselves use regularly.
Where there is pain there is inflamed tissue that is reacting and changing and you should be looking to find what is the best healing process for you. This a great opportunity to hear the best takeaways from a range of great professionals who have been guests on the podcast and shared great practical advice.
KEY TAKEAWAYS
When there is pain in the back this is inflamed tissue that is reacting and changing in the same way as other tissues in your body.
Even when the source of the irritation has been removed the tissue will continue to be inflamed and will take some time to settle down and reset.
Work on stability and mobility to create the strongest back possible.
You need to strengthen and work on movement in a controlled environment.
It’s part of being human having to pick things up and you can practice a movement to develop strength.
We rest, de-load then build movement back up again.
Movement is key and a positive mindset will make a difference.
Muscles need movement and bones and discs need loads.
If something doesn’t work it just means you need a different approach and a different professional.
Patients who are proactive in their recovery always recover better than those who are not.
Thinking about the positives, what can you do now that you couldn’t last week? The small wins mean you are moving in a positive direction.
BEST MOMENTS
‘Calm sh#t down, build sh#t back up again’
‘There can be a mental disconnect between the back and the rest of the body’
‘Damaged, angry, hyper-sensitised tissue will produce pain even if the stimulus is not very much’
Avoiding Training Injuries & Myth Busting With The Endurance Physio
Épisode 25
jeudi 8 octobre 2020 • Durée 01:08:36
The Endurance Physio, Mike James joins Dave and Rob to look at how to avoid injury, train successfully for the events you want to take part in and share some myth-busting in this fascinating episode.
Mike explains how anyone can train for and take part in endurance events if they understand how to be consistent and what their starting point is.
He discusses the most common types of injuries and why it’s vital to put in the preparation and perfect each step of training consistently before reaching for the marginal gains along with great advice on exercises that will make the difference
KEY TAKEAWAYS
You can be either a robust or fragile athlete. Those who are fragile athletes just need to be more consistent.
People pick up the most injuries because they attempt to nail marginal gains before they have perfected the first 95%
In endurance athletes 75% -85% of injuries will be lower limb, soft tissue non-traumatic and overuse, the other 25% will be traumatic, upper body associated with falls.
With tissue it’s not the load, it’s the load you are not prepared for. People sometimes pick up injuries through doing something different.
With endurance sport, any treatment will be about preparing for load. Sometimes you need to stop but it is usually about modifying the movement.
Having a wide range of activities will benefit backpain.
Every patient I see can go on and self-manage.
Changing too quickly can cause overload for endurance athletes.
Most problems with endurance athletes come from being too keen, to eager and naïve.
Coaches can make a difference if you get a good coach with the right program for you.
Cardio is king but the secret is the timing of training across the year.
It’s about creating stability, robustness and different load through the tissues
You can only benefit from the training you are resting from and you can improve recovery by making sure the training is of the right intensity.
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ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram
Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173
Belavý, D. L., Quittner, M. J., Ridgers, N., Ling, Y., Connell, D., & Rantalainen, T. (2017). Running exercise strengthens the intervertebral disc. Scientific reports, 7, 45975. https://doi.org/10.1038/srep45975
Low back pain and sciatica in over 16s: assessment and management NICE guideline [NG59] Published date: 30 November 2016 Last updated: 22 September 2020
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him.
-Instagram
Rob Beaven
Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.
