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Arthritis
All joints wear with use like any bearing in a machine. In humans, these joints must be repaired otherwise the person would be worn out, probably by the age of five. The sympathetic nerves monitor this repair mechanism. Arthritis is caused by back trouble upsetting these sympathetic nerves. It is surprising the degree of wear that can often repair itself when the back problem is resolved. (See Back Pain and Associated Problems) (See The Autonomic Nervous system)
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Abnormal curvature of the spine
The spine curvature can be pulled out of shape by the reflexive muscle spasm which attempts to protect bruised facet joints in the spine. This muscle spasm can cause a scoliosis, Kyphosis or an abnormal Lordosis. (See Back Pain and Associated Problems)
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Disc disorders
A disc bulge, disc prolapse, ruptured disc and 'slipped disc' are all terminology to describe varying degrees of disc damage. (See Back Pain and Associated Problems)
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Facet joints
In the back the facet joints are the joints between one vertebral arch and another. They are the most common cause of back problems. (See Back Pain and Associated Problems)
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Joint pain
All joints wear with use like any bearing in a machine. In humans, these joints must be repaired otherwise the person would be worn out, probably by the age of five. The sympathetic nerves monitor this repair mechanism. Arthritis is caused by back trouble upsetting these sympathetic nerves. It is surprising the degree of wear that can often repair itself when the back problem is resolved. (See Back Pain and Associated Problems) (See The Autonomic Nervous system) .

Joint pain can also be associated with the toxins from a streptococcal infection (See Streptococcal infections), infections, injuries and autoimmune diseases.
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Myalgia
Myalgia means muscle pain and is a symptom of many disorders. (See Back Pain and Associated Problems) (See Myalgic Encephalomyelitis)


Muscle cramp
A muscle cramp is an abnormal painful contraction generated in the muscle itself. A muscle cramp in the spinal muscles is the most common cause of back pain. (See Back Pain and Associated Problems)
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Muscle spasm
A symptomless normal contraction of a muscle, generated by disease/dysfunction and not from the brain. (See Back Pain and Associated Problems)
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Non-specific back pain
Non-specific back pain (NSBP) may be defined as any back pain from which all diagnosable causes have been eliminated, and therefore a precise pathoanatomical diagnosis cannot be given.

The statistics on the prevalence of NSBP are staggering.
- Seventy to eighty percent of the British population are thought to experience back pain, severe enough to seek medical help, at some point in their lives.

- The annual prevalence of back pain in the United Kingdom (UK) is approximately 40% of adults.

- Back trouble is the single biggest cause of absenteeism from industry and is estimated to cost £1632 million in direct care and treatment.

- The total cost of back pain to the UK is estimated at £12300 million.

- The total somewhat ineffectual treatment of backs cost the health service three times the total cost of cancer treatment.

(See Back Pain and Associated Problems)
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Neurovascular dysfunction
Neurovascular is the nerve control of blood vessels. Neurovascular dysfunction can be associated with a back dysfunction. This is because muscle spasm in the spine influences the autonomic nervous system. Symptoms include pain, tingling, burning and swelling. These symptoms often encompass the whole limb or head, and at worst the entire body (A non-dermatomal pattern). (See Back Pain and Associated Problems) (See The Autonomic Nervous system)
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Oedema
Oedema is excessive fluid in the tissues, causing swelling. (See Back Pain and Associated Problems)
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Referred pain
Referred pain is pain felt in a part of the body other than where it originates. (See Back Pain and Associated Problems)
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Shingles
What is Shingles?
Shingles is a painful red rash caused by the same virus that causes chicken pox. It is believed that at the time a child has chicken pox the virus crawls up a sensory nerve and then lays dormant in the spinal cord. When an adult, if they become run down or stressed the virus can reactivate, infecting the nerve root of the sensory nerve. This inflammation in the spinal cord results in impulses going the wrong way down sensory nerves to the tissues that nerve supplies. The faulty information causes a massive upset to the local blood supply resulting in a painful red rash and blisters. This is strictly along the course of the nerve involved and therefore only occurs on one side of the body.

What are the symptoms of shingles?
Shingles most commonly affects the lower part of the trunk radiating around the trunk on one side only. Occasionally it can be up the neck and face, involving the eye. Rarely, two nerves are involved, in which case the second one may be involved a week or so after the first one prolonging the illness.

The patient often feels unwell with a slight temperature and fatigue for 2-3 days before the local lesion appears. The next symptom and the first that suggests shingles is a pain or burning sensation around the body following the course of a sensory nerve. It is after about 2 days, but can rarely be as much as 2-weeks that the typical red flare appears and then the painful blisters. The patient usually feels low at this time and sometimes becomes depressed. The lymph nodes often become moderately enlarged and tender. The blisters burst after 3-5 days causing sores, which eventually scab over and recover in 2-3 weeks.

Who can get Shingles?
Shingles can occur in adults of almost any age. It most often occurs in people after the age of 40 who have had chicken pox in their youth.

It is thought to be impossible to catch it from somebody who has chicken pox. I am not convinced of the truth of this as I have seen a number of people who contracted the disease two or so weeks after visiting a child who had chicken pox. You cannot catch shingles from a person with shingles but it is possible to acquire chicken pox from a person with shingles. It is also possible to get shingles twice or more in one's life. It should be remembered that the fluid in these blisters is contaminated with the chicken pox virus so must be treated with great caution.

Complications
Unfortunately the pain which is actually generated in the spinal cord does not clear up in about 20% of cases leaving the patient with a distressing complication, often for the rest of their life (post herpetic neuralgia).

When the blisters rupture the site can become infected and this may need treating with an antibiotic.

When the eye is involved, pain and soreness can often continue indefinitely. At worst it can result in blindness. The patient should insist on having treatment for the herpes if the eye is involved to limit the damage and avoid complications later.

What is the treatment?
I cannot emphasise too strongly that active treatment is possible and the sooner it is started the more rapid the recovery and the chance of complications, especially pain, is diminished or eliminated.

The doctor should give an antiviral medication as soon as the disease is diagnosed. Unfortunately it becomes less effective as the days pass and probably does not help after the rash is well underway. The rash is modified and the recovery time reduced by using an anti-viral preparation on it. The patient also usually requires a strong painkiller for the pain while it is present and may require antibiotics if the blisters become infected.

Most virus infections cause a massive destruction of vitamin B. Large quantities of this by mouth and preferably by injection (daily) make the patient feel enormously better, probably speed up the recovery and will almost always prevent the lethargy and depression.

It is my experience that the pain may not actually be caused by the herpes but by the facet joint lining the canal through which the nerve passes becoming swollen and pressing on the nerve. Treatment using The Sherwood Technique accelerates the recovery from the shingles, lessens the incidence and severity of post hepatic pain and also relieves any symptoms that may occur from the swollen joint. It is therefore extremely worthwhile. Treatment involves massage and ultrasonic waves just above where the rash starts. This is aimed at relieving muscle spasm and to speed up the repair mechanism. Muscle stimulation uses the pumping property of the muscles to reduce the tissue oedema and mobilisation stretches the joints, further reducing the inflammation.

Treatment is usually very successful in people with post herpetic pain that they have had for less than a year. Unfortunately after a year, the treatment is not nearly as successful.

What can I do for myself?
- Obviously it is important to avoid becoming too run down where it is possible.

- Taking vitamin B complex may lessen your vulnerability to the disease and also the side effects of the disease especially depression and lethargy.

- Exercises involving movement of the spine helps to improve the circulation and drainage of the spine. Pilates is especially suitable for this.

- Ice (frozen peas) to the vertebrae just above the rash reduces the inflammation, cuts back the circulation and reduces the oedema in the spinal cord (1 -1.5 minutes).

- There are no specific dietary recommendations but obviously the better the diet, the fitter the patient.

- I personally advise older people to avoid contact with children with chicken pox to avoid the risk of catching shingles.
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Spondylitis
Spondylitis is an active inflammatory process in the spinal joints. (See Back Pain and Associated Problems)
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Spondylolisthesis
Spondylolisthesis is a condition in which one vertebra slips forward on to another. (See Back Pain and Associated Problems)
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Spondylosis
Spondylosis is often diagnosed as the cause of back pain. It is a degenerative condition and I believe it seldom exists. (See Back Pain and Associated Problems)
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Sprains
A sprain is an injury which occurs when ligaments are overstretched.
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Strains
A strain is an injury which occurs when muscles are overstretched.
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Back Pain and Associated Problems
Pain in any part of the neck and back is almost always due to a muscle cramp - there is a slight ache if only a few fibres cramp to an agonising pain if the whole muscle is involved. Facet joints at any level of the spine can press upon spinal nerves causing associated referred pain, and this can be felt in the arm, leg, head or trunk.

The sympathetic nerve centres (sympathetic ganglion) lie virtually on the muscles of the spine. Muscle spasm causes the nerve centres to become waterlogged producing mostly single problems but not infrequently the whole system can be involved causing serious illness (the typical symptoms of ME and chronic fatigue syndrome). Sympathetic malfunction effects mainly blood vessels, joints and the bowel. The other significant problem associated with back problems is considerable disruption of a person's sex life. The effect of pain is obvious but other problems like loss of libido and impotence can be explained by the sympathetic upset.


Back Treatment
Treatment must be directed at the basic cause of back pain and this is a bruised facet joint. The pressure of the protective muscle spasm must be relaxed, the poor blood circulation from the loss of the muscle pump must be improved, and the associated tissues require stretching to counteract the shortening that takes place through years of the spasm pulling the vertebrae together. This can be achieved by physical medicine using The Sherwood Technique.
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The Autonomic Nervous System
A large number of functions in the body take place without any conscious interference. To achieve this we have two separate and somewhat opposed nerve systems; together they are called the autonomic nervous system. The sympathetic adrenalin system is responsible for all maintenance and repair in the body, including regulating all parameter levels such as blood pressure, blood sugar, and general levels of energy. It also is involved in creating a state of super efficiency to make the body more able to cope in a physical emergency such as if a lion was seen 50 metres away - fright is associated with this. The sympathetic nerve centres (sympathetic ganglia) controlling the whole system lie along the muscles of the back and rely on them for a proper circulation. This accounts for the fact that so many apparently unrelated problems such as indigestion, dizziness, depression and fatigue can be caused by a back problem.

The opposing system is the parasympathetic system that comes into its own after a meal, making the person torpid and activating all the digestive processes. The parasympathetic nerve centre (parasympathetic ganglia) lie in the brainstem protected by the skull and is not therefore prone to malfunction.
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A lymphatic malfunction
The Lymphatic System is the sewage system of the body. Ducts from the tissue spaces between the cells drain the fluid through the lymph nodes back to the circulating blood. The lymph nodes are similar to sewage farms, filtering and detoxifying the fluid before recycling it. They also perform the further function of producing antibodies against foreign protein as found in invading bacteria or viruses carried to them from the tissue spaces. The Tonsils, Adenoids, and Appendix are all part of the lymphatic system.

One of the most common complaints is the recurrent streptococcal throat infection. This is relieved in many cases by the removal of the Tonsils and possibly the Adenoids denoting the fact that at least these organs can suffer damage. A number of cases, however, are only partly improved by this manoeuvre and a few not at all. In all these cases the cervical (neck) lymph nodes are to a varying extent enlarged and hard. If the Tonsils are prone to a breakdown of function - why not the lymph nodes as well? When large and hard they are either working overtime, which is unlikely in the view of the continuing nature of the illness, or overloaded, functioning poorly and partially obstructed. The fact that they can break down supports the latter view.

Consideration of other chronic infections shows that in their specific drainage areas a similar condition of enlarged and hard lymph nodes occurs. E.g. enlarged cervical (neck) nodes with chronic sinusitis and recurrent loss of voice. Enlarged ileac (abdominal) nodes with chronic cystitis and enlarged chest lymph nodes with chronic bronchitis.
This is further borne out by the fact that these nodes can be restored to normal function by treatment forcing fluid through them and by breaking up the debris in them by means of electrical and ultrasonic wave treatment. As the nodes clinically improve so, shortly afterwards, does the state of the infection and patient.

As the blockage lessens the drainage from the area improves resulting in an overall higher resistance to infection; thus of course eliminating that already present. Secondly, normal function of the lymph nodes results in a quicker and stronger antibody response.
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Treatment
The basic principles when treating the lymphatic system are to mechanically break up the debris within the lymph nodes, forcing fluid through them to restore their patency and get their activity back to normal. This can be achieved using methods such as massage and ultrasonic waves.
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