Kay Bradley-Higgins
Accredited Sarah Key Practitioner

What goes wrong with the back?
The Sarah Key concept proposes 5 stages of spinal breakdown

Most back problems begin with a simple, reversible problem. It may be so mild that you had never really noticed there was a problem, until of course the pain starts. With advice, exercises and treatment we aim to help settle the pain that may be arising from these changes, enabling you to manage your back pain in the long term.

  • Sarah’s first stage is a stiff spinal segment. It is also the most common. A segment becomes stiff, we don’t always know why. It could be an injury, prolonged poor sitting postures or weak muscles. Once a segment becomes stiff, the disc wall loses its elasticity, losing spinal flexibility. The disc wall is then less able to stretch to allow fluid into the disc, making it stiff, less efficient as a shock absorber, as well as painful.
  • Stage 2, facet joint arthropathy occurs as part of the ageing process. This is sometimes known as arthritis. If the discs become thinner, the facet joints are pushed closer together, putting them under a little more strain. This creates a ‘knock on’ effect to the surrounding muscles, leaving them less able to protect the joint. Unlike the disc, facet joints have a very good blood supply. If they are ‘irritated’ they can quickly swell. This can be very painful and can even lead to pain being referred into the leg. This condition can be quite disabling, but usually settles quite quickly.
  • Stage 3, the acute locked back. This often occurs without warning, maybe with no significant history of back pain. It is usually triggered by a trivial activity, such as bending to pick up the post. The back ‘goes’ and you may be in agony for a day or two.
  • Stage 4, the prolapsed or ‘slipped’ disc. This isn’t as common as we used to believe. A dehydrated disc can be painful, but more importantly it can change the way the disc works. Pressure normally borne by the fluid nucleus, is spread to the walls of the disc. This can cause the walls to “buckle”, causing weakening of the disc wall from the inside out. Sometimes what is left of the fluid centre causes the disc to bulge, leading to back and sometimes leg pain. Leg pain develops when the nerve supplying the leg is irritated on its way out of the spine. This too can be very painful and may require medication to keep the pain under control.
  • Stage 5, the unstable spinal segment. This occurs when the disc has lost its fluid. With no fluid acting as a ‘ball bearing’, keeping the vertebrae apart, the vertebrae above ‘slips’ on the one below as the spine bends forward. This is often felt as a catching pain in the back, particularly when bending forward. This is often accompanied by an awkward movement as your body tries to avoid the pain. People with this often become wary of moving in certain directions. This condition can often flare up and settle down on a regular basis. It can be improved by strengthening the muscles, particularly the core.

The last two problems in particular do not really come on without warning. There is usually a long history of back pain, even though it may have only been minor. This is why it is important to seek professional advice early on, helping to prevent deterioration and teaching you how to help your own back.

The SIRPATM Programme
Based on the work of Dr John E Sarno

Dr Sarno suggests that often, chronic pain is actually caused and driven by the brain and nervous system, rather than any physical problem. The response is an adapted stress response and therefore as the process is reversible, full recovery is possible. There is growing research in this area with excellent results.

Unfortunately people in chronic pain often hold the widespread belief that pain must have a physical cause, despite research concluding this is often not the case. The information on the SIRPA ™ site can help you recognise just how inextricably linked the mind and body are and how hidden stresses not only affect pain, but can cause persistent and often debilitating pain and other chronic conditions.

Chronic pain is maintained unconsciously by the brain and nervous system, but evidence shows that it is possible to reprogramme the brain and change these nerve pathways using conscious strategies. Most rewarding of all is that because the process is reversible, full recovery is possible, no matter how severe or long standing the pain.

The focus is on recovery not just management. If you have tried lots of other therapies and have had investigations that have shown no significant pathology, this approach may be for you.

I see many scans in my NHS role, I see ones with severe changes where patients have little pain, as well as seeing those that have normal scans, but are in terrible pain.

The SIRPA approach uses conscious, self-empowering strategies to resolve the underlying causes of the pain and teaches people to live life with less resistance.

If you are interested to know more about this programme, I would suggest reading any of the books by Dr Sarno, or Chronic Pain your key to recovery by Georgie Oldfield, who brought this programme to the UK.


Being in pain is unpleasant at best, but at its worst, it can be very debilitating. We all want to live a pain free life.

My aim is to help you improve your pain and get you back to your best, both mentally and physically. The activities we pursue make life enjoyable, whether it’s rugby, football, going to the gym or dancing. So often, people with pain are told to stop the activities they enjoy ... they stop, but the pain doesn’t improve, making them doubly miserable. I will always do my best to help you get back to the things you enjoy.

I use a number of treatment methods, including the Sarah Key Method. Used by HRH the Prince of Wales, it is an innovative approach to back pain that teaches you to look after your own back in the long term. Focusing on returning to normal activities, helping you to realise that your body is strong and teaching you exercises to keep it that way. The Sarah Key method uses the foot rather than the hand to mobilise the spine. It sounds strange, but it feels much more comfortable than small thumbs, as the heel has much better padding.

I have also completed a course in the SIRPA™ method. Looking at you holistically, including your mind as well as your body. The latest research shows that various things, such as emotions, stress and beliefs, can influence our pain experience. By helping these things as well we have a greater chance of getting rid of the pain for good.


Initial assessment, taking at least an hour

Initial assessment takes about an hour. During that time, I will ask you a lot of questions, give you a thorough examination and explain my diagnosis, discussing with you what I feel the main problem is. I will then treat you, usually with my feet. You will be given an exercise programme to do daily at home. I will also give you an explanation of how the back should work and where things can go wrong. This information will help you to better look after your back, helping you to understand why the exercises are so important. The exercises will help improve your movement and function, whilst reducing your pain.

Follow-up appointment (half an hour)

Sometimes, just understanding how your back works and knowing that there are things you can do to help yourself, will bring a sense of relief. The Sarah Key method is very effective, but don’t expect me to “fix” you on my own. Your participation (ie doing the exercises) is essential to you managing the problem in the long term. As this method relies on you doing some of the work at home, you may not need as many sessions as with a more traditional physiotherapy approach.

How to pay

Treatment sessions are payable for by cash or cheque at the end of each session. Receipts are available on request.

SIRPA TM assessments

SIRPA assessments are very different to your usual physiotherapy assessment, involving the completion of questionnaires and an in depth interview. This method also requires you to do some homework.

The SIRPA programme requires a lot of time supporting patients outside the clinic. My assessment time and pricing may have to rise to reflect this in the future.

The Physiotherapy and Massage Clinic
7 Northumberland St, Huddersfield, HD1 1RL

07877 697 059