COVID-19 - how Osteopathy could support your rehabilitation post infection.
 
Disclaimer: This post is based on our clinical findings in patients who’ve had COVID-19, therefore it is mainly anecdotal. Internet links have ben added where appropriate.
 
The main symptoms of COVID-19 are changing all the time but over the course of the pandemic we’ve seen patients suffering with the musculoskeletal effects of the virus, which have had a profound effect on the way they breath. This, in turn, has a knock-on effect on other areas of the body and even the nervous system. Patterns have continued to emerge in those contracted the virus. 
 
What happens to the musculoskeletal system?
Lung capacity is sometimes reduced in patients who’ve had COVID-19 causing shallow breathing, this reduces oxygen intake leading to post-viral fatigue. This may be exacerbated by a continuous cough. Over time the ribcage may become restricted, and the patient is no longer be able to breath deeply. 
 
Common clinical examination findings in patients who’ve had COVID-19:

• Restriction in the ribcage and back caused by shallow breathing, limiting thorax expansion, and coughing, leading to intercostal muscle tightness/spasm.
• Shortening of the diaphragm muscle (primary muscle of respiration) due to limited ribcage expansion. 
• Use of “secondary muscles” of respiration to enable the patient to take a deeper breath. These muscles are found in the neck and upper back; this can lead to tightness/pain in the neck and shoulders due to muscle fatigue and even headaches if the neck becomes restricted.

 
How can Osteopaths help?

• Retraining and strengthening breathing with exercises and mediation techniques. 
• Mobility exercises and stretches for the neck, thorax and lower back to optimise movement through the spine and reduce restriction.
• Hands on treatment using diaphragm stretching and articulation through the ribcage and neck. 
• Cranial treatment is sometimes effective rebalancing the nervous system.

 
 
What can patients do to help themselves?

• Rest! In the first few weeks after contracting the virus it’s important to rest and recover. Avoid strenuous activity as this will create too much stress on the body.
• Slowly reintroduce exercise, with gentle walking, stretching and breathing exercises.
• Keep hydrated. 
• Avoid stimuli such as alcohol, caffeine and sugar. These can be inflammatory and will hinder your body’s recovery.
• Book an osteopathic consultation and see how we can help you. 

 
Everyone responds differently to any virus; many people have experienced all the symptoms of COVID-19 whilst others were completely unaware they had it in the first place. It’s important to understand what you can do to help yourself. The NHS Covid recovery website is a good resource for those looking to tailor their own recovery. 
 
Janine Norris
Abshot Osteopathy
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Understanding persistent pain
Persistent pain is very common and affects over 14 million people in the UK alone.

What is persistent pain and how does it differ from acute pain?
Pain, whilst unpleasant, can be a very useful sensation to have. Short-term or ‘acute’ pain helps us learn from our experiences and protects us from future injury. It is part of our natural healing process. For example, if you burn yourself on a hot stove, you might learn to be more wary in future and the discomfort of any blisters would remind you to keep the area clean and protected from infection.
The common approaches to acute pain, for example immediate pain that you feel after an injury or strain, includes avoiding the cause, applying ice or heat packs and engaging in light activity which may help to ease the worst of the symptoms. As the problem resolves, the pain tends to improve and usually disappears within 3-6 months.  However when pain continues over a longer period of time, it becomes what is known as ‘persistent pain’ which will require further management.  This type of pain has no clear beneficial purpose and may not respond well to the conventional treatments you would use for acute pain, such as anti-inflammatory or analgesic painkillers.

So am I suffering from ‘Acute pain’ or ‘Persistent pain’?
 
Acute Pain

• Rapid onset
• Useful pain
• Diagnosis can be made
• Cause is usually clear
• Change can be seen visually or with tests and scans
• Short term (6-12 weeks)
• Associated with signs of inflammation
• Responds well to treatemtn including pain killers and anti-inflamatories

Chronic or persistent pain

• Persistent after an acute episode or gradually builds up
• No clear beneficial purpose
• Diagnosis is often uncertain
• The cause is often unclear due to a ‘confused nervous system’
• Examinations such as blood tests and scans may not identify any change
• Longer than 6 weeks and often persists
• Not usually associated with inflammation (though swelling can still occur)
• May not respond to treatment

What if I have persistent pain?
Sometimes, if you have had persistent pain for a long time, the nervous system can become more sensitive to pain, so previously non-threatening events, such as a change in the weather or the light pressure of the duvet on your skin at night, can now be perceived as painful. This effect, known as ‘central sensitisation’ may also mean that your symptoms may vary from day to day for no obvious reason.

Examinations such as blood tests and x-rays may not identify the reasons for the pain, making it harder for your doctor to make a diagnosis. As such, persistent pain can be difficult to diagnose. As a result, some people can feel that others don’t believe they are in pain or don’t understand what they are going through which can make their experience even more distressing.
 
Things that increase your pain

• Stress
• Tension
• Thinking about the pain and the difficulties
• Immobility and reduced fitness
• Over-activity (not pacing yourself)

Things that decrease your pain

• Relaxation
• Deep breathing
• Distraction and fun (eg. hobbies, music, study, work, friends)
• Graded exercise will release pain relieving and mood enhancing chemicals
• Pacing activity

How your Osteopath can help
As highly trained healthcare practitioners, osteopaths are able to assess and examine you to establish the potential causes of pain and recommend if you should be referred to a GP or other healthcare practitioner, if your pain requires further investigation. 

If you are experiencing persistent pain, your osteopath may able to advise on graded exercises and provide manual therapy which research suggests may stimulate the body to produce strong natural painkillers (endorphins) that can be of benefit. 

Abshot Osteopathy welcomes new patients 07908 415376

It is common for women to experience pain and discomfort during the course of their pregnancy. The body undergoes drastic change not only in physical appearance, hormones are affected too!
 
Postural change
The body’s centre of gravity shifts during the second trimester of pregnancy. This postural adaptation is necessary to allow room for the growing baby. The pelvis will tilt forward increasing the arch in the lumbar spine. The shoulders may also fall forwards due to breast enlargement causing a forward head posture, this can lead to tension in the neck and shoulders. These postural changes may lead to aches and pains, which may be exacerbated by the hormone Relaxin.
 
The hormone Relaxin
Relaxin is secreted in the body after ovulation and throughout pregnancy, a high concentration in secreted in the first trimester. Its function is to ‘relax’ ligaments and tissues, especially in the pelvis, to prepare the mother for giving birth. However, it loosens all connective tissues within the body! Couple this is weight gain and postural adaptation, the musculoskeletal system is susceptible to strain.
 
Musculoskeletal Complications
As osteopaths we see a number of musculoskeletal problems during pregnancy.  The most common presentations include:

• Lower back and sacroiliac joint pain
• Pelvic pain (SPD)
• Sciatica
• Carpal tunnel syndrome (CTS)
• Rib sprains/restriction
• Headaches
• Upper back and neck tension
• Peripheral joint strains from ligament laxity

 
 
How may our osteopaths help?
Your osteopath will take a detailed case history including information about previous medical history, pregnancy progress and the presenting complaint. The patient will then be examined using movement and special tests to assess any areas of weakness, tenderness, restriction or strain. Once a diagnosis is made the practitioner will advise on a treatment approach. This is usually consists of gentle, hands on joint articulation and soft tissue massage. Exercises will be given where appropriate. Pregnant women usually respond well to treatment and may only need a few sessions.
 
What else can help?

• Keeping active
• Pregnancy yoga can be beneficial
• Staying hydrated
• Mindful eating
• Booking an osteopathic appointment! 

Janine Norris, Specialist Paediatric Osteopath
​Abshot Osteopathy

Osteopathy is a gentle treatment suitable for babies and children. Osteopaths are trained in therapeutic approaches that are suitable for a broad range of individuals for all ages, including pregnant women, children and babies.

For Baby
At your baby’s first appointment your Osteopath will carry out an osteopathic assessment to look for body tension and restrictions.  Neck and body restriction may arise from a complex delivery, a fast delivery or conversely a prolonged delivery and Osteopathy can be a very helpful aid to relaxation for new born babies. Osteopaths are also trained to screen for medical conditions and will tell you if your baby needs to see another health professional such as a doctor, specialist, lactation consultant, midwife or health visitor.

How can Paediatric Osteopathy help my baby?
Osteopaths use a range of techniques including gentle mobilisation of the skull, spine and peripheral joints; stretching and massage, and cranial osteopathy. Cranial techniques are safe, gentle, and non-manipulative and are often the mode of choice when treating young children and new born infants. Some of the most common presentations osteopath’s see in babies include: breastfeeding issues, digestive problems such as reflux and constipation, developmental delay, restriction in the neck and in peripheral joints.

For your Child
We are delighted to work with children with specific needs, disabilities and learning disabilities. An Osteopath will adapt their therapeutic approach depending on the individual needs of the patient and each presenting complaint. Manual therapy techniques employed may include articulation and gentle manipulation of joints and soft tissues, cranial osteopathy and an exercise programme where appropriate.
Osteopaths work under the principle that there may be a number of contributing factors to the symptoms and will therefore evaluate not only the area which is producing the symptoms but also associated areas that may be adding to the presenting complaint. This can include: nutrition, history of trauma, previous injury, social/relationships, environmental factors and family health history to manage your child’s health as a whole.

For Pregnant and Postnatal Women
A woman’s body changes during pregnancy. Some of those changes include the softening of ligaments due to the hormone Relaxin and weight gain leading to changes in posture and centre of gravity. This postural adaptation can lead to additional pressure on joints in various parts of the body, including the spine and pelvis.
Osteopathy may help to relieve the stresses and strains on your body during pregnancy and after birth using the principle that healthy balance and function of the musculoskeletal framework of the body is essential to whole body health. Techniques used include gentle joint mobilisations, soft tissue massage and stretches. Often exercises are prescribed as part of the management programme.

Women’s Health
From onset of periods to pregnancy, menopause and beyond, Women's Health Osteopathy addresses the specific needs of optimising health and wellbeing. Using Osteopathic principles and applying them to the female pelvis and body as a whole, understanding hormonal influences, mechanical strains, dietary and nutritional impact, and antenatal health, your pregnancy and birth history including postpartum recovery, Janine with her interest and experience is able to create a treatment plan to address complex and diverse Women's Health needs specifically.

​… and finally for New Fathers
New fathers experience many of the same demands as new mothers, such as sleepless nights and tiredness whilst caring for the new addition to the family. Fathers can also benefit greatly from osteopathic treatment to address aches and pains or chronic issues. 

Sports Massage

What is Sports Massage?
Sports Massage is a form of massage involving the manipulation of soft tissue to benefit a person engaged in regular physical activity. Soft tissue is connective tissue that has not hardened into bones or cartilage and includes skin, muscles, tendons, ligaments and fascia. Sports Massage is designed to assist in correcting problems and imbalances in soft tissue that are caused from repetitive and strenuous physical activity and trauma. The application of sports massage, prior to and after exercise, may enhance performance, aid recovery and prevent injury.
The benefits of Sports Massage:
Sports Massage through manipulation of manipulation of soft tissue prior to and after exercise promotes physical, physiological, neurological and psychological changes that aid performance and particularly recovery. Some examples of the benefits are:

• The release of muscle tension and pain
• The removal of waste products such as acetic acid and carbon dioxide.
• Reduced soreness from DOMS ( delayed onset muscle soreness) as a result of vigorous exercise.
• And improved posture and flexibility.

How does Sports Massage differ from other massage?
Whilst other forms of massage have aims in common with Sports Massage (such as physical and mental relaxation) Sports Massage is specifically designed to assist active people in the sports or fitness activities. It works extremely well alongside Osteopathy treatment as a maintenance option.

For further details or to book a session with our Sports Masseuse, Harry Couchman please do call us: 07908415376

Unless you are unlucky enough to have a fall whilst out for a pedal, cycling is one of the best sports you can do for your well-being. Good for your brain, your heart and your bodily health in general, recent research conducted by the British Medical Journal has found that cycling regularly can significantly lower the risk of many serious illnesses, such as heart disease.
However, as with all endurance sports, you can sometimes end up with a ‘pain here’ or a ‘niggling ache’ there. If not managed properly by a medical professional, these cycling injuries can develop into longer term problems that could slow you down and even stop you cycling.
We Osteopaths want to keep you pedalling. Manual therapy can provide an easy solution to your issues, keeping you on the roads while shedding light on the reasons behind your injuries and giving you simple ways to prevent them from happening again.
As a starter for ten, here’s a list of the most common cycling injuries, what causes them, and what you can do about it. An Osteopath can help if you need further explanation, massage manipulation and an individual treatment plan.
1. Neck Pain
Symptoms: Pain and ache in neck, can radiate to middle part of the back. Rotating and bending your head can be difficult, making it feel ‘blocked’.
Common Causes: One of the most common complaints for any cycling discipline, it is often the result of reduced flexibility in the upper back or neck with poor adaptation to sustained posture. Your spine is one of the strongest parts of your body, but it can be very sensitive when overstrained leading to a painful muscle spasm. Muscles like to be active and moving, so holding a static position you aren’t familiar with or for longer than you are used to can make them painful and stiff.
What you can do: Gentle neck stretches can help loosen your neck and get it moving more freely.
2. Hand pain
Symptoms: Pain, which can be accompanied with weakness and pins and needles, in your ring finger and little finger.
Common Causes: Irritation of a nerve which passes on the underside of your wrist, known in medical terms as ‘ulnar neuropathy’. This is caused by holding handlebars in one position for too long, this can be associated with restriction in the forearm muscles and wrist joints.
What you can do: Try altering your grip position more frequently when out riding to prevent the build-up of tension. If things don’t improve, an Osteopath can help to increase the mobility of your wrist and elbow to reduce any tension on your nerve.
3. Forearm pain – ‘Arm Pump’
Symptoms: The nemesis of every downhill or bike park rider, an intense ache in the fore-arm that hits at the end of a lap and can make ‘un-gripping’ your hands difficult.
Common Cause: Tired, tight forearm muscles.
What you can do: To start, consider altering the rotation on your handlebars or brake lever angle, so the wrist is in line with the arm when standing on the bike. Including some post ride stretching into your routine
4. Low Back Pain
Symptoms: A sharp pain or ache in the lower part of the back, which can radiate to the buttock and thighs. This can be accompanied with a feeling of stiffness when getting up from sitting.
Common Causes: Another very common condition affecting up to 60% of all cyclists at some point. Low back pain is often the result of sustained posture with decreased flexibility in the hips. As the low back is relatively fixed when sitting on the saddle in order to encourage efficient power transfer through the hip, this can lead to a strain in the lower back muscles. Having a desk job can also not be helpful, as it can reduce the flexibility in your back if you don’t have regular stretches to keep supple.
What you can do: Check the angle of your saddle isn’t too low or tipped up first. Lower back and hip stretches can relieve tension in the muscles.
5. Hip Pain
Symptoms: Pain at the front and outer side of the hip, can travel down the thigh towards the knee cap.
Common Causes: Tightness in muscles at the front of the hip (known as the hip flexors) from prolonged sitting (either cycling or at work) can lead to decreased flexibility and be linked with irritation of bursa located at the front of the hip (these are fluid filled sacs that sit between the muscle and bone to reduce friction). Commonly known as ‘Greater Trochanteric Pain Syndrome’.
What you can do: Check first that your saddle height is correct. Stretches will help to make your hip muscles more flexible, and seeking treatment from your Osteopath can relieve the tension and get your hip moving normally again.
 6. Knee Pain
i) Patella-Femoral syndrome
Symptoms: Pain or a deep ache around the kneecap. The knee can feel stiff when first getting up from sitting.
Common Causes: An imbalance of muscles on the thigh or at the hip can sometimes lead to a change in balance of tension across the knee cap. This is known as ‘Patello femoral syndrome’.
What you can do: Firstly, check the height of your saddle to make sure it is optimal for your height and not placing extra load on one group of muscles. Getting into a routine of hip and knee stretches can also help reduce tension over the knee cap and get things moving a better. Over-training can also be a cause for knee pain, so if you are putting in some hard miles to work up to a sportive, make sure you are sequencing your training appropriately and having enough rest days.
ii) ITB Syndrome
Symptoms: Pain focused around the outside of the kneecap, often accompanied with a feeling of tightness in the hip on the same side.
Common Causes: The ‘IT’ (Ilio-Tibial) band is a length of fibrous tissue which runs from the hip to the outside of the knee and is an important area which many muscles blend in to. With repeated movement and decreased flexibility in the hip external rotators (particularly Gluteus Maximus) this can alter the muscle balance around the knee and create tension on the outside of the knee cap leading to irritation of the knee cap. This can be the result of over training and incorrect saddle adjustment.
What you can do: Take a look at the height of your saddle and check if it is too high or low. Adding some mobility and flexibility exercises to your post cycling routine can help reduce the build-up of tension around the outside of your knee.
iii) Patella Tendonitis
Symptoms: Tenderness and pain underneath the knee cap on the front of the lower leg. Sore after riding and can be painful during the first few minutes of cycling.
Common Causes: The patella tendon attaches the bottom of your kneecap to the top of your lower leg. Although it is very strong and can handle the large amount of force that pass through it when extending the leg, it can become irritated when placed under too much demand, such as with over training or poor bike set up.
What you can do: First thing is to continue riding but scale back on your training if possible, and make sure you take adequate rest days. A program of stretching and exercises to help strengthen the tendon have shown to be most effective by research, these can be tailored to you by your Osteopath. Lastly, check the size of the frame and saddle height you are riding with to ensure your riding position is efficient.
7. Ankle Pain
Common Causes: ‘Achilles tendonitis’, an overuse injury of the tendon which runs from the calf muscle to the back of the foot. Often the result of training too much, too quickly, where the tendon becomes irritated from not allowing time adequate time between rides to strengthen. Bike set up can affect it too, if pedal cleats are set up too far forward and the saddle is too high, the ankle can be held in a pointed down (‘plantar flexed’) position which can place further tension on the achilles tendon.
What you can do: Break up training to allow for adequate active rest and make sure the tendon gets enough healing time. Applying ice (wrapped in a towel for not longer than 5 minutes) can help with pain relief and then finally checking your saddle height and cleat placement are not placing too much load through the back of the ankle.
8. Foot Numbness
Symptoms: Pins and needles and/or with a loss of sensation in the foot (particularly the under surface), often after cycling for a short period, made worse by slow cadence and cycling up hills.
Common Causes: Ill-fitting shoes or cleats placed too close to the toes can create tension across the metatarsals (the bones in your feet). This can compress the nerves in the foot leading to temporary numbness. Lots of hill climbing can also create more pressure on the foot and create further tension across the joints.
What you can do: Check your shoe size and make sure they are a comfortable fit and not too tight. Additionally, having a good look at the placement of your pedal cleats and making sure that the pressure is directed to the ‘ball’ of your foot can help reduce tension across the metatarsals. If you have been riding lots of hills or training for a hill climb, try and vary some rides so to alleviate some pressure build up whilst out on the bike.
 9. Saddle sore
Symptoms: A real pain the backside. Soreness between the contact area of your buttock and the saddle.
Common Causes: Skin irritation from an increased in friction between the buttock and the saddle. Often from a poorly fitting saddle or old or inadequately padded cycling shorts.
What you can do: Head to your local bike shop and try out some different saddles to see which one is a good fit. Double check your saddle height and angle to ensure you aren’t creating pressure points. If the saddle is angled too far upwards, it can increase the side to side movement in the pelvis increasing friction. Invest in a new pair of shorts and some chamois cream to reduce the build-up of friction on the skin.
10. AC Joint sprain
Symptoms: Pain on the top of the shoulder around the tip. There can be a raised area above the joint where the capsule has been damaged.
Common causes: Falling onto an outstretched hand from your bike can transmit the force through your arm up into your shoulder, where the joint capsule can be strained.
What you can do: First point of call after any major trauma or fall with prolonged pain should be to consult a healthcare professional. Depending on the grade of the sprain with affect what can be done about it. This can range from manual therapy to surgery.

An Osteopath can assess, diagnose and put you on the right treatment/ rehabilitation plan. If you would like help please call: 07908415376 and speak to Hannah.
​#hbosteopathy #abshotosteos #osteopathyforhealth

Sporting activities are part of everyday life for many of us and a sports injury can be incredibly frustrating, especially when there is potentially a long recovery process and you just want to get back out there and play.
 
We aim to help by:

• Restoring joint flexibility
• Improving joint mobility
• Restoring structural balance
• Reducing adhesions and soft tissue restrictions

 
Sports injuries may be caused by direct contact, an accident such as a fall or a heavy blow, not warming up properly, using inappropriate equipment or poor technique. They often happen if you push yourself too hard or overuse.
 
The most common injuries we treat are:
Knee injuries
Hip injuries
Ankles
Foot injuries
Muscle strain
Ligament injuries
Tendonitis
Back pain
 
An Osteopath will treat these issues accordingly using physical manipulation, muscle stretching and massage. This combination of techniques enables the therapist to improve mobility, relieve muscle tension or soft tissue restrictions by enhancing the blood supply to muscles and connective tissue to ensure your body is in its optimum state and enable you to perform, or train, to your full capacity.
 
Hannah is our Sports Injury Osteopath, and, having supported Fareham Hockey Men’s 1st X1 players through their premiere league hockey for two seasons, she has experience in immediate first aid as well as short and long term rehabilitation support. The Osteopathy and Injury Management Centre at Abshot Country Club is open to non-club members too, we are here to help: 07908415376
 
#sportsinjuries #sportsrehab #musclepain #getbackoutthere #abshotosteos #rehab #osteopathy #sportsmassage

Pregnancy is one of the most significant changes a woman’s body goes through. As well as her body’s shape altering dramatically, there are also physiological changes. For instance, increased hormones can cause ligaments to loosen. These factors lead to postural changes, joint strain and altered fluid movement around the body. As a result, pregnant women often experience:

• Back and neck pain
• PGP (pelvic girdle pain) or SPD (symphysis pubis dysfunction)
• Hip and knee pain
• Sciatica

Osteopathy provides safe, gentle hands-on treatment which can alleviate pain, helping the body to adapt more comfortably to changes experienced during pregnancy. In addition, regular osteopathic treatment leading up to labour, is a good way to help the body cope with, and recover from the physical and psychological challenges ahead.

Post Natal
Following birth, a woman’s body will slowly return to its normal form. However, underlying changes in supporting muscles and joints, particularly around the pelvis, can make her more vulnerable to back pain. In addition, becoming a mum presents a whole set of new stresses: post-birth exhaustion, lack of sleep, lifting heavy car-seats and breast-feeding posture to name a few.  Osteopathy can help resolve aches and pains, women commonly experience after giving birth, ensuring that those early years can be enjoyed to the fullest.
 
Janine Norris our new Associate Osteopath is particularly interested in women’s health and has experience treating pre and post-natal women. She is also knowledgeable in nutrition and promoting the benefits of diet, exercise and lifestyle in preparation for labour.
 
If you would like an informal chat or to book a consultation please do call or message 07908 415376 and we will do what we can to help.

Hannah Ramsay
Principal Osteopath

​A patient came to see me complaining of neck pain this week. It wasn’t ‘text neck’ but more shoulder and neck pain associated with their adopted position to hold a mobile whilst typing on a lap top. It seemed simple but, by suggesting the use an earbud, we demonstrated that they could sit straighter and relax their shoulders and therefore hopefully avoid the need for further treatment.

5 simple things you can do to avoid neck and shoulder pain arising from desk based activities.

Tip 1: Feet firmly on the ground
Keep your feet flat on the floor and slightly ahead of your knees, which are bent at a 90- to 120-degree angle. Use a lumbar support cushion or if one is not available, grab a small throw pillow to alleviate back pain.
 
Tip 2: Shoulders relaxed and natural
Shoulders are relaxed, upper arms fall normally at your sides, elbows are close to your body. Head is generally in line with your body — not thrust forward — and the middle of your computer monitor is at eye level.
 
Tip 3: "Arm" yourself for success
Hands and forearms are parallel to the floor. The ideal keyboard position is slightly below the height of your elbows and sloped slightly away from you. This position allows your upper body to relax and keeps circulation from being cut off in your lower arms and hands.
 
Tip 4: Neck-free when talking
Use earbuds, a headset or speakerphone so that you don’t have to tilt your head and hold the phone between your neck and shoulder.
 
Tip 5: Keep moving
Even with the best posture, you can get aches and pains from sitting in one position for too long.
Set a timer to remind yourself to get up once an hour to:

• Stretch and walk around
• Bend over and touch your toes
• Do some jumping jacks
• Run in place
• Roll your shoulders slowly
• Do arm circles to get your blood flowing

These activities won’t just help your body, they will also help your mind and concentration. If you use a lumbar support cushion, change its position on your chair. If you can, do some of your work, such as phone meetings, while standing or even walking.
If you do develop neck and shoulder pain 

• Take a hot bath with bath salts
• Alternate ice, then heat on the affected area (allow time to warm up naturally and cover the pack where possible to prevent skin burns)
• Have your family member give you a massage

Or talk to your Doctor or an Osteopath if you have on going pain.
Hannah
H B Osteopathy