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Cheyham Lodge, 11 Cheam Road, Ewell Village, Epsom, Surrey KT17 1ST

Some recent research findings on triggers for back pain.

Below is a copy of a Reuters Health information article by By Andrew M. Seaman

(February 11, 2015) –

Factors that can trigger pain in the lower back include working in awkward positions, being distracted, and being physically or mentally tired, a new study shows.

“Back pain is a major public health concern,” said Manuela Ferreira of The George Institute for Global Health at The University of Sydney, Australia, one of the study’s authors. “It’s among the leading causes of disability around the world.”

Ferreira and her colleagues interviewed nearly 1,000 people who developed sudden lower back pain in 2011 and 2012, asking whether they’d been exposed to any of 12 possible triggers in the two hours before their pain started.

Overall, people were most likely to have sudden lower back pain in the morning.

Manual tasks involving awkward positions were tied to an eight-fold increase in risk for lower back pain, the researchers found. Manual tasks involving objects away from the body, animals or people, and unstable objects increased the risk of back pain between five and six times.

Being distracted during a task or activity increased the risk of sudden lower back pain by 25 percent, they found. Being physically or mentally tired increased the risk about four times.

Alcohol consumption and sex were not tied to an increased risk of sudden lower back pain, however.

The new study can’t explain why certain things greatly increased the risk of back pain while others did not.

There are some theories, however. For example, people may be at higher risk of back pain in the morning because they may not be fully alert yet. Or, Ferreira said, the disks in the spine might be more susceptible to damage in the morning.

She said people who are used to lifting heavy objects probably know how to do it safely, but people should ask for guidance from doctors or physical therapists if they’re unsure.

“Back pain will affect about 10 percent of the world’s population at some point in their lives,” Ferreira and her colleagues wrote February 9 online in Arthritis Care and Research.

“Although we have many studies looking at the interventions for back pain, we don’t have a lot of knowledge about prevention,” Ferreira said.

“People who are not involved with these activities on a daily basis, they should pay attention to how they’re lifting,” she advised. “Even brief exposures to those activities can lead to back pain.”

Also, she said, it helps to be physically and mentally strong, with a healthy diet and regular exercise.

Comment from Osteopath R Katesmark; whilst the above is not exactly world shattering news to anyone who has suffered back pain it is worth reiterating that awkward lifting movements is really all about leverages & the inherent structural vulnerabilities of the spine.

For example lifting a weight away from your body vastly increases the leverage( & therefore strain) on the lower lumbar spine. Similarly lifting even light objects in an awkward position ( for example with the back  rotated, & bent forward to the side ) means that the large muscle groups cannot work as effectively to support the spine, thereby leaving the ligaments/disc’s vulnerable to damage,

Although the above article correctly stresses that fatigue is an important factor it fails to mention that rushing/sudden movement is also a significant risk factor. 

So, a few rules are;

  • Don’t rush physical activities
  • Avoid strenuous lifting in the early morning
  • Test the weight of the object first ( get help if heavy)
  • Avoid lifting from an awkward position.( your weight should be evenly distributed through both feet,  with the object straight in front & close to you)
  • Keep the weight as close to your body as possible through whole lifting activity.
  • Bend the knees when lifting
  • Don’t embark on strenuous activities when tired.




Keith Gooch , Reigate, Surrey

My daughters Lisa and Jennifer have both suffered with headaches and stress related issues, without Richard’s expertise in osteopathy and his ability to treat their backs, necks and heads, thus giving them the release from their reoccurring headaches and pain, their lives would be far from normal.

Michael. Health worker

I thoroughly recommend Cheyham Lodge for anyone with a back or neck problem. Both my wife and I have required treatment and they always seem to know what’s wrong and how to fix it.

Rose  .   Grt Bookham

I had had back pain for many years and nobody seemed to be able to help. An orthopaedic surgeon said that it was muscle problem and I would have to learn to live with it. But after having four or five sessions in Mr Katesmark my back felt better than it had done for ages.

Mr Jackson. Car mechanic.

I had seen several different people about my neck but Richard was a first one to explain in detail what the problem was and what I needed to do to help myself.

Jodie. student

It’s amazing, of the one treatment I felt completely different and within two days all the pain disappeared.

Beware of text neck

An article by spinal specialist in New York ,Dr K Hansaraj, caught my eye recently. He was warning of the dangers of spending too much time texting.

Here at cheyhamlodge osteopathic clinic we have been aware that the introduction and widespread use of smart phones/tablets and laptops (when used on the lap) has to be taken into consideration when managing patients with neck and upper back pain.

The problem is leverage: our heads weigh between 10 and 12lb but as we angle it down the effective weight, and therefore strain on the neck, goes up exponentially. For example at 15° the effective weight is 27lb and at 60° -the usual angle of the neck when looking at a smart phone in the lap- it rises to as much as 60lb! This puts a significantly increased tension on the spine and surrounding muscles.

Of course this is also true if reading a book in your lap, but it is clear that all these different electronic devices have resulted in people spending more time with their neck at this unnatural angle and a corresponding increase in neck and upper back pain.

There are other mechanical factors which may make an individual more prone to this problem and these may need to be managed with treatment and exercises. But as prevention is always better than cure it makes sense to limit the amount of time you spend on these devices and where possible place laptops on tables or hold mobile devices higher (more level with the eye) to reduce the strain on the neck .

N.b. As head clinician at a headache and migraine clinic headpainrelief.co.uk it is also worth noting that increased use of the above devices and resultant neck tension is also responsible for many patients headaches.

Sheila. Businesswoman. Chessington

For months I had been having from daily headaches  and severe pains behind my eyes often occurring twice a week. I had seen a nerve specialist who told me I had migraine and suggested taking daily  beta-blocker pills. However my doctor suggested seeing Mr Katesmark who treated my neck and head three times and completely got rid of the migraines, it was like a miracle…I felt better than I had done for months and didn’t need take the pills.

David White. Retired accountant

I first visited  Richard about 30 years ago with an acute lower back problem which various osteopaths, chiropractors and physiotherapists had failed to improve.  He made me mobile again and I was able to resume playing all the sports I had been unable to play for several months.  Since then I have visited Richard for occasional maintenance on my back and to sort out various other problems with my shoulder, neck and knee.  Over the years I have learned to treat my lower back with more care and my visits to Richard have become less frequent.  I have already recommended him to several friends and colleagues and would not hesitate to do so again.

Anita, Chipstead

Richard Katesmark is an excellent osteopath who has been treating me for various problems over the past 20 years and in whom I have complete confidence.  He is the first person that I would recommend anyone to consult with a problem .