UNDERSTANDING LOW BACK PAIN

Kieran is passionate about understanding all the factors that cause low back pain; the genetic, environmental, physical, psychological and the lifestyle components. This helps you get out of pain and then develop a lifestyle that helps prevent recurrence of pain.


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Kieran is a chartered physiotherapist, registered nutritional therapist and corrective exercise specialist who specialises in helping people in chronic pain get back to what they do best.

Kieran is fascinated to understand the causes of someone's pain. From here he puts together a plan using physiotherapy, exercise, nutritional therapy and education to help you get back to what you do best.

Kieran is based at the Bowskill Clinic, 4 Duke Street, W1U 3EL near Bond Street tube station. Where patients are unable to attend the clinic he can do home appointments.

To find out more about Kieran see his bio here

To ask Kieran a question or book an appointment; call 07830160323 email kieran@kieranmacphail.com

2.13.1.3i Progression from Regional Pain to Widespread Pain

Littlejohn and Guymer (2019) suggest that the ubiquitous presence of segmental symptoms and signs adjacent to a spinal region in regional pain syndrome suggests that certain biomechanical factors are important. They hypothesise that referred pain from deeply placed structures via mechanoreceptor input from deep spinal musculo-ligamentous structures, perhaps associated with strain or degenerative change, that interacts with sensitised dorsal horn neurones at the relevant spinal level. Conversely it could be local neuro-inflammatory factors that drive these segmental changes.

References
Littlejohn, G.O. and Guymer, E., 2019. Chronic pain syndromes: overlapping phenotypes with common mechanisms. F1000Research, 8.
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Carvalho‐E‐Silva et al (2019) found genetic factors to significantly contribute to the variance in chronic LBP including lifetime chronic LBP, activity limitation, and pain intensity associated with more recent episodes of LBP, but not for pain intensity associated with people's report of the worst pain episode. Heritability estimates were fairly similar across different LBP outcomes in a population-based twin sample, and not dependent on how it is assessed or experienced. However, we could not detect any significant heritability for a report of intensity experienced during the worst LBP episode experienced. Of course as we study these areas we may find genetic contributors which may be difficult to draw out due to significant contributions of environmental factors.

References

Carvalho‐E‐Silva, A.P.M., Harmer, A.R., Pinheiro, M.B., Madrid‐Valero, J.J., Ferreira, M., Ordoñana, J.R. and H. Ferreira, P., 2019. Does the heritability of chronic low back pain depend on how the condition is assessed?. European Journal of Pain, 23(9), pp.1712-1722.
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  • kieran@kieranmacphail.com