The Back Pain Podcast

Dave and Rob are with physiotherapist Adam Dobson discussing scans and in particular how MRI scans can and are used in connection with back pain. Scans are important but only for a small number of patients with back pain and Adam explains in detail the pathway and context that may lead to a scan being done along with reasons why a detailed clinical diagnosis is so important in this episode packed with great information and content. Its ultimately about the right scan at the right time and this is a great opportunity to find out more.   KEY TAKEAWAYS 90% of back problems are not diagnosable on a scan and a scan will only be important for a small number of patients with back-related problems. Scans can be used to rule something out such as a fracture, cancer or an infection and may open up a change of treatment plan. If there is a good quality working diagnosis then imaging can create a potential additional step before treatment begins. Patients should know what a scan is likely to show, the implications of the findings and what it might change. Scans are highly detailed and show lots of things that may not be relevant and are common in lots of the population. These things are not predictors for pain or function in the future. Patients should be prepared and educated to help them understand imaging. If you’ve had a problem for less than 6 weeks, the nerves are working and there are no indicators for serious pathology there is a high chance your problem will resolve itself over time. It’s about the right scan for the right person at the right time The picture can change - If you are told you don’t need a scan it doesn’t mean you will never need one. If you have persistent and disabling pain there is something wrong but it can be about the factors involved and where best to focus effort with therapy and support powerful options.   BEST MOMENTS ‘If it’s is unlikely to change the treatment plan and there is no evidence for serious pathology then there is a strong argument that imaging is not required’ ‘An MRI scan can be used as a reassurance about what’s not there’ ‘In collaborative working with the patient imaging is a malleable decision’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link Adam Twitter https://twitter.com/adamdobson123 What is sciatica booklet https://www.southtees.nhs.uk/content/uploads/ST1112-Sciatica-Booklet.pdf Handy information guides on back pain, sciatica, Cauda Equina, posture and more. https://www.southtees.nhs.uk/services/back-pain-triage-and-treat/patient-information-educational-resources/ Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173   Belavý, D. L., Quittner, M. J., Ridgers, N., Ling, Y., Connell, D., & Rantalainen, T. (2017). Running exercise strengthens the intervertebral disc. Scientific reports, 7, 45975. https://doi.org/10.1038/srep45975   Nature or nurture in low back pain? Results of a systematic review of studies based on twin samples P.H. FerreiraP.Beckenkamp C.G. Maher  J.L. Hopper   The 'Lived Experience' of patients having a Cervical or Lumbar MRI scan Armitage, Annabelle; Harland, NicholasPain and Rehabilitation - the Journal of Physiotherapy Pain Association, Volume 2020, Number 49, July 2020, pp. 57-62(6) Physiotherapy Pain Association   Low back pain and sciatica in over 16s: assessment and management NICE guideline [NG59] Published date: 30 November 2016 Last updated: 22 September 2020   NHS website back pain website https://www.southtees.nhs.uk/services/back-pain-triage-and-treat/ National Low Back and Radicular Pain Pathway   https://www.boa.ac.uk/uploads/assets/e26cc007-74c3-4b22-94e408dd54ac79da/spinal%20pathfinder.pdf     ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.com                         Support the show: https://thebackpainpodcast.com

Rob and Dave come together to share great advice on a question that they are frequently asked ‘is back pain stress-related?’ Currently, there are lots of reasons why people feel stressed and in this episode, Rob and Dave share a range of different things anyone can do to lower their levels of stress. If you are able to decrease your back pain you will be able to lower your stress and the first thing you can do is listen to the Back Pain Podcast, a great source of information, content and advice all of which will help you to understand, decrease and manage any back pain and in turn lower your levels of stress.   KEY TAKEAWAYS Exercise is a great way to relieve stress and vital if you want to lower your stress levels. Try and remove yourself from the situation or environment that is making you feel stressed. Getting outside and experiencing the natural world is a great way to de-stress. Organise your thoughts to lower overwhelm, write down everything you need to do so that you can prioritise, delegate and outsource. Take a step back and take a constructive overview, this can help to get things in perspective. If you have a big task to complete break it down into smaller chunks. Relieve your levels of stress through breathing – take 10 deep breaths slowly to calm yourself down. Helping someone else is a good stress reliever and will also make you feel better. Set yourself a challenge that can translate into a daily goal. If you learn how to decrease your back pain then you will be decreasing your stress.   BEST MOMENTS ‘Listen to the Back Pain Podcast and learn how to decrease your back pain and lower your stress’ ‘There is a little bit of self-gain in undertaking some selfless activities’ ‘Try and find activities at home that you enjoy’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.com                    Support the show: https://thebackpainpodcast.com

David Poulter is a physical therapist working out of Minnesota in the United States and shares great information about how dynamic our interbody joints, our discs, are effectively adapting to movement and load. He explains how discs are structured and work with the interbody joint getting its nutrition from loading and compression. With his extensive expertise and experience, David provides an in-depth and comprehensive explanation of both the construction and function of these interbody joints and shares why the truth is that discs don’t slip.   KEY TAKEAWAYS The disc is the joint between 2 vertebrae. Where one vertebra joins another there are complicated structures. It’s the bulging of the material in the disc that causes people to think its slipping. The outer aspect of the disc conveys information about motion, position and space. In the centre of the disc, there are no nerves because it’s all about compression but there are pain structures on the outer layers of the disc structure. Injury can be caused by doing something too quickly or doing something for too long. Treatment should be based on the patient and their individual history. After an injury in rehab, you need to make sure you don’t back to something for too long, too strong or too quickly. Rehab should follow the process of unloading,  temporary rest then progressive loading to return people to where they were before. Sitting, standing, bending are all normal and taking yourself away from your normal is more likely to result in harm to your discs. Discs are developing and dynamic as we grow and if you do something long and often and the disc will adapt.   BEST MOMENTS ‘Symptoms are a warning system to tell us to change what we are doing’ ‘These are just joints and they need to be returned to graded function’ ‘A disc gets its nutrition from movement and loading’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link Retlouping twitter   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

In this episode, Rob and Dave talk to Laura Finucane and Sue Greenhalgh, consultant physiotherapists who are launching a video about when you should seek urgent help for your back pain. The majority of back pain is not serious but it’s important to know what to look for, the red flags so that anything more serious is not overlooked and this episode has detailed advice on how and what to do and is an essential listen for anyone suffering from back pain.   KEY TAKEAWAYS Serious pathology for back pain is rare but it’s important to look for and identify early on The majority of back pain is not serious but it’s important to know what to look for so that anything more serious is not overlooked There are risk factors that will raise the concerns of professionals but its dependent on the context. If you experience back pain that is getting worse or you haven’t experienced before, pain that spreads from your back in a band around your body or odd feelings in your legs, feeling unsteady, pain that stops you sleeping or gets worse when you lie down then seek help immediately. Early identification for serious pathology makes the difference in recovery and quality of life. A change with the back pain progressing can mean it needs to be investigated. As a patient, it can be frustrating to answer lots of questions but the detailed questions are what help the clinician with the subtle signs that can be important in understanding what’s going on. Many people can present with worrying symptoms but it will turn out to be nothing to worry about.   BEST MOMENTS ‘If we can increase awareness people will get to the right place in a timely manner’ ‘Our job is to put context around the questions being asked and empower patients to speak out about what’s going on for them’ ‘The vast majority of back pain is nothing to worry about’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link Musculoskeletal Association of Chartered Physiotherapists ttps://www.macpweb.org Link to MACP video Discussed https://www.macpweb.org/Resources/86f5045c-3423-4f29-b21c-492a5f77e265 Cauda Equina Flash Cards https://www.macpweb.org/Cauda-Equina-Information-cards Illustrated and Edited by Laura Bassi from Fisio Camera:  http://www.youtube.com/c/FisioCamera   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

Rob and Dave discuss one of the questions they are asked the most ‘I’ve got back pain should I use ice or heat? There’s lots of conflicting information out there but the answer is it doesn’t matter, neither will cause you any harm it’s all about working out which one is best for you and will provide the relief you are looking for from your back pain. Rob and Dave explain how often you should apply relief treatment in this reassuring episode that explains exactly how heat and ice work and why it’s all about working out which one is the one that works for you.   KEY TAKEAWAYS Whatever makes you feel better is the treatment to continue to use and if it stops providing relief then try the other. You should be trying either ice or heat to test it, moving about and continuing to use the relief treatment that is best for you. If someone is suffering with severe pain and cannot move the recommendation could be for ice first. Ice can help to numb pain and relieve sciatica if you apply it directly to the area. The relief treatment can be repeated for 10-15 minutes up to every hour whether its heat or ice. Topical heat from products can work but they will not have as much impact as ice and heat. Reusable ice and heat packs can be helpful when you are at work or away from your home.   BEST MOMENTS ‘Try ice and if it doesn’t help then try heat’ ‘Each to their own it’s about whatever works for them’ ‘You can interchange between ice and heat if it works for you’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

Many people  (10% of the population) suffer from chronic widespread pain and in this episode, Rob and Dave share the best takeaways and nuggets of advice from previous interviews that they themselves use regularly. Where there is pain there is inflamed tissue that is reacting and changing and you should be looking to find what is the best healing process for you. This a great opportunity to hear the best takeaways from a range of great professionals who have been guests on the podcast and shared great practical advice.   KEY TAKEAWAYS When there is pain in the back this is inflamed tissue that is reacting and changing in the same way as other tissues in your body. Even when the source of the irritation has been removed the tissue will continue to be inflamed and will take some time to settle down and reset. Work on stability and mobility to create the strongest back possible. You need to strengthen and work on movement in a controlled environment. It’s part of being human having to pick things up and you can practice a movement to develop strength. We rest, de-load then build movement back up again. Movement is key and a positive mindset will make a difference. Muscles need movement and bones and discs need loads. If something doesn’t work it just means you need a different approach and a different professional. Patients who are proactive in their recovery always recover better than those who are not. Thinking about the positives, what can you do now that you couldn’t last week? The small wins mean you are moving in a positive direction.   BEST MOMENTS ‘Calm sh#t down, build sh#t back up again’ ‘There can be a mental disconnect between the back and the rest of the body’ ‘Damaged, angry, hyper-sensitised tissue will produce pain even if the stimulus is not very much’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

The Endurance Physio, Mike James joins Dave and Rob to look at how to avoid injury, train successfully for the events you want to take part in and share some myth-busting in this fascinating episode. Mike explains how anyone can train for and take part in endurance events if they understand how to be consistent and what their starting point is. He discusses the most common types of injuries and why it’s vital to put in the preparation and perfect each step of training consistently before reaching for the marginal gains along with great advice on exercises that will make the difference   KEY TAKEAWAYS You can be either a robust or fragile athlete. Those who are fragile athletes just need to be more consistent. People pick up the most injuries because they attempt to nail marginal gains before they have perfected the first 95% In endurance athletes 75% -85% of injuries will be lower limb, soft tissue non-traumatic and overuse, the other 25% will be traumatic, upper body associated with falls. With tissue it’s not the load, it’s the load you are not prepared for. People sometimes pick up injuries through doing something different. With endurance sport, any treatment will be about preparing for load. Sometimes you need to stop but it is usually about modifying the movement. Having a wide range of activities will benefit backpain. Every patient I see can go on and self-manage. Changing too quickly can cause overload for endurance athletes. Most problems with endurance athletes come from being too keen, to eager and naïve. Coaches can make a difference if you get a good coach with the right program for you. Cardio is king but the secret is the timing of training across the year. It’s about creating stability, robustness and different load through the tissues You can only benefit from the training you are resting from and you can improve recovery by making sure the training is of the right intensity.   BEST MOMENTS ‘Most people get injured through simple errors and lack of consistency’ ‘People try to accelerate through their apprenticeships’ ‘Endurance athletes have poor beliefs about it all being about the amount of time and miles they do in training’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link  Facebook - https://www.facebook.com/TheendurancePT Twitter - https://twitter.com/theEndurancePT https://www.instagram.com/the_endurance_physio/?hl=en     ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

If you have regular back spasms what should you do? This is frequently asked in clinic and in this episode, Rob and Dave explain what you should do and why initiating small movements that can be adapted through increased load and repetition are the key to improve your range of movement. Pain or hurt doesn’t equal harm and it’s important to listen to your body and remember that the spine and body are designed to move so having a full range of movement and maintaining it is key for the human body. This episode includes some great advice on movements you can make that will make all the difference.   KEY TAKEAWAYS Someone who is in a back spasm with 10/10 pain and not able to walk should try to make small movements and increase them. It’s about initiating a movement that uses something else, such as the wall or the bed to take your weight and increasing the movement repetition by repetition. Just because you experience discomfort it doesn’t mean you should stop. Approach the point of pain, back off and you will find you will be able to achieve more with each movement. Little rotations and movements will make a difference. With gentle movement and motion, it’s not about a set number of repetitions, it’s about moving little and often If you undertake a movement that makes your body feel like it’s about to spasm you need to undertake a similar movement that puts the spine in a similar position without the load and potential threat. Pain or hurt doesn’t equal harm. The spine and body are meant to move so having the full range of movement is very important. Maintaining an active range of motion is vital.   BEST MOMENTS ‘Listen to your body it will tell you when it’s too much’ ‘The first repetitions will be sore but they will become easier’ ‘Gently, gently along with little and often’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com

When you experience pain during any activity you will question whether you should push through the pain or stop and in this episode, Rob and Dave share great advice on how to return to activities or exercise safely. People’s pain threshold is subjective and movement is an important part of the journey to recovery but it’s about starting back in the right way and understanding when you are experiencing increased pain. This episode is a great opportunity to learn more about when and how you can get back to the activities you love.   KEY TAKEAWAYS Depending on your pain threshold you should never continue to exercise if the movement is causing increased pain. You have to be aware of the 24hour pain response. If you can still function and the pain is manageable then exercising could continue. Any indications of nerve pain will mean a reduction in activity. Everything is relative to your normal level of activity. If you are returning to sport or exercise it’s about building back up to previous levels. If you can’t run then do hill walking or have a plan to alternate between running and walking to begin the process and then build on this. Begin with a decrease in the load on the body either through time, physical weight or number of repetitions. Building resilience will increase your threshold. Rest is relative, when you are told to rest it’s about taking a rest from the aggravating activity, you should still be maintaining movement. Early movement is very important in the journey to recovery.   BEST MOMENTS ‘You have to return to any activity with common sense’ ‘Activities such as gardening are weighted lower force and this is undertaken over a longer time so take regular breaks’ ‘If you practice you can increase your tolerance and decrease the potential for problems in the future’   VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast recommended products affiliate link   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.com                                    Support the show: https://thebackpainpodcast.com

How can you get a decent night’s sleep when you have back pain or sciatica? Dave and Rob provide some great tips and hacks to help anyone with back pain get through the night. Any pain, including back pain and sciatica, can seem much worse at night when there is nothing else to focus on but there are things you can do and the easily followed advice in this episode will help you to achieve better sleep and good quality sleep always means better recovery.   KEY TAKEAWAYS If you are a side sleeper placing a pillow between your legs stops rotation of the spine. If you are a back sleeper place a pillow under your knees creating a bend and altering the angle of the spine. A long pregnancy pillow can help you to elevate and change your leg angle often relieving sciatica pain. Using a mindfulness and meditation app, like Headspace can help you to take your mind off the pain. If there is an activity you do that alleviates pain, complete it just before going to bed. Sometimes moving around in the night and then returning to bed can help you sleep. Don’t forget about pain killers – you can take them when you wake at night and there are painkillers available to take at night. The more good quality sleep you can get the better your recovery will be.   BEST MOMENTS ‘Sometimes that little mindfulness nudge can take your mind off the pain’ ‘Often pain can seem worse at night because you have nothing else to focus on’ ‘Don’t go to bed in a heightened pain state’   VALUABLE RESOURCES Link to video here - https://www.youtube.com/watch?v=fj_RvcrMd8w The Back Pain Podcast The Back Pain Podcast recommended products affiliate link Headspace App Pregnancy Pillow   ABOUT THE HOSTS Dave Elliot Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com if you have any questions for him. -Instagram   Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter   CONTACT METHOD Instagram Twitter Facebook hello@thebackpainpodcast.comSupport the show: https://thebackpainpodcast.com