020 8520 5268 | Ashlins Natural Health, 181 Hoe Street, E17 3AP sarah@saraholiverosteopathy.com

Weekend Reads August 2018 – Back pain, sleep and livers

Another month is nearly over so it’s time to get up to date with health and wellbeing news.

1. Channel 4’s Live Well For Longer looked at back pain and osteopathy.

2. Poor sleep may contribute to feelings of loneliness.

3.  What does running do to your brain?   “When you are under stress, metabolic processes in your liver convert the amino acid tryptophan into a molecule with the mumble-inducing name of knyurenine. Some of that knyurenine finds its way into your brain, where its accumulation has been strongly associated with stress-induced depression, anxiety disorders and schizophrenia. When you exercise, the levels of an enzyme called kynurenine aminotransferase build up in your muscles. This enzyme breaks down knyurenine into the related molecule kynurenic acid, which, importantly, cannot enter the brain. In this way, exercising your skeletal muscles by running clears from your bloodstream a substance that can cause mental health problems. It is important to note that, for technical and ethical reasons, some of the details of this mechanism have been proven only in laboratory animals.”

4. How the humble cabbage could help prevent cancer (based on research on mice)

5. 12 facts about your liver. It’s the only organ which can completely regenerate!

What I’ve Been Up To

I was glad to see some rain this month as my garden and allotment were really suffering with all the dry weather.   everything seems to be springing back to life now. Here are some carrots that I grew:


I spent an enjoyable evening doing the tour at Crate Brewery, and we also squeezed in a visit to Howling Hop Brewery.

My other half did a really nice gig at Luna Lounge in Leytonstone (I’m not too impressed with his posture though).


Of course we really enjoyed IndieTracks festival at the end of last month!


We attended a friend’s wedding this month which gave us a nice excuse to dress up a bit.

This weekend we are going on a flying visit to Cornwall for a family birthday which I am really looking forward to.


We’ve signed up for a 10k in Valencia in December so I have started running again.  I’m using a training plan on the Zombies Run app and am enjoying it so far!

What have you been doing this month?


What causes back pain during pregnancy?

It is no secret that pregnancy, labour and parenthood put a huge strain on you and your body.

From general tiredness to aching backs and limbs and even debilitating conditions such as pubic symphysis dysfunction, there are a myriad of potential problems facing mums and mums to be.

One of the most common complaints is low back pain, which is experienced by up to 80% of expectant mothers, and may be accompanied by pelvic, groin and leg pain.  It may also persist for several months after giving birth – the very time you could do without it!

what causes back pain during pregnancy? click through to find out

By understanding the common causes of back pain, you can find ways to prevent and reduce it.


One major factor is the weight and size of your baby. At up to 6kg, this places extra strain on the joints of your lumbar spine and pelvis, and on the muscles of your back and tummy.

There is a natural arch in your low back which is designed to act as a shock absorber.  You can see it if you look at someone side on. Carrying the weight of a baby causes this arch to become exaggerated,  which may reduce its shock absorbing ability and lead to pinching of the small joints in your spine.  This is turn makes it harder for your back muscles to keep you upright.  They may go in to spasm, resulting in tiredness, aching and stiffness in your low back.

During pregnancy your abdominal muscles become stretched.  They may also separate (this is called diastasis recti).   This means your abdominal muscles can’t contract to support your low back quite as easily as pre-pregnancy.  This can further increase the pressure going through your low back.


Your pelvis also takes a lot of the strain of carrying a baby.  It begins to tilt forward, further increasing the curve in your low back.  Pressure is placed upon the three joints in the pelvis; the pubic symphysis at the front, and two sacro-iliac joints at the back.  The pubic symphysis may widen by up to 9mm.

This may cause the pelvic bones to move slightly out of their normal positions, which in turn causes you to feel pain in your low back and legs.  To make matters worse, the baby sometimes come to rest on a bundle of nerves in the abdomen, which can cause shooting pains and numbness in the leg.


Our joints are usually supported by ligaments, which bind bone to bone.  During pregnancy these ligaments become a looser than normal thanks to a hormone called relaxin.  While this is necessary for childbirth, it has the unfortunate side effect of reducing the stability of your joints and thus aggravating the problems discussed above.


Thankfully, there are many simple but effective techniques for managing back pain.

  • Prevention is better than cure.
    If you are generally active and healthy, have good muscle tone and core strength and don’t usually suffer from back pain you are more likely to have a pain free pregnancy.
  • Take care of your posture.
    Try to stand and sit up right rather than slouching.  Avoid crossing your legs.  Use a small cushion to support the small of your back when sitting down.  This helps reduce the pressure to your low back and pelvis.
  • Support your back and your bump.
    Try to sleep on your side, with your knees bent up and a cushion under your tummy.  You can also try placing a pillow or folded towel between your knees.  When you are standing, ‘tuck in’ your bottom to flatten the curve in your low back.  If you are suffering from back pain, a support belt may help.
  • Seek help.
    If back pain has set in and the above steps aren’t shifting it, get professional help.  Speak to your GP and midwife as there may be other causes of back pain such as urinary tract infection.  Consider having ‘hands on’ treatment such as osteopathy.  Ring 020 8520 5268 to book an appointment or free 15 minute chat with me.



How do I choose a good pillow?

There’s nothing like a good night’s sleep.  That feeling of waking up pleasantly rested, not too hot and not too cold, supported by a comfy pillow and mattress is just bliss.  So it is pretty annoying when an uncomfortable pillow stops you sleeping.

how to choose a pillow

Choosing a pillow is very personal.  Your best bet is to try lots of different ones before deciding which is your favourite.  Luckily there are a few guidelines to narrow down the options.

For side sleepers try a larger, fairly firm pillow.  You want to be able to lay on your side with your neck fairly straight, so it’s not leaning down towards your mattress or up towards the ceiling.  The broader your shoulders, the larger the pillow.

For back sleepers a flatter pillow is better.  Your head should feel supported but the pillow shouldn’t lift your head up very much.  Ideally your neck remains quite straight.

If you are a larger build  go for a firmer pillow.  Your head and neck may be heavier so need more support.

If you are a lighter build a softer pillow will probably be ok.

If you suspect your pillow is too soft try putting folded towel underneath it to make it firmer.  Sleep on it for a few nights and see if you like it.

You may also like to consider the pillow’s contents; is it hypoallergenic, is it washable?


I often find that supple, healthy necks are feel comfortable in many situations, and stiff neck joints and muscles cause discomfort even with very good pillows.

If you’re having difficulty finding a comfy pillow you may have some irritated muscles or joints in your neck or upper back.  It would probably be worth seeing an osteopath or similar therapist who can help improve your flexibility.

How can you treat sciatica?

There are lots of treatment options for sciatica.  Different combinations will work for different people but any treatment needs to be informed by an accurate diagnosis.


Treatment basically involves reducing pain and improving your strength and flexibility.


I use lumbar spine mobilisations to improve flexibility, reduce muscle guarding, improve circulation and reduce local inflammation.  Some people believe these techniques help reduce the size of a disc bulge.

I use different variations of these techniques, usually starting with gentler versions and moving up to more forceful techniques as the pain reduces.

Back Pain Treatment E17


I also work on local muscles in the low back, glutes, hamstrings and hip flexors.  This aims encourages flexibility, reduce pain arising from muscle guarding, retrains your nervous system to activate muscles and reduces sensitivity.   Usually these are massage style techniques but I also use stretches and modified stretches such as Muscle Energy Techniques (METs).

With most sciatica sufferers I will also work on their mid back and shoulders as I find this is useful for short term relief.


Most important of all is exercise!   I give all of my patients simple stretches to do each day.  I also give simple exercises to strengthen and reactivate the core muscles.

It’s important to stay active with gentle walking and as many normal daily activities as you can tolerate.  It is not a good idea to rest for long periods as this allows your muscles to stiffen. It’s also quite boring and isolating and leads you to dwell on pain.

Knee Hugs Stretch for Low Back Pain

Many of my sciatica patients use painkillers to help manage their symptoms.  I can’t give specific advice on painkillers but they are usually fine to use alongside osteopathy and exercise.   It is best to speak to your chemist for advice on over the counter medication or your GP for prescription medication.    Many of my sciatica patients use ice packs to help manage pain.


If conservative treatment doesn’t help you may wish to consider other treatment options.  Injections into the facet joints are commonly offered and can give some pain relief.  If your sciatica symptoms are caused by a disc herniation you may be offered an operation to reduce the size of the disc bulge.


Most cases of sciatica resolve with time and non-invasive treatment such as those described above.

If you think you have sciatica please give me a call on 020 8520 5268 to find out how I can help.

Whats the best sleeping position?

I’m often asked what the best sleeping position is, and the best answer is whichever position feels most comfortable.

Having said that there are some advantages and disadvantages to each position.

On your Back

Many people with neck pain seem to find it more comfortable to sleep on their back.   It’s best to sleep with a fairly flat pillow so your neck is held in a nice neutral position.

Some people find resting on their back with their legs straight can irritate the low back.  Those people might find it more comfortable with a pillow under their knees or with their knees bent.


On your Side

Sleeping on your side with your legs slightly bent is a good choice for most people.   It usually places your spine in a neutral, supported position which is pretty comfortable.  It’s best to choose a pillow which supports your head and doesn’t causes your neck to tilt sideways.

If you have low back pain you could also place a cushion between your knees to support your low back.


On your Front

Sleeping on your front can place strain on your neck as you have to turn your head to the side.  However, if you feel comfortable on your front just go for it!  A flat pillow is best here.  You might also like to put a small pillow under your tummy as this can be more comfortable for your low back.