"23 and 1/2 hours" - watch this video!

A Doctor-Professor answers the old question "What is the single best thing we can do for our health?" in a completely new way. Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.


This video reminds us that the best way to stay healthy remains one of the simplest.  At least, there seems to be plenty of time to do it, when put this way!


Click on the following link to view Dr. Evans' website:
www.myfavouritemedicine.com/23-and-a-half-hours/


or watch the video here:

The Great British Pain in the Neck

• Britons are more likely to suffer from neck pain
• Massaging the spine is more effective than medicine in short and long term

People living in Britain are among those most likely to suffer neck pain according to an article* published in January 2012 which states those living in high-income countries are more susceptible to the problem than those living in low or middle-income countries. The study of neck pain treatment, published in Annals of Internal Medicine, also reveals that women are more likely than men to experience neck pain and that the problem is particularly prolific among office and computer workers.

Britons are exceptionally hardworking and driven with the UK ranked as the 13th most prosperous country out of the 130 countries measured in the 2011 Legatum Prosperity Index. Much of the work in high-income countries including the UK is conducted at a desk where ergonomics and stress are common factors that can result in neck pain and exacerbate existing conditions. 

According to the article, spinal manipulation, which is practiced by osteopaths and some other health practitioners, was more effective at relieving symptoms than medication. Medication, whether over-the-counter or prescribed by GPs, is often a popular choice among time-poor workers who are reluctant to take time off for expert treatment. However patients who were taught self-massage techniques rather than solely having to rely on treatment provided by professionals also benefitted more than those taking medication.

Kelston Chorley, Head of Professional Development at the British Osteopathic Association says: “These research findings are positive for individuals, employers and employees. Pain relief medication can be expensive and learning self-massage techniques mean individuals can be empowered to help manage their pain. Further, where medication is ineffective, this can result in ongoing problems that could have been resolved earlier and may even worsen as a result.  This can mean people have to take time off work for extended periods.

“An osteopath will usually provide some initial treatment to help correct any underlying cause for the condition and will always provide self help strategies for neck pain so patients can manage their condition in the future.”

The article also says that mobilisation, described by the BOA as repetitive movements of joints to free up restrictions and increase the movement of joints and surrounding tissues, may be a better first treatment for non-specific neck pain than manipulation, described as unlocking restricted joint and surrounding tissues with a single highly specific movement, which can be an uncomfortable experience for some patients.

Kelston from the BOA concludes: “In many cases of acute or chronic neck problems manipulation is not always the first line of treatment by an osteopath. Using a combination of soft tissue massage, mobilisations and self help exercises often proves to be a more appropriate solution than the “neck clicking” commonly associated with manipulation.”

About the British Osteopathic AssociationThe British Osteopathic Association (BOA) is the professional association for osteopaths in the UK, acting as an independent representative body whilst promoting osteopathy to the general public and government. The BOA is committed to supporting, protecting and caring for its members and promoting opportunities for individual and professional development in osteopathic practice. There are nearly 4,000 osteopaths on the UK register who carried out over seven million treatments last year, and many of these are members of the British Osteopathic Association.  For more information and to search for an osteopath, visit the website www.osteopathy.org

* To read the article in full visit: http://www.annals.org/content/156/1_Part_1/1.abstract?aimhp

Teachers at risk of pain!

Teachers are at particular risk of developing musculoskeletal disorders (MSD) such as neck, back and shoulder pains, new research has revealed. 


A report from the British Osteopathic Association found that there was a high prevalence of teachers reporting problems such as a pain in the back, neck and upper limbs and believes this is due to the stressful working conditions, large class sizes and lack of resources faced by teachers. 


"Psychosocial factors have also been positively associated with MSD among school teachers, and the current review suggest that psychosocial factors such as high workload / demands, high perceived stress level, low social support, low job control, low job satisfaction and monotonous work are most likely associated with MSD among school teachers," the report reads. 


The research revealed that nursery school teachers are more likely to suffer from lower back pain due to the time spent on tasks which involve sustained periods of kneeling, stooping, squatting or bending. School teachers spend a significant amount of time in a 'head down' posture such as reading, marking assignments on writing on a whiteboard, so are most likely to suffer from a wider variety of problems including pain in the back, neck and upper limbs. 


According to the latest figures from the Labour Force Survey 2010-2011, musculoskeletal disorders were responsible for 15 sick days per case. "Physical stress imposed on the body by protracted periods of poor posture, sitting on chairs designed for children not adults etc. will produce muscle and joint imbalances, strains and soft tissue stresses which become habitual leading to more chronic recurring pains and episodes of pain," says Osteopath Kelston Chorley, Head of Professional Development at the British Osteopathic Association. "It is the chronic build up of strain and habitual bad posture that leads to many of the problems that osteopaths frequently see related to the teaching profession - particularly towards end of term. Osteopathy, as recommended by NICE guidance for low back pain, can have a very beneficial outcome both in the acute period of pain but more importantly, preventing the acute episode from turning into a chronic condition". 


Earlier this year, 96 per cent of teachers who responded to a Teacher Support Network e-newsletter survey said their health and wellbeing had been affected by their workload. 


"I have chronic neck pain which is mostly ignored or laughed at at work. I have to beg people to help me do things, which is humiliating at the very least," explained one respondent at the time. 


"I have constant exhaustion, forgetfulness, sore throats, aching body every day," added another. 


Are you struggling with back, neck or shoulder pains at school? 


Here are some helpful tips for teachers from the British Osteopathic Association:  


Health tips for teachers 


The main problem for primary and nursery teachers is that they are stuck in static postures and need to move their bodies around. With teachers of older children the problem tends to be stress. Both make the body stiff and tense. The following exercises done at the end of every working day will help teachers to combat the daily strains on their bodies from working in a physically strained environment. 

• To loosen your neck, turn it slowly and gently from side to side ten times
• To relax tense shoulders, roll them 15 to 20 times. 
• Lie on your back on the floor and bring your knees to your chest, hug them, then release your arms while keeping you legs in the same position. Twist your legs gently across the left of your body, hold for a few seconds. Bring back to the middle then twist your legs over to the right. Release your legs back to full extension on the floor. Repeat this 15 times. 
• Regular exercise such as swimming - anything to get the whole body moving 
• Start an after-school exercise club for teachers! 

Download the British Osteopathic Association's free app which has video exercises individuals can follow to loosen their neck, back and shoulders:

iTunes: http://itunes.apple.com/gb/app/osteopathy/id427802141?mt=8&ls=1

Android: https://market.android.com/details?id=com.oakley.osteopathy

Want to try Osteopathy?

Absolute Health clinic in south Leicester is offering a free consultation and initial treatment to any teacher in the area.  

When you book 3 treatment sessions in advance you only pay for 2. Save £46!

Offer applies to new patients only.  Payment by cheque, debit card or cash - book in clinic or over the phone - 0116 282 7766.

Offer ends 31st October 2012.

  

Osteopathy helps headache and migraine

Is osteopathic manipulation effective for headaches?

Ashley C. Keays, DO, MPH; Jon O. Neher, MD;

Valley Family Medicine, Renton, Wash

Sarah Safranek, MLIS

Health Sciences Library, University of Washington, Seattle

Evidence-based answer It can be. Spinal manipulative therapy (SMT), a component of osteopathy, has been shown to be variably effective for the treatment of headaches. For the prophylactic treatment of cervicogenic headaches and for acute tension headaches, SMT is superior to placebo. For tension headache prophylaxis, research shows a trend toward better outcomes with amitriptyline than with SMT. For migraine prophylaxis, SMT has an effect similar to amitriptyline (strength of recommendation: B, based on a systematic review of various quality studies).

Clinical commentary 3 osteopathic techniques that work for my patients Charles Webb, DO Oregon Health and Science University, Portland Headaches often have more than one cause—physical, psychological, and pharmacological—and each requires treatment. I start by systematically eliminating specific headache triggers. Meanwhile, I find osteopathic manipulative treatment to be an easy and timely intervention to abort headache symptoms and improve patient well-being. I use a variety of manipulation techniques, including cervical soft tissue massage, occipital decompression, and myofascial unwinding. Cervical soft tissue massage of the paraspinal tissues helps relieve the spasms of tension headaches. Occipital decompression involves using the fingertips to manually stretch the paraspinal tissues at the base of the occiput; it works well in my experience to abort migraine headaches. I teach patients to use a rolled up hand towel behind their neck to do occipital decompression at home, which helps prevent further headaches. Myofascial unwinding is a technique that literally unwinds the tissues encasing muscles in spasm.

  EVIDENCE SUMMARY

For cervicogenic headaches: Spinal manipulative therapy reduces pain

Three studies¹ evaluated SMT for treatment of recurrent cervicogenic headaches). A multicenter trial²randomized 200 patients with cervicogenic headaches to either SMT (8–12 sessions over 6 weeks) or placebo. The SMT group had significantly reduced pain (at 1 week, effect size [ES]=0.7; 95% confidence interval [CI], 0.3–1.2; and at 12 months, ES=0.4; 95% CI, 0.0–0.8) and fewer headaches (ES=0.7; 95% CI, 0.3–1.1 at both time points) than placebo.

FAST TRACK Spinal manipulative therapy reduces the pain of cervicogenic headaches

Another RCT³ with 105 patients compared SMT (3 times a week for 3 weeks) with placebo. The SMT group reported significantly less pain after 3 weeks (ES=2.2; 95% CI, 1.7–2.7).

A third trial⁴ randomized 30 patients to either SMT, mobilization (small oscillatory movements to a joint within its normal range), or wait-list placement. At the end of treatment, there was a nonsignificant trend toward greater pain reduction in patients receiving SMT than either those receiving mobilization (ES=0.4; 95% CI, –0.5 to 1.4) or those on the wait list (ES=0.6; 95% CI, –0.4 to 1.5).

For tension-type headaches: Results are mixed

Two trials⁵ investigated the efficacy of SMT on tension-type headaches. The first, an RCT with 150 patients with recurrent headaches, compared SMT (2 sessions per week) with amitriptyline (10 mg daily week 1, 20 mg daily week 2, then 30 mg daily) for 6 weeks. At the end of 6 weeks, the SMT group reported a nonsignificant trend toward more headache pain (ES for SMT vs amitriptyline= –0.4; 95% CI, –0.8 to 0.0), but fewer side effects. They had similar headache frequency and medication use.

Another study⁶ of 22 patients compared SMT with 2 different controls (palpation and rest) for acute tension-type headache. The SMT group was significantly more likely to experience immediate improvement (ES=1.8; 95% CI, 0.4–3.2).

For migraine: Spinal manipulative therapy is similar to amitriptyline

In 1 trial⁷ of migraine prophylaxis, 218 patients were randomized to either 14 sessions of SMT for 2 months or oral amitriptyline (titrated up weekly during the first month and continued at 100 mg daily over the second month). The headache index (a measure of daily pain intensity) was equivalent in both groups in the last 4 weeks of treatment (ES for SMT vs amitriptyline= –0.1; 95% CI, –0.5 to 0.3).

A month after both therapies were stopped, there was a nonsignificant trend toward a lower headache index in the group that had received SMT than the group that had received amitriptyline (ES=0.4; 95% CI, 0.0–0.8). Ten percent of the medication group withdrew from this study due to side effects; no side effects were reported from SMT.⁷

Another RCT⁸ of migraine prophylaxis with 88 patients compared SMT twice weekly for 8 weeks with mobilization techniques. At 8 weeks post-treatment, there was a nonsignificant trend favoring SMT over mobilization in decreasing pain (ES=0.4; 95% CI, –0.2 to 1.0).

Recommendations from others

FAST TRACK For migraine, spinal manipulative therapy is as effective as amitriptyline

The National Headache Foundation⁹ states that “the value and cost-effectiveness of chiropractic, osteopathic medicine, and physical therapy in migraine have not been proven in clinical trials. Conflicting results and poor clinical trial design limit the ability to judge the effectiveness of manipulative treatments. Physical therapy, although limited in its study, has proven more effective than manipulative treatment in selective cases.”

References
1. Biondi DM. Cervicogenic headache: a review of diagnostic and treatment strategies. J Am Osteopath Assoc 2005;105(4 Suppl 2):16S–22S.
2. Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27:1835–1843.
3. Whittingham W.  The efficacy of cervical adjustments (toggle recoil) for chronic cervicogenic headaches [PhD dissertation]. Melbourne, Australia: Royal Melbourne Institute of Technology; 1997.
4. Bronfort G, Nilsson N, Hass M, et al. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004;(3):CD001878.
5. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. Amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Physiol Ther. 1995;18:148–154.
6. Hoyt WH, Shaffer F, Bard DA, et al. Osteopathic manipulation in the treatment of muscle-contraction headache. J Am Osteopath Assoc 1979;78:322–325.
7. Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. J Manipulative Physiol Ther 1998;21:511–519.
8. Parker GB, Pryor DS, Tupling H. Why does migraine improve during a clinical trial? Further results from a trial of cervical manipulation for migraine. Aust N Z J Med 1980;10:192–198.
9. Mauskop A, Graff-Radford S. Special treatment situations: alternative headache treatments. In: Standards of Care for Headache Diagnosis and Treatment.Chicago, IL: National Headache Foundation; 2004;115–122.

March 2008 · Vol. 57, No. 3: 190-091

From the Family Physicians Inquiries Network

The Journal Of Family Practice ©2008 Quadrant HealthCom Inc.

Osteopathy vs. Chiropractic

The outspoken critic of Complementary Medicine - Professor Edzard Ernst - recently commented in a blog on the 'Pulse Today' website.  Although I don't often agree with Ernst's findings, there is some interesting information below:

Osteopathy - how different is it to chiropractic?

31 October 2011

In the past, several commentators have suggested that I repeatedly single out chiropractors and attack them continuously and unfairly. My critics argue that osteopaths do more or less the same things as chiropractors, based on the same, poor evidence, yet I never seem to make a fuss about osteopaths.

This, they believe, is unfair. Chiropractors, in particular, seem to feel that I have an axe to grind. I think these allegation are misleading – and here is why.

According to their own General Chiropractic Council (GCC) survey¹ the vast majority of UK chiropractors believe that they can treat non-spinal (visceral) conditions effectively. For instance, 63% of them claim to be able to treat infant colic¹. According to the corresponding General Osteopathic Council (GOC) survey², very few UK osteopaths seem to believe they can treat such conditions.

The GCC survey² also reveals that close to 100% of all chiropractors use high-velocity thrusts regularly. By contrast, the GOC survey³ suggests that this is done by only 47% of the UK osteopaths. As it is this technique which is suspected to cause the dramatic complications⁴ which continue to be reported e.g.⁵, the difference is, in my view, highly relevant.

Independent evaluators of the existing data will arrive at the conclusion that the evidence-base for the effectiveness of osteopathy is not much different from one for chiropractic³. But, at least, osteopaths treat non-spinal conditions less frequently, and – most crucially – they use hazardous techniques less often than their chiropractic colleagues.

What follows, I think, is obvious: GPs who feel that a patient might benefit from spinal manipulation/mobilization should consider the above evidence carefully when deciding whether to refer this patient to a chiropractor or to an osteopath.

Reference List

  (1)   General Chiropractic Council. Consulting the profession: A survey of UK chiropractors. (http://www.gcc-uk.org/files/link_file/ConsultTheProfession.pdf). London: General Chiropractic Council; 2004.

  (2)   General Osteopathic Council. Snapshot Survey 2001 Results. 2001.

  (3)   Ernst E, Pittler MH, Wider B, Boddy K. The Desktop Guide to Complementary and Alternative Medicine. 2nd edition. Edinburgh: Elsevier Mosby. 2006.

  (4)   Terrett AGJ. Current concepts in verebrobasilar complications following spinal manipulation. Iowa, USA: NCMIC Chiropractic Solutions; 2001.

  (5)   Kelley A. Ada man, 29, dies of stroke after chiropractic treatment. 2011;www.newsok.com [Accessed 26-06/2011].

Bowen Therapy helps roll away chronic pain

[Extracted from Vitality magazine Sept/Oct 2011]

The Bowen Technique is a natural, drug-free, non-invasive complementary therapy, invented in Australia and introduced to the UK in the 1990s. Bowen Therapy has a particularly strong record of success in the treatment of back pain. A national study, carried out by The Bowen Therapy Professional Association (BTPA) in the summer of 2006, showed that 95 per cent of back pain sufferers experienced either complete relief or a marked improvement, after a series of no more than three Bowen treatments.

The Bowen Technique prides itself on being able to trigger the body’s own healing systems. Rather than 'making' the body change, Bowen 'asks' the body to recognise and make the changes it requires.

With primarily fingers and thumbs, the Bowen practitioner makes small, rolling movements over muscles, tendons, ligaments and soft tissue at precise points on the body, using only the amount of pressure appropriate for that individual. No hard-tissue manipulation or force is needed or used. Between each set of moves, the body is allowed to rest for a few minutes,

to allow it to absorb the information it has received and initiate the healing process.

Bowen is generally pleasant to receive, each session lasting 30 to 60 minutes, depending on the age of the client and the nature of their condition. Many clients become so relaxed they fall asleep during the treatment.

Short-term (acute) injury may be resolved in one to three Bowen treatments, while long-standing (chronic) conditions may require longer. A gap of five to ten days is recommended between Bowen sessions; so that the body can process the subtle information it has been given. As well as back pain, Bowen Therapy also may help with a host of other health issues

such as frozen shoulders, sports injuries, whiplash, migraine, hay fever, asthma, IBS

or fertility matters.

Brighton Bowen therapist Sarah Yearsley has treated Channel 4’s Born Survivor Bear Grylls for many years now.  Grylls says of his Bowen treatments with Sarah, “It (Bowen) has helped keep my body together despite the continual bashing it takes. It’s a vital support in putting right a whole range of new aches and pains, making sure that old injuries don’t cause

me problems, and helping me fight stress and fatigue.”

As with many other alternative therapies, the success of a treatment mainly depends on visiting a legitimate, well trained practitioner, who is a member of an organisation like BTPA (The Bowen Therapy Professional Association). Members of this association are qualified in Anatomy & Physiology and First Aid. They are also fully insured, abide by a strict code of conduct and ethics and are committed to a programme of continuing professional development.

Free treatment on offer

Following on from our 'Groupon' offer, if you recently had an Osteopathy treatment, ask us for a voucher - introduce a friend and get one Osteopathic treatment free.


Our clinic relies on word-of-mouth referrals so we are always grateful if you can recommend us to your family, friends or work colleagues.


We are also looking for testimonials - if you have had a great treatment and would like to tell others what benefits you received, we will offer you a £5 gift voucher as a small 'thank you'.