Body Pain

It can sometimes be hard to determine the exact cause of your back pain. There are different structures in your back that could be responsible, including muscles, discs, nerves, ligaments and joints. Your brain can also get confused about what's actually hurting, so a herniated disc might feel like a bruised muscle.

This is why seeing a doctor or physiotherapist is important if you're experiencing back pain. They can conduct a thorough examination, and you will have the opportunity to describe your pain so that they can work out the most likely cause. That helps determine the most appropriate back pain treatment.

Upper back pain isn't as common as lower back pain, but it can still affect a lot of people.

The upper back tends to be less vulnerable to injury, but it can still experience problems. Upper back pain can cause stiffness, discomfort or sometimes a sharp pain in one spot. It can also result in radiating pain down the arm, chest or even further down the body. Most upper back pain isn't related to a serious issue, but it can still feel sore and irritating.

Pain in the upper back is generally due to either muscular irritation or problems with joints in the thoracic spine (the section of your spine that is attached to your ribs). Some of the common causes of upper back pain include:

• Poor posture
• Improper lifting technique
• Overuse
• Injury from sports, car accidents and other incidents

A doctor can get to the bottom of what's causing upper back pain, especially if it won't go away. Your doctor can look at your medical history and lifestyle, give you a physical examination, and conduct diagnostic tests, which might include X-rays or MRIs.

Upper back pain treatment includes rest and modifying activity levels, as well as using heat, ice and massage. Physiotherapy can be beneficial too, particularly for if you’ve been experiencing pain for a while.

Your lower back does a fairly big job that includes supporting the weight of your upper body and spinal cord. The muscles in your lower back enable you to bend, twist and move your hips to walk while the nerves supply sensation and power the muscles in pelvis and legs.

It’s perhaps not surprising that the demands of daily life – including sitting all day at a desk –  easily lead to lower back pain, which sometimes radiates down your legs. The most common cause of lower back pain is a strained muscle or ligament. Rest, over-the-counter painkillers and heat or ice packs can all help to treat this type of injury. Keep moving though – continuing some moderate activity helps reduce stiffness and discomfort.

Chronic (long-lasting) back pain can feel a lot more frustrating to deal with. It's often caused by a problem with a disc, the nerves or the joints. Causes of chronic lower back pain can include:

• Lumbar herniated disc
• Degenerative disc disease
• Facet joint dysfunction
• Sacroiliac joint dysfuntion
• Spinal stenosis
• Spondyloisthesis
• Osteoarthritis
• Trama/injury

Lower back pain may be caused by disuse of the muscles or spasming caused by poor posture or nerve irritation. Sitting at a desk all day in an inadequate chair or sleeping on a poor quality mattress can cause or worsen back pain.

Physiotherapy exercises for lower back pain focus on stretching your back muscles and other muscles that support your back, such as your abs, hips and leg muscles. Developing greater core strength helps relieve strain on your back.

Your physiotherapist can give you a personalised stretching routine to follow that will help to relieve your back pain and address its cause.

Many people experience back pain after sustaining a sports injury to their lower or upper back or neck.

Playing sports helps to keep you healthy, but there’s always the risk of injury whether from trauma or repetitive strain. You might strain a muscle, damage a ligament, put stress on your joints, or fall or get knocked over. Back pain can come from individual pursuits like weightlifting, running, cycling and even golf. Contact sports might also lead to injury.

Sports injuries can be particularly disappointing because they can make it difficult for you to keep up your usual level of activity. You might be training for an event or may already be an elite athlete who plays at professional or semi-professional level.

When you injure yourself, physiotherapy can help you to heal and get back to the sport you love as soon as possible.

Back pain treatment after a sports injury may include:

• Resting – but don’t stop moving completely or you’ll stiffen up
• Gentle exercises such as walking or swimming or anything else that doesn’t increase your pain
• Gentle stretches such as those described above for upper or lower back pain.

Each sport uses your back in a particular way. A sports physiotherapist understands the particular way your chosen sport affects your back and can develop a tailored back pain treatment plan to strengthen your back and reduce the risk of further injury. Your sports physio can also monitor your progress and help you return to your sport at the right time.

While you can find useful information about back pain online, seeing a physiotherapist about your pain is really the best thing to do.

Your back is a complex structure that you rely on for almost every movement. Back pain is also complicated, with many different causes that affect treatment choices. Sometimes the true cause of your back pain is not what you first thought.

Seeing a doctor or physiotherapist helps you find the right answers and sets a direction for your back pain treatment.

Working with a therapist ensures you get accurate advice that will help you to heal and avoid making things worse. You can try some physiotherapy treatments at home, but they could only get you so far. A physiotherapist can show you what will really work and help you to deal with your back pain in the short-term and long-term.

Fibromyalgia (FM) is a chronic neurological condition that causes widespread musculoskeletal pain and fatigue.

It involves a number of symptoms felt in different parts of your body. That pain does not seem to be due to any inflammation or damage but rather to an overactive pain system.

Fibromyalgia most commonly affects young to middle-aged women and its presentation is varied, often fluctuating in its clinical course.

At the moment, we don’t have a good answer to that question.

We’re still trying to understand the cause of fibromyalgia. Genetics may play a role as well as environmental triggers such as infection, psychological stress or physical trauma.

You’re at greater risk of developing fibromyalgia if you:

• Are female
• Have another condition such as osteoarthritis, rheumatoid arthritis or lupus
• Have a family member with fibromyalgia
• Recently had an illness or infection
• Have pain from an injury or trauma
• Have experienced emotional stress and depression.

Fibromyalgia involves significant changes in your central nervous system that amplify painful sensations.

Injuries can come at the worst of times, and the knee is no exception. It may be before an important sports match, a dance performance, or a hiking expedition that has been months in planning.

Whatever the situation, it is important not to ignore knee pain and seek out an assessment as soon as possible. If you are experiencing pain, swelling, stiffness, weakness, instability, or locking it's important to seek professional advice. Your physiotherapist will aim to identify the cause of your knee pain and advise on the most appropriate course of action.

There are many different conditions that can cause your knees can become painful and inflamed. Our physiotherapists will take your symptom and medical history into account when performing their assessment in order to provide the most accurate diagnosis.

Some of the most common causes of knee pain are:

Ligament ruptures
When ligaments (such as the ACL, PCL, LCL or MCL) are damaged, the knee joint may become unstable. Ligament damage often happens from a sports injury. A torn ligament severely limits knee movement.

Runner's knee (ITS Syndrome)
Iliotibial band syndrome is an overuse injury of the connective tissues that are located on the lateral or outer part of thigh and knee. It causes pain and tenderness in those areas, especially just above the knee joint.

Osgood-Schlatter disease
Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).

Knee osteoarthritis
Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints (cartilage) wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage.

Jumper's knee (patella tendinopathy)
Jumper's knee (also known as patellar tendinopathy) is a degenerative condition to the patellar tendon, the cord-like tissue that joins the patella to the shin bone. Jumper's Knee is an overuse injury. That means it occurs after frequent knee flexion movements.

Patellofemoral pain syndrome
Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the patella, or kneecap. It includes conditions such as patellofemoral maltracking and Chondromalacia Patellae. 

While there are over 300 types of headaches (according to the International Headache Society), there are a few types of headaches which are very common.

Tension Type Headaches
These are the most common types of headache, with some reports indicating that as many as 2 out of 3 adults will experience this type of headache at some point in their lifetime.  It is characterised by pain of moderate intensity on both sides of the head, with the sensation of pressing or tightening (with many patients describing the sensation of their head being squashed in a vice)

Migraines
Another common form of headache disorder, which is characterised by one-sided head pain (although can be on both sides) of moderate to severe intensity.  These attacks of pain last between 4-72 hours, and are often associated with nausea, vomiting and sensitivity to light and sound.  Migraines are often debilitating, and are categorised as with or without aura (temporary neurological signs such as visual disturbance before the onset of head pain).

Cervicogenic Headaches
These are headaches caused by an issue with the upper neck region. Dysfunction of the joints in the upper 3 levels of the vertebra of the neck are the most common cause but muscles, nerves and ligaments can also cause pain to radiate from the neck up into the head, which is then experienced as a headache. Cervicogenic headaches usually start as pain in the neck, and symptoms are usually on only one side of the head and often milder than with a tension type headache or migraine.

Headache triggers are anything which can lead to the onset of your headache or migraine.  Headache triggers vary from person to person, and how much they contribute to your headache also varies.  But headache triggers shouldn’t be confused with being the cause of your headache.  The cause of most headaches is sensitivity of the lower brainstem (lower part of the brain).  One or more triggers can increase this sensitivity and set off a headache or migraine (similar to water overflowing a bucket).  Some of the most common headache triggers include:

• Stress (a trigger for 70% of people with migraines)
• Poor sleeping patterns (either reduced quality or quantity of sleep)
• Diet / foods  e.g. the most common culprits are cheese (and other dairy), chocolate, alcohol, caffeine, artificial sweeteners, deli meats and foods containing MSG
• Dehydration (a trigger for up to 1/3 of migraine sufferers)
• Smells e.g. perfumes, chemicals, strong smelling foods
• Bright lights
• Medication overuse (regular use of acute headache medications more than 9 days per month can increase or perpetuate headaches)
• Fluctuating hormone levels
• Upper neck dysfunction (the top 3 levels of the neck contain nerves which set off referred pain into the head)

Keeping a headache diary can be a helpful way of tracking the involvement of triggers.

Migraine is a complex neurological disorder that affects up to 20% of the population. It exists on a spectrum with some people experiencing occasional, mild symptoms while others have frequent and debilitating attacks.

One neurology professor describes it as ‘an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger.’

There are two main types of migraine: migraine with aura and migraine without aura.

Migraine without aura is the most common type, accounting for 70-90% of all migraines. Symptoms vary from person to person but may include:

• A throbbing headache
• Sensitivity to light, sound and smell
• Nausea and vomiting.

A smaller percentage of migraine sufferers experience migraine with aura (aura describes neurological symptoms of migraine such as visual disturbances).

If that’s you, you’ll probably experience all the symptoms above plus:

• Strange visual symptoms such as blind spots, coloured spots, stars, zig-zag lines, flashing lights, tunnel vision or even temporary blindness
• Numbness or tingling
• Weakness
• Dizziness
• Vertigo (feeling like the room’s spinning)
• Speech and hearing changes
• Feelings of fear and confusion.

A migraine attack may last hours or days, disturbing work, school or social activities. They’re a big deal.

Indeed, migraine is the sixth highest cause of years lost due to disability worldwide according to the World Health Organization. There are around 6.4 million Australians dealing with regular migraines with a total economic cost of $40 billion. Don’t let anyone tell you it’s ‘just a headache’.

There are a number of triggers which can be involved in the lead up to a headache or migraine, and changes in hormone levels can be one of them.  Estrogen and progesterone play an important role in regulating the menstrual cycle and pregnancy, but unfortunately they also interact with other chemicals in the brain involved in headaches.  Headache / migraine sufferers often find that their headaches are worse or more frequent during times where there is a drop in the level of these hormones. 

The good news though is that fluctuating hormone levels don’t necessarily have to lead to worsening migraines as they are just one of a number of factors / triggers involved in the onset of a headache.  Managing your diet, maintaining good quality and quantity of sleep, ensuring adequate hydration, finding ways to help manage stress levels, physiotherapy for soft tissue and upper neck mobilisation, and pain medications around the time of lowered hormone levels are all good ways of minimising the impact of your hormones.

This is due to a phenomenon called an aura.  An aura is a fully reversible (non-permanent) perceptual disturbance which occurs before a migraine, lasting between 5 and 60 minutes.  Auras are experienced in a few different ways by migraineurs, but by far the most common is visual changes.  Other sensations, such as a phantom unpleasant smell or confused thinking can also occur as part of an aura.  Auras occur due to a slow moving wave of electrical activity in the brain, but at this point researchers haven’t been able to figure out exactly why it occurs.  Auras don’t occur in all migraine sufferers, and tend to be more common in male migraineurs.  The presence of an aura doesn’t indicate that you have a serious pathology or mean that your migraine will be more debilitating e.g. females who experience an aura often have less head pain during the headache phase of a migraine, and sometimes people will experience an aura and not go on to develop a headache at all.

Physiotherapy is a natural therapy for migraine.

Your physio will listen to your symptoms and ask you some questions then do a thorough physical examination to assess different parts of your body looking at your:

• Range of motion
• Strength
• Pain
• Posture.

Phyios understand that your body is complicated. One muscle may be tense to compensate for a weaker one somewhere else. Both need attention.

Physiotherapy for migraine may pay particular attention to releasing tension in your neck and shoulders to reduce the occurrence of headaches. Physiotherapists can also help to improve your balance and reduce dizziness.

Migraines are complex. They influence (and are influenced by) many aspects of your physical and mental health. Sycamore Health is a multidisciplinary practice, giving you the benefit of coordinated care from a GP, psychologist, physiotherapist and exercise physiologist.

In recent years, there has been lots of research into headaches and aerobic exercise (exercise of physical activity which increases the heart rate).  While more research needs to be done in regards to the effect of exercise as an acute treatment for headaches, there is some very promising findings that aerobic exercise is helpful as part of a preventative strategy for headaches / migraines, reducing the number of headaches days per months, as well as potentially headache intensity, duration and the psychological effects of headaches. 

Aerobic exercise which seems to be most helpful includes walking, cross-training, jogging and cycling, and should be performed at a moderate intensity at least 3 times per week.

It should be noted that exercise can be a trigger for some people’s headaches / migraines, and this should be taken into consideration when exercising.

DISCLAIMER: You should seek medical advice before starting an exercise program.

While it’s a bit harsh to go blaming mum or dad for your migraines, there does seem to be an association between migraines and family genes.  There are a number of genes (including KCNK18, CKIdelta, and CACNA1A) which appear to leave a person susceptible to a higher risk of developing migraines.  If both parents suffer from migraines, there is up to 70% chance that their child will also suffer from migraines, but if only 1 parent has a history of migraines, then this risk drops to as low as 25% chance.

It needs to be stressed though that the inheritance of these genes DOES NOT mean that you will definitely go on to suffer from migraine attacks.  Migraineurs also tend to have a number of environmental factors and lifestyle factors which can sensitise the brain and trigger migraines.  Managing as many of these factors as possible will minimise the chance of migraines or decrease the intensity and frequency of attacks

Osteoarthritis (OA) is one of the most common types of arthritis.

It affects the whole joint, including the bone, cartilage, ligaments and muscles. While it can affect any joint, it is most commonly found in the knees, hips, fingers and big toes.

Osteoarthritis involves the breakdown of the cartilage that covers the ends of bones in joints. This causes the bones to rub together, resulting in pain, swelling, and a loss of motion. Because it’s progressive, osteoarthritis tends to get worse over time.

While it can affect people of all ages, the prevalence increases drastically beyond the age of 45. About a third of over-75s experience osteoarthritis. 

About 1 in 11 Australians are living with this condition.

When we’re diagnosing a condition we take into account both signs and symptoms.

Symptoms reflect your own personal experience of this condition. Professionals may not be able to see a symptom like fatigue but we know it’s very real and we take it into account when diagnosing and treating your condition.

Common symptoms of osteoarthritis include:

• Stiff, painful and tender joints
• A grating sensation when you move (because the cartilage that cushions your joint has worn thin)
• Hard lumps around your joint (those are bone spurs growing on your joint)
• Loss of flexibility – it may be difficult to move the joint through its full range of motion.
• A sign is objective evidence that can be seen by your doctors and physios. We may see signs of OA when we examine you or they may show up in imaging scans.

 Signs of OA include:

• Swelling due to inflamed tissues around the affected joint
• Damage to the joint cartilage, the cushion between your bones that allows your joint to move smoothly
• Bony spurs growing around the joint (you may be able to feel a lump)
• Deteriorating tendons and ligaments around the affected joint.

Signs and symptoms are a bit like being in love. The feeling is intense, powerful and wonderful but can’t really be seen by anyone. Love leads to obvious signs of care and affection which others can see.

Osteoarthritis (OA) is not a mechanical wear and tear process. Far too many people, including doctors and physiotherapists, believe osteoarthritis is caused by wear and tear.

This false belief naturally leads to advising patients to stop walking, running, doing heavy weight training etc. to ‘save’ their joints.

The truth is you need to do the exact opposite! Your physio can recommend exercises that have been demonstrated to be the most effective treatment for early and moderate osteoarthritis of all of our joints.

So, if it’s not wear and tear – what is it?

Osteoarthritis is a biologically mediated inflammatory process...what does that mean I hear you ask?

Inside our joints we have hundreds of powerful chemicals and compounds that are made by certain cells in the synovium (the smooth lining of our joints). When our joints are healthy, these cells naturally respond well to loading and produce more lubricant after exercise. Our joints literally receive a wash in happy healthy chemicals that support cartilage health and nutrition status.

Then a switch might flip… Similar to the changes that lead to other disease states. That biological switch can turn on genes in our DNA responsible for coding for chemicals that are hostile to the health of our cartilage. Over time those chemicals build up and slowly cause cell death in the synovium. This weakens the cartilage and its ability to cushion our joint as they’re loaded. This in turn can lead to swelling, inflammation, heat, and sometimes, pain.

What causes the switch to flip?

This is a more difficult question to answer. What we do know is that it’s not caused simply by wear and tear from exercise! The biological switch may be triggered by code in your DNA. Perhaps your parents have OA so your risk is higher. Perhaps it’s caused by the confluence of factors associated with poor metabolic health (high blood pressure, obesity, diabetes etc.). We know previous injury and/or surgery to the joint, even if these occurred decades earlier, can kickstart a cellular cascade later in life. One bleeding episode in the knee can initiate the process. Meniscus tears (especially when they are surgically removed) can also compound the problem.

We know the presence of harmful chemicals in the joint space actually go down after jogging or weight training. There’s also research to show the health of our cartilage goes up with running; it gets better at moving fluid in and out after the cyclical loading.

If you have been told to rest because you have osteoarthritis, kindly ignore this well-meaning but terrible advice. If you have very severe osteoarthritis, you may need treatment above and beyond exercise alone.

Not only is exercise the best medicine for osteoarthritis, it has a myriad of spillover effects including reducing your risk of dementia, heart disease, managing weight, lowering blood pressure, improving mental health and overall wellbeing.

If you have a degenerative and arthritic joint – it needs to be moved and loaded! You are NOT wearing out your cartilage by walking or running.

Obesity is a significant risk factor for osteoarthritis because:

1. Those extra kilos place greater strain on your larger weight-bearing joints like your knees and hips
2. Extra fat tissues produce proteins that cause harmful inflammation in and around your joints.

 Other risk factors for osteoarthritis include:

• Age
• Previous injuries
• Joint overuse
• Genetics/family history
• Gender (females are more likely to develop osteoarthritis)
• Other medical conditions including rheumatoid arthritis

Here at Sycamore Health, we treat many patients dealing with osteoarthritis in one or more joints. We understand the pain it causes and are experienced in helping you manage the condition.

Physiotherapy is one of the most widely recognised treatments for osteoarthritis. Your Sycamore Health physio can assess your condition and your broader health and wellbeing then prescribe a program of exercises designed to:

• Strengthen your bones
• Improve your balance to prevent fall injuries
• Reduce pain
• Improve function.

We can also recommend assistive devices to help your condition.

So, if your joints are hurting, please come to see us. We’d love to help.

Sciatica is a type of pain that occurs when something in your body pinches, irritates or inflames your sciatic nerve's origin in your lower spine.

It's not really a condition but rather a particular type of pain. It falls under the broader categories of neuropathy (nerve problems) and radicular pain (pain due to an irritated nerve root – in this case, the sciatic nerve).

The sciatic nerve is the longest and largest nerve in the human body measuring about 2 cm wide. Starting in your lower back, one sciatic nerve sets off down your left side while its twin moves down your right, through your buttock and down the back of your leg until it reaches your foot.

This big nerve does a big job. It enables you to move your hamstrings above your knee and your calf muscles below it. It also supplies sensation, giving you feeling in your lower legs and feet.

Sciatica pain tends to follow the path of the sciatic nerve, causing trouble anywhere from your butt to your feet. It varies quite a bit from one person to another but is usually only felt on one side of your body.

If you’ve developed sciatic pain, you might experience:

• Mild or severe pain down the sciatic nerve pathway
• Tingling / pins and needles
• A sharp, burning sensation
• Worsening symptoms when you cough, sneeze or sit still for too long.

Occasionally, sciatica is more serious. You need urgent medical attention if:

• You start to lose control of your bladder or bowels
• You feel weak or numb or are in severe pain.

Referred pain is fascinating. It means that you might feel pain in one area of your body when the true problem is somewhere else.

That experience can happen when messages from different parts of your body travel the same nerve pathway, just like 3 cars heading to different places may share the same stretch of motorway for a while.

Referred pain means that a heart attack may cause pain in the left arm. It means a throbbing headache may actually indicate a neck problem. And it means a problem in your spine can cause pain in your leg.

As mentioned above, sciatica is a type of radicular pain that happens when something pinches or irritates the sciatic nerve’s origins in your lower back. Looked at like that, sciatica is actually a symptom of something else. There’s often an underlying problem that has triggered sciatica.

That’s why, when we treat sciatica, we’re not only trying to deal with your symptoms but to identify and treat the underlying condition that’s causing the sciatic pain.

Your spine is made up of bony building blocks called vertebrae. They sit on top of each other with a spongy cushion in between called a disc.

Running through the hollow centre of this spinal column is your spinal cord, a bundle of nerves that connect your brain to your body (your central nervous system). Your peripheral nervous system then connects your central nervous system to the rest of your body. The sciatic nerve is part of this peripheral nervous system. It’s job is to help you move and feel your lower body.

Sciatic pain occurs if a nerve branch is irritated where it exits the spine. There are a few places where this happens. The location of your pain relates to which nerve branch has been impinged.

Many different lifestyle habits or medical conditions can lead to sciatica. A few of the most common are:

• A slipped disc  
• Osteoarthritis
• Spondylolisthesis (a slipped vertebrae)
• Piriformis syndrome (tight or swollen muscles in your backside)
• Pregnancy (the baby’s weight can put pressure on the nerve).

Sometimes it’s hard to identify the underlying cause, which can be frustrating.

Sciatic pain affects a wide range of people but tends to be more common if you:

• Are getting older since wear and tear over the years can change your spine (osteoarthritis)
• Are overweight as that means your spine has to work harder to support you
• Sit still a lot
• Have done a lot of heavy lifting or twisting, increasing your risk of back injuries.

The duration is as varied as the symptoms, unfortunately. Some people find that their sciatic pain resolves relatively quickly and are able to get back to normal in a few weeks or months.

Others experience chronic sciatica pain that’s always there in the background, though the pain is often less severe.

A physiotherapist can examine you, rule out other potential causes and identify the underlying condition that may be triggering your sciatic pain. Your physio can then work with you to treat the underlying cause and relieve your symptoms through education, exercises and advice.

A car accident can be a distressing experience - one minute you’re going about your business, commuting to work or going to the shops, and the next minute you’ve been rear-ended and your day is ruined. 64% of Australians surveyed in 2021 reported being in at least one car accident, so you are far from alone. While improved safety technology is making our roads safer every day, it’s important to stay vigilant and take the right steps to recover if you’ve been in an accident.

There is a range of injuries that a sudden deceleration from a car accident can cause to your body, including fractures and soft tissue damage such as muscle strains and damage to joints or ligaments. Whiplash is one of the most common injuries as a result of a car crash. 

Common injuries from a car crash include:

• Fractures
• Strains
• Sprains
• Neck injuries (such as muscle spasms or damage to bone structure)
• Whiplash
• Back pain
• Chest injuries
• Bruises
• Spinal injuries such as a disc bulge

After a crash, you take your car down to the mechanic for an assessment. They’ll check the wheel alignment, engine, and body of the car to make sure that there are no underlying issues and that everything is still where it should be and doing what it should be doing. But you need to do just the same thing with your body! A physiotherapist will act like a mechanic, and they can assess you to make sure that you are in good shape. They can address any aches and pains and assemble a treatment plan to improve your symptoms if required.

If you have any of the common injuries listed above, physiotherapists can provide support and injury rehabilitation services, helping you to know how to manage the pain caused by the injury, how to exercise safely, and whether it is safe to return to your regular activities without causing any further damage. 

Additionally, you might feel some uncertainty or anxiety about the changes that have occurred in your body, wondering what’s gone wrong or how long it might take to heal. Physiotherapists can explain your injury to you and help you to understand the root cause of your pain, as well as provide pain management support.

We often find pain, after traumatic events like a car crash, can persist well beyond the timeframe for tissue healing. On the surface this seems quite strange! Why would you have lingering symptoms if the underlying tissue has fully healed? Well, we are now starting to uncover some of the answer. 

In some respects, humans are like cars and in other respects we are quite different. We are similar in that we both have mechanical and structural components that require fixing. However, unlike a car a human has a complex nervous system integrated throughout the body. So while our tissues heal and ‘forget’ the accident, the nervous system ‘remembers’ and persists in a state of hypersensitivity. Another way to think about this is by way of analogy. If we perform bicep curls for a long period of time, our muscles adapt and we get better at bicep curls. If we experience pain for a long period of time, our nervous system similarly adapts and gets ‘better at producing pain’. (This is overly simplified and not strictly correct, but it is, I think, near-enough to be helpful). 

Physiotherapists are experts, not just in injury management, but also in pain management. We can guide you through the process from start to finish with the knowledge and experience to get you back to your physical best! 

Physiotherapists can assist with whiplash management after a car crash. Whiplash is named after the cracking of a whip, and it occurs after the neck suddenly moves backwards and forwards, which is typical after rear-end collisions. This rapid movement can cause soft tissue damage to the tendons, muscles and other structures of the neck. They can become overstretched or strained, leading to neck pain, and often referred pain in the form of headaches. Other symptoms of whiplash include stiffness, swelling, tenderness and reduced mobility. Some whiplash symptoms resolve after a few days, but in other cases, the pain may last for weeks or months following the initial injury. 

A physiotherapist can provide assessment after a whiplash injury and advise on a recovery plan, as well as provide assistance with symptom management. They can perform massages to reduce tension in soft tissues, and apply heat and cold to aid in the management of pain and inflammation. They can also provide advice about the correct posture and positioning of your neck for recovery to prevent further damage and ease any pain that may be caused by muscle strain.

A car crash can cause a variety of potential issues with your back, such as a disc bulge or lumbar sprain. Overstretching or tearing of muscles in the back can often occur, as well as tightness and muscle spasms that can make for a painful back. Physiotherapists can assist you with the management of this back pain, identifying the location and likely cause of the problem, and helping you to avoid any harmful movements and promote healing wherever possible.

Bruised ribs are caused by a direct blow to the chest. They can cause chest pain that varies in quality and severity, from mild to severe. It can impact on activities such as sleeping, lying down, running, coughing and even breathing. Movement may be restricted as bending or twisting the torso can lead to pain. Physiotherapists can advise on a safe plan to return to activity and provide treatments such as dry needling, protective gear, taping, gentle stretches, and advice on lifestyle and activity modifications to minimise pain and discomfort.

A physiotherapist can examine you, rule out other potential causes and identify the underlying condition that may be triggering your sciatic pain. Your physio can then work with you to treat the underlying cause and relieve your symptoms through education, exercises and advice.