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Treating Long-Term Back Pain

by Tim Hanwell(more info)

listed in back pain, originally published in issue 266 - November 2020


If we get out of bed one morning with a bit of back pain, the chances are we are unlikely to do anything about it. It’s easy to put it down to ‘just one of those things’ that will take care of itself. We have no idea how or why it happened but we shrug it off as something everyone has to put up with now and then. A few days later, when the pain still hasn’t subsided, we might try some over-the counter pain relief such as Ibuprofen or paracetamol.

It’s only probably a week or two later when the pain has become quite debilitating that we might take ourselves off to the GP who has a whole cabinet of pain relief and muscle relaxants that’s bound to do the trick. By now, if all this has failed, we might start considering Pilates, yoga, swimming and hot and cold packs to change the blood flow to the body.

During stage one we can see we have taken all the obvious steps to:


Back Pain 266


Cope with the Pain

  • Ignored it and hoped it would go away;
  • Taken pain killers/anti-inflammatories such as paracetamol or Ibuprofen;
  • Sought stronger pain killers from the GP;
  • Embarked on exercise such as Pilates, swimming and stretching;
  • Alternated with hot and cold compresses.

The hardest thing about the above is that we are now possibly three or four weeks into the problem and there has been little relief from the pain, which can be depressing and debilitating.

Many years ago, the advice for back pain sufferers was always complete bed rest, with pain killers, but over the years that has changed, and we now know that backs heal better when there is movement in the muscles and joints.

However, when you are in severe pain you’re unlikely to feel like moving around, so you do instinctively move less. But lying down and resting will not do any good in the long term.




What can You Do to Help Yourself?  Find The Cause!

As an osteopath I am always keen to find out what caused the pain. Sometime this can be easily rectified:

You might be suffering from some upper back pain after working slumped over a laptop.  Adding a laptop stand and using a separate keyboard will help improve poor sitting posture and take the strain from your upper back. Try and keep your head in line with your shoulders, your head is heavy (5.5kgs!) so if it is slouching forward the muscles at back of the back of the neck and shoulders will be working overtime and could become painful.

It could be some lower back stiffness after some exercise. Perhaps some simple lower back stretches before or after could help. Knee hugs and gentle rotations will help loosen the lower back.

Sometimes pain can be from a repetitive source such as tennis or using a mouse. Perhaps a different size tennis racket handle or mouse would help reduce the muscle tension.

Two Instances where People Seek Help for Back Pain

Sometimes the reason is obvious. We remember lifting something awkwardly or tripping clumsily and feeling something ‘give’ in our backs.

For example, builders and plumbers who are lifting repetitively will often seek help from an osteopath after just one incident – they prefer not to ‘wait and see’ as time off work is lost income.

But then there are those who have no idea what has caused the pain and these tend to fall into the category of ‘postural breakdown’.

We are seeing more people now who are being asked to sit for ridiculously long hours in the workplace.

They are bent over laptops and computers and their backs are fixed into a static position for long periods of the day. It is essential that we are proactive in minimising the build-up of back pain caused by our everyday lives.


Working from Home


Avoiding Back Pain Caused in the Workplace

  • Make sure your desk and chair are positioned correctly and in a comfortable position; that puts the least strain on your back;
  • Leave your desk every 45 minutes. Set a timer on your watch or screen saver to remind you to walk around and stretch;
  • Don’t be too efficient by trying to multi-task such as taking a loo break and grabbing a glass of water on the way back. Take these as separate breaks and only fill a small glass so that you have to get up again – and again;
  • Don’t have individual waste bins - put a bin in the centre of the office for everyone so that you need to get up to throw away your rubbish. Likewise, the printer should entail a bit of a walk;
  • Have a sit/stand desk. People have been known to lose weight by making no other changes in their lives than this and it’s a good way to provide some variety for the lower back.

If you require help with your workstation set-up we offer video call workstation assessments. Just email me

The next obvious step to alleviate long-term back pain is to seek medical help.

Osteopath or a Physiotherapist

An osteopath will generally aim to stretch and loosen up the muscles and joints through mobilisation and manipulation while an NHS physiotherapist will tend to opt for a series of exercise-based treatments.

It is at this point when everything seems to have failed that the patient will begin to consider more invasive options.

Steroid Injections and Surgery

These are a last resort that people reach out for when they have tried absolutely everything else.

But in recent years we have seen another alternative with the introduction of IDD Therapy, the fastest growing non-surgical spinal treatment.

Around 6 years ago I was in that hopeless position myself, in such terrible pain that I was considering surgery. People forget that osteopaths and physiotherapists often suffer back pain themselves due to the physical requirements of their work.

Whilst I was researching spinal surgery online, I discovered IDD Therapy, and I felt it could offer me the relief I was looking for. My pain had been caused by a compression injury and the decompression IDD Therapy offered made complete sense.

By my third session I was starting to feel better and I even got back the power in my big toe that I didn’t even realize I had lost.

It was the best decision I ever made for my back and I was so impressed I bought a machine for my own practice to help patients in a similar position.

IDD Therapy

IDD is a computer-controlled treatment that helps decompress the specific spinal segment causing the pain. Patients lie on a treatment couch where they are connected to a machine with a pelvic and a chest harness. The machine applies a gentle pulling force at a precise angle to take pressure off the targeted disc and to gently mobilize the joint and surrounding muscles.

Patients typically have a programme of IDD Therapy and long-term problems can need 20 sessions over a six-to-eight-week period.

What is unique is the angle of the stretch. Most of the time our bodies are pressed into the ground due to gravity. Nothing really stretches the spine like this does.

The goal is to relieve muscle spasm, and as the pain subsides therapists use gentle manual therapy to strengthen the back.

It is what your back has been crying out to do since it was injured. IDD is very clever, by adjusting the computer input we can place the epicentre of the pulling forces so they target the problematic area.

I have had people fall asleep during treatment as it is so relaxing and I have had patients weep with relief after treatment, admitting they had been sleeping in a chair for five years (as they couldn’t lie flat in a bed) or kneeling beside the bed all night because these have been the only comfortable positions for them.

A patient recently contacted me to say she had run a marathon after her course of IDD. Although she had been a runner in the past, she believed her days of pounding the streets were well and truly over.

Around three quarters of people with long-term back pain who come for IDD Therapy get better and many more see a marked improvement. IDD Therapy aims to reduce the back pain to the extent that it is either no longer present, or, at worst, is so mild that it has no detrimental effect on daily life.

When we help patients with their pain and get them moving again, they can get on with their lives and that reinforces their progress. That said, some people might need a top-up session, especially if their lifestyle, or workload, places pressure on the back. We keep the data from previous treatments and use it if patients do come back. 

Just seeing how quickly it can make a change to people’s lives is incredible. My only problem these days is not being able to get on the machine myself for a treatment as it is so in demand!


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About Tim Hanwell

Tim Hanwell DO is the Principal Osteopath and Director of IDD Therapy at Berkhamsted Osteopaths and an Osteopath at the London School of Economics Treatment Clinic in London.
IDD Therapy (Intervertebral Differential Dynamics) is the fastest growing non-surgical spinal treatment for intervertebral discs with over 1,000 clinics worldwide and a network of clinics across the UK.

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