Specialist Mechanical Lower Back Consultation
The 3 Hour Consultation
This specialist lower back pain diagnosis, is performed by our clinical principal Michael Parr, an evidence based practitioner, specialising in lower back pain, assessment, rehabilitation, and performance enhancement. He has trained with the lead experts in the field, honing his skills and techniques, including training in courses such as ‘Converging on a Precise Diagnosis: The Three Hour Assessment’, ‘Building the Ultimate Back from Rehabilitation to Performance’, ‘High Performance Training’, ‘Progressing backs from pain to performance’, and ‘The Detailed Back Assessment: Converging on a Precise Diagnosis: The Three Hour Assessment Master course’.
This consultation process is for someone with severe lower back pain, or symptoms associated with lower back sensitization, which can cause re-occurring or consistent episodes of pain. This pain is believed to be musculoskeletal in nature, and after all the investigations, opinions and several failed clinical therapies, the pain still occurs. You need clarity, ‘makes sense’ approaches, and an effective diagnosis as to the current cause of lumbar pain (low back pain), a comprehensive appraisal of your chronic lower back pain case, efficient assistance, and someone who is actually trying to help you out of pain, with practical advice and application. This will be the start of a convergence of a diagnosis.
Understanding the pain mechanism, is key to success. Our approach will be to try and identify the cause of the pain during your assessment, which will include by intentionally provoking it. This will provide clear data of what is provocative for your pain, and will allow us to formulate a clearer understanding of the pain triggers.
This method is essential and irreplaceable, in assessing what postures, motions and loads, will trigger and amplify your pain, in addition to learning, which ones offer pain free movement alternatives.
This will assist in guiding you through finding and removing your personal pain triggers.
We shall use the rest of the consultation to train you in which of these alternative movements and motions allow for enjoyable, pain free lifestyles. Winding down the pain sensitivity, so that which may have hurt last month, is now found to be tolerable in the next month.
Michael has been trained by the most respected lower back pain specialists and experts in the world, in their research informed, evidence based approach to diagnosis, and rehabilitation programmes, with a great deal of people finding benefit, no matter how long they have had the pains, and no matter how many people they have had consultations with before.
We will then work to try and lay out a step by step guide, to getting you back to health.
During a Specialist Complex Low Back Pain Diagnosis Consultation, Our Aims Together Will Be:
Identify Pain Causes – Complex Low Back Consultation
Through thorough assessment, we will help you to learn to distinguish the distinct causes and progressions of your back pain (your pain sensitizer). Outlining any potential activities in your daily schedule that are causing and aggravating your lower back pain. Achieving an understanding of what are the primary pain mechanisms (your pain trigger mechanism). Back pain always has a cause!
Find Pain Reduction – Complex Low Back Consultation
We will work together to help find postures and movements that are less sensitizing and less pain sensitive, allowing you to clearly understand what to do to achieve this. This will help show you how to stop the cause of the pain. Firstly, you will learn to calm your back, and ease the now identified aggravating mechanisms. This will assist you to reduce your pain, calming your lower back pain (pain de-sensitization). Secondly, we will focus on identifying if you have pain free movements, addressing the mechanism of pain, by maintaining the less sensitizing, and less pain inducing postures. While still allowing for achievement of your movement goals. Pain reduction is better than pain management!
Coach Pain Free Movement – Complex Low Back Consultation
Next, we will use these new found healthy movement patterns, re-grooving these healthy motor and movement patterns, to re-achieve pain free motor control. That will promote pain free living, and allow you to continue to do the activities you love.
Matching corrective, therapeutic and performance enhancement exercises, to your case. This will coach you to clearly understand what to do to allow the building of a foundation for pain-free movement.
Time to get movement back!
Provide Report & Training Programme – Complex Low Back Consultation
We will provide strategies and exercises to help you on your way to starting to achieve and maintain a healthy and robust spine. Ensuring you clearly understand some progressions and milestones.
Preparing you in the move forward, in the preparation of beginning rehabilitation, in the not so distant future. Focusing you in regaining your active lifestyle, optimizing your health outcome, and enhancing you performance.
If needed, for another clinic to continue assisting your progress, we can produce a report outlining our findings and actions, including a precise description of the pain mechanism (most of the time), of any identified pain causes, of any specific pain free postures and relieving postures found, of all pain free movements which have been coached, and identifying the suggested training programme ahead. This report could be sent to the referring clinician with a recovery plan.
Let’s outline an opportunity to progress!
I have had regular Osteopathy appointments with Michael, from Elementary Health, for a number of years following my first appointment after my lower back seized up. After my first appointment Michael implemented a gradual increase in time between appointments and I now see him every three months for what I call my “back maintenance.” It is hard to put into words the complete service Michael offers as he certainly doesn’t stop at only carrying out my “back maintenance”. He is very forthcoming with suggesting suitable strengthening and stability exercises and will offer advice and interesting discussion about the body and how it works. His knowledge in all of these areas is extremely competent and he clearly has a great desire to improve his own personal knowledge through external training. Michaels manner during appointments is as good as it gets. I have never felt uncomfortable during an appointment and can imagine that he adapts this manner accordingly for each of his clients. If I was asked to recommend an Osteopath, Michael would come very highly recommended.
Complex Low Back Consultation Procedure
For new patients, or the application of new therapies, a full detailed case history is taken, all provided images and reports reviewed, and any prior investigations and current goals discussed, so these can be taken into consideration.
Next, if clinically appropriate, you may be asked to dress down to your underwear to allow us to look at the presenting problem. (However, feel free to wear small shorts, if it makes you feel more comfortable).
You will then be asked to perform simple movements, a mixture of postures, motion and training patterns (dynamic assessment), to help us gain information and understand your posture and movement capacity, and then interpret this in regards to your presenting complaint and goals. Identifying key links in your case.
Then, a detailed passive examination, along with some specific investigations will be performed. If required, additional examination, and questioning will take place. The physical assessment often taking over an hour or more, to assess your back and associated aspects, to identify the pain triggers, muscle insufficiencies, functional deficits, and injury. While testing movement patterns, endurance, and stability. Developing a detailed understanding of what could be causing you back pain. A diagnosis will then be discussed, and if appropriate at this point, treatment will begin.
We aim to identify the cause of the pain during your assessment, by intentionally provoking it. This allows us to formulate a clearer understanding of the pain triggers. This allows for identification of movements, postures, and loads that are potential pain triggers. Building an understanding of your potential injury mechanisms and pain triggers.
Then when suitable, the consultation will continue on to management strategies uniquely customised to your assessment findings. This will be followed by guiding you, through finding and removing your personal pain triggers. Then you will learn corrective movement patterns that prevent and desensitize your lower back pain, trying to prevent future injury. The aim is to coach you to understand these potential pain triggers, and correlate them to your known anatomical and structural injury.
You will then undergo guided learning trying to eliminate your injury mechanisms and pain triggers. We will match corrective, therapeutic and performance enhancement exercises, to your case. We will be coaching you to clearly understand what to do to allow the building of a foundation for pain-free movement. Demonstrating and coaching a remedial core stabilisation programme, and associated motor structures, for corrective exercise prescription, and performance training strategies, is our aim.
For treatment, we provide a seamlessly layered combination approach of diagnosis, education and therapeutic application. This includes education of anatomy and pain theories, manual therapy, osteopathy, posture advice and training, lifestyle advice, hydrotherapy guidance, dietary overviews, and dynamic exercise therapy with motor control training rehabilitation with your new found healthy movement patterns, re-grooving these healthy motor and movement patterns, to re-achieve pain free motor control. All of these work together to provide a uniquely structured approach, towards the aim of restoring your brain’s interpretation, or ‘mapping’ of your healthy functioning body, giving you back the control!
After treatment intervention, you will be re-assessed to ensure efficacy and to optimize the development of therapeutic strategies, for precision care and training.
Guidance for aftercare will be provided, which will assist by aiding to establish and prioritise lifestyle and training components, which can be initiated independently. This will include a regression and progression programme, as an adjunct in achieving your goals.
A report can be produced for you, outlining our findings and actions, including a precise description of the pain mechanism (most of the time), note of any identified pain causes, any specific pain free postures and relieving postures found, all pain free movements which have been coached, and the suggested training programme ahead. The report will be provided to you, and will be sent to the referring clinician with a recovery plan.
During this process and any subsequent treatments, you are welcome to have another adult individual present, to act as a supportive chaperone, if required.
The Initial Consultation will last 180 minutes (3 hours), and all follow up appointments for treatment will last 30 minutes, unless a 60 minutes treatment is required.
If there are any other questions, or, you wish to book a consultation with Michael Parr the consulting osteopath in Cambridge, based at Elementary Health. Please don’t hesitate to call or email.