Spinal Pain: An Alternative Approach

Without doubt the most frequent kind of problem with which I am asked to deal is pain coming from the spine. This can manifest as pain in the areas near the spine (the back and the neck) or in areas connected to the spine by nerves (frequently the legs, the arms or the thorax and chest). Sometimes there are other, associated symptoms in these connected areas, like tingling, pins and needles or numbness.

My approach to these problems is based on an osteopathic view of health and illness. It follows that it differs in fundamental ways from the usual approach of orthodox medicine or physiotherapy.

The medical approach to spinal pain

As medicine is generally practised it:

  • Allows little time for the doctor to spend talking to and examining the patient.
  • Aims to identify a distinct pathological cause (i.e. a “disease”).
  • Makes frequent use of x-rays, scans and blood tests to do this.
  • Tends to regard the painful or diseased part in isolation.
  • Uses the principal strategy of suppressing symptoms.
  • Relies on drugs as first line treatment, physiotherapy as second line, surgery as third line.
  • Physiotherapy reflects these characteristics of the medical approach.

My approach to spinal pain

In contrast, as an osteopath, I:

  • Allow as much time as is necessary for talking to and examining the patient.
  • Am more interested in why you have become unwell than in the name of your disease. Generally the kind of treatment you receive is not greatly affected by your medical “diagnosis”. It is determined much more by how your body is working mechanically, the factors in your life which are preventing you from getting better, and your general state of health.
  • Find only secondary and relative value in x-rays, scans and blood tests. That is because in most cases of uncomplicated spinal pain, they are not relevant to your treatment or management.
  • Try to relate your problem to what is happening in your whole body, your mind, and your life.
  • Believe that suppressing symptoms can cause bigger problems (symptoms are often a necessary part of the body’s healing response), preferring instead to remove any obstacles to healing.
  • Rely on manual treatment, lifestyle changes and counselling: this is usually sufficient and complete treatment.

A complex system

The spine is not just a column of bones. It could be likened to an extremely sophisticated robotic machine controlled by extremely sophisticated computer circuitry. There is immense potential for glitches in its workings even with no sign of anything that might be labelled medically as a “disease”. Osteopaths call such glitches in spinal workings “dysfunction” or sometimes “osteopathic lesions” (an older term).

I use manual treatment to remove or reduce these «glitches», helping the spine to return to as near normal functioning as possible. Clearly, if joint or disk degeneration have significantly altered the basic shape or quality of the tissues of the spine, improvement may take longer or be incomplete. However, moderate improvements in function can turn a painful spine into a largely pain-free one even in the presence of what doctors call “disease” (for example, arthritis, disc hernias, etc.)

Craft, expertise, and modern science

In my experience the osteopathic approach, well practised, is clearly beneficial for patients who suffer from spinal pain. Osteopathy is a craft. I have been learning this craft for nearly three decades, and I am still learning. Nothing that I have learned so far has led me to doubt the basic principles underlying its usefulness as a therapeutic discipline. However, scientific knowledge of the workings of the spine and its problems is constantly expanding. As an expert in the care of patients with spinal problems, I keep myself continually abreast of the most recent research, in order to ensure that I am able to deliver the best care.

Copyright (c) Robert Hale 2022. Photo by Marco Verch, via Flickr. Creative Commons CC BY 2.0 licence.

Robert Hale practises osteopathy in Santa Eulalia, Ibiza.

Treatment of Pain by Osteopathy and Acupuncture

Pain relief is a large part of most health professionals’ work. In my profession as a healthcare provider, the treatment of pain is one of my areas of special interest. Let me tell you a little bit about pain and how I approach it.

There are two general kinds of pain:

  1. Pain coming from some damaged part of the body («nociceptive pain»).
  2. Pain generated by the nervous system without any damage to the body («neuropathic pain»).

Whoa! Wait! How can there be pain without damage? Well, here are a couple of ways. First example: There may have been damage which has now healed, but the nervous system has not adjusted back to normal. Second example: The nervous system may have become sensitised by numerous previous physical or emotional traumas, so that it produces pain response to minor physical stimuli. Note here that all pain is produced in the brain, even though it is felt in the foot, or stomach or head. The difference is that in the first case it is related to actual current damage and in the second case it is not.

The first kind of pain (nociceptive pain) can be further broken down into pain coming from the outer body like skin, muscles and joints («somatic pain») and pain coming from the inner body organs («visceral pain»). The latter can be confusing because it is often first experienced in the muscles of the outer body. The osteopath is uniquely prepared to distinguish between these kinds of pain, a distinction which is critical in their treatment.

Above I said that the treatment of pain was one of my areas of special interest. That is not exact. It would be more accurate to say that the treatment of the person in pain is my area of expertise. The difference is that as a holistic practitioner I treat people, not symptoms or disorders. By treating the person, the symptom goes away or at least gets better, indicating an improvement in any underlying disorder.

The disciplines that I practise, osteopathy and acupuncture, are excellent at treating people suffering with pain. In my experience osteopathy is the treatment of choice for most kinds of common pain complaints, while acupuncture is sometimes preferable for certain kinds of neuropathic pain and some kinds of inflammatory arthritis. In the latter case I would also make use of my knowledge of herbal medicine.

My formal studies have well equipped me to recognise conditions which require conventional medical treatment or which would best be managed by other health professionals. For example, my great interest is helping people with chronic pain (pain that has been present for months or more), a condition in which there are always psychological and behavioural factors involved. When I recognised this, I took a three-year masters degree in health psychology in order that I may help these people better. Nevertheless I am not a qualified psychologist, and if there are issues of serious trauma or depression, deep emotional conflicts, or addiction then I would refer to a competent health professional for this aspect of the person’s care.

Most Common Pain Complaints

  • Spinal pain (back pain or neck pain caused by strains, minor injury or degeneration)
  • Muscle tension
  • Headaches (from spinal problems or muscle tension)
  • Tendinitis (of the shoulder, elbow e.g. tennis elbow, wrist, knee, hip and ankle e.g. Achilles tendon)
  • Frozen shoulder
  • Osteoarthritis (affecting the hip, knee, ankle, shoulder, elbow, fingers)
  • Foot pain (e.g. plantar pain, metatarsal pain)
  • Sciatica
  • Brachial neuralgia (nerve pain in the arm)
  • Strains and sprains
  • Pain around the rib cage


Copyright (c) Robert hale 2021.
Photo by Nick Youngson via Picpedia, reprosuced according to Creative Commons CC BY-SA 3.0 licence.

Robert Hale provides treatment for pain by osteopathy and acupuncture in Santa Eulalia, Ibiza.