Andrea Lucchetti, owner of Wymondham Chiropractic Clinic, brings us his latest column, comparing the overwhelming range of pastas available with the choices people must make when choosing who to see for their musculoskeletal pain.

Being Italian, I do love my pasta. As anyone who has been in an Italian supermarket can testify, there is an almost endless amount and variety of pasta on offer. Even just the long, thin spaghetti is available in many different thicknesses!

My family live on Lake Como, north of Milan, and our regional pasta is called pizzoccheri. It looks a little bit like tagliatelle but has buckwheat flour in it, making it almost purple in colour. Most people of Lombardy probably have never heard of it. However, it is a fantastic dish for the British winter, with butter, garlic, sage, potatoes, and savoy cabbage all melted into the pasta with fontina cheese and Parmigiano.

There are different shapes of pasta for different sauces. Choosing pasta can become very confusing!

The same can be said for people with musculoskeletal pain, whether it is backpain or neck pain or a sports injury. Who do you go to?

The list of choices includes physiotherapists, chiropractors, and osteopaths. Deciding which one to choose can be confusing. Although I am a chiropractor, who also happens to have a holistic approach to medicine, I will try and give an unbiased view.

Before I go any further, it is worth mentioning that many back and neck problems resolve within six weeks. Taking paracetamol and perhaps an anti-inflammatory, such as Ibuprofen – if it is safe for you to do so, always check with a GP or pharmacist – would be a good starting point. If you have intense pain then it is probably not going to appreciate being heated up with a hot pack, but may well respond to cold therapy. If the pain is more of an ache, then heat may be beneficial.

If the pain persists, seeking professional advice from a chiropractor, physiotherapist or osteopath could be a good option. All three professions are state registered, which is good to know, and all three work within NICE [National Institute for Health and Care Excellence] guidelines.

Historically, the three professions were quite distinct from each other, with chiropractors focusing on restoring neurological function, osteopaths focusing on improving blood flow, and physiotherapy focused on restoring movement and function when someone is affected by injury, illness or disability. All three have historical roots back to antiquity with Hippocrates writing about manual therapy back in the day, and all three emerged with their own colleges in the late 1800s. Nowadays, all three courses are degree based with chiropractic and osteopathy being four-year courses and physiotherapy three. Chiropractors are also further qualified to take x-rays.

I personally think that a musculoskeletal therapist who sits in the middle of these three great professions and is skilled in rehab exercises and joint mobilisation, has advanced diagnostic skills and can treat the cause of the problem rather than just symptoms, is a worthy choice. Although I am a chiropractor, I also do a lot of physiotherapy type work as well as acupuncture and exercise prescription. Try to go to someone who is recommended by word of mouth – this may well be a physio, chiro or osteo!

In my practice, we spend one hour with our new patients to examine, diagnose, and discuss treatment. Clinical evidence shows that good practice for treating low back pain is a combination of exercise, prescriptions, and hands on therapy.

We are now in the winter season, so make sure that you use the morning exercises that I shared in the first issue and take care while lifting heavy boxes of Christmas decorations and turkeys! Always use your legs to bear the weight, not your spine, and I will discuss this in further detail in the spring issue.

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