Posts from August, 2013

Spinal injections for back pain

Written By davecasey6719@gmail.com, On August 29, 2013

How a jab of gel could be the surgery-free solution to your bad back

Clinical trials likely to start in three years

Excruciating: Eighty per cent of Britons suffer with back pain at some point in their lives

An injection that could ease the misery of back pain for millions has been the holy grail for medicine over the last 40 years, but to date all attempts have failed. Another such treatment has been invented by British scientists hoping to succeed where others have failed. The latest treatment uses and injection of gel that contains thousands of microscopic sponge-like particles that inflate and gel together inside the body, attempting to repair damaged and worn-away spinal discs.

Almost everyone over the age of 50 has degeneration of the intervertebral discs, which cushion the vertebrae that make up the various sections of the spine. Eighty per cent of Britons suffer back pain at some point in their lives. The most badly damaged discs are treated through surgery in a major operation in which vertebrae are fused together, and patients can take months to recover.

In contrast, it is hoped that patients would be back to normal only days or weeks after treatment with the gel. The injection, which is the result of 25 years of work at Manchester University, contains billions of tiny particles which form a liquid in the syringe. Once inside the body, they turn into a gel. Lead researcher Dr Brian Saunders, of the university’s School of Materials, said: ‘It is made up of lots of really, really small microgel particles, sponge-like particles, each about one-thousandth the width of a human hair, floating around in water. ‘When we inject them, they expand and push against each other like a boxful of balloons blowing up and pushing against each other. ’As a result, they lock together, creating a strong, load-bearing material, the journal Soft Matter reports. Dr Saunders said: ‘By the time we get to 50 years old, 97 per cent of us have degeneration in some of our intervertebral discs and it gets progressively worse. It causes a lot of time off work and is a major issue because as a society we are all getting older and heavier.

‘Treatments go from simple ones like physiotherapy to very severe ones like spinal fusion. ‘That’s a major operation which involves lots of time in hospital and lots of time recovering and there’s not really that much in between, so for years we’ve been working on an injectable approach that doesn’t involve surgery. ‘We hope it could be done in the outpatients part of a hospital, rather than going into a surgical theatre and you’d be in and out, rather than spending days in hospital.’

The gel is likely to be injected into people for the first time in around five years. If all goes well, it could be widely used to ease back pain three years after that. Professor Tony Freemont, a co-author of the paper, said: ‘Degeneration of intervertebral discs results in chronic back pain which costs the country billions of pounds per annum and causes untold misery for sufferers and their families.’ Back ache is one of the biggest causes of absenteeism, accounting for nearly five million lost working days a year.

All attempts in the past for quick fix pain relief have failed again and again unfortunately spinal dysfunction is complicated and we need to preserve our spines and regular chiropractic treatment can help keep our spines flexible over the years.

 

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Market Harborough Chiropractor explains why pilates is not a cure all for back pain

Written By davecasey6719@gmail.com, On August 19, 2013

How pilates can make your bad back worse: It can help reduce pain and improve posture, but as one woman’s story shows, there are hidden dangers. Spinal problems are complex and require specialist examination before patients embark on a spinal rehabilitation program that may not be correct for their specific problem.

Here is an example to demonstrate.

Like thousands of women, Sophie  decided to do Pilates to get back into shape after giving birth. While driven by the desire to lose her post-baby belly, Sophie, 38, was also keen on it for medical reasons.

She was born with scoliosis, an abnormal curvature of the spine, and her doctor had warned that the extra weight of the baby could put added strain on her fragile back and muscles.  A maternity nurse told her that Pilates a series of stretching exercises to improve physical strength and flexibility was excellent for women post-birth.

The classes are particularly good for back problems because the exercises strengthen the muscles that support the spine. ‘Seven months after the birth I felt ready to start exercising,’ says Sophie

‘I told the instructor about my scoliosis and the pregnancy, and he nodded and told me to join a class.  ‘I went once a week for three months as part of a group of 12 people, and everything was fine, but then overnight my left leg went numb. ‘I mentioned this, but the instructor didn’t seem concerned and just told me to take it easy. I didn’t think to question it.’ But within a few weeks the numbness worsened and Sophie had excruciating pain at the base of her spine. Concerned, she went to the doctor. ‘I was referred to a specialist and given an MRI scan.

The results were irrefutable — I’d rupture  a disc.  ‘The increased pressure and strain of the exercises had aggravated my weakened spine, causing the disc to rupture, so it was pressing on my nerve. ‘Worse still, the damage was so extensive they thought the only way round it was surgery to trim the disc.’

Pilates is considered to be  helpful for improving back pain and posture. It’s recommended to those suffering from back pain because participants are taught how to target the core muscles.

These are the transversus abdominus (the muscle that runs between the ribs and the pelvis), the multifidus (next to the spine in the lower back) and the pelvic floor muscles.

It used to be the thought that they play a pivotal role in protecting the back, but this role has now being increasingly questioned and over stated by many practitioners.

Unfortunately, more and more people are suffering problems as a result of these exercises. The problem is how Pilates is being taught. ‘I’m seeing an increasing number of patients who have aggravated degenerate discs after attending pilates classes because they thought it would help with their back problems,’ says David Casey a qualified chiropractor specializing in spinal rehabilitation. A view that is taken by many orthopaedic and spinal surgeons who also have to carry out unnecessary surgery which could be avoided with correct tailored exercises.

While many surgeons and qualified chiropractors recommend exercises for back pain and after injury, if exercises are carried out incorrectly they can weaken the back and cause existing conditions to deteriorate. A specialist chiropractor is professionally qualified, undergoing a five years medically based degree program and  would be able to diagnose these conditions more specifically and design a more appropriate program of exercise.

Pilates, practised by an estimated one million Britons, was devised 80 years ago by Joseph Pilates, a German sportsman, to improve muscle strength. We see this as the main problem says Dr Casey,” that using techniques developed in the sports field are not appropriate to spinal rehabiliation”. Spinal rehabilitation is the art of taking a diseased weaken spine and bringing up to a level to maintain the activities of daily living not up to an athletic standard.

Pilates is dominated by working on the deep abdominal muscles; one of the main exercises involves drawing in the tummy to the spine and lifting the pelvic floor. Drawing in the abdominal muscles has been shown to weaken the spine not strengthen it.

When exercise  isn’t tailored to an individual or taught correctly according to the patient’s specific diagnosis problems  occur.

‘Traditional Pilates incorporates exercises that can be challenging, often too challenging,particularly if you have an existing back problem.  ‘Indeed, even if you carry them out correctly, they can put excess strain on the spine and surrounding muscles.  ‘Classes of more than 12 people don’t help. There’s no way the teacher can keep a close eye on every person’s moves, and a student won’t know whether they are doing an exercise correctly, which can lead to problems.’

Unfortunately, this puts the 80 per cent of Britons who suffer from back pain at some time in their lives in a Catch-22 situation: their orthopaedic surgeons, doctors and physiotherapists may recommend Pilates, but not all classes on offer will be beneficial.

Chiropractors have extensive  training, which means they have a real understanding of anatomy  in particular, back conditions and the strengths and weaknesses you may have.’

‘I have managed to avoid an operation, but only with a combination of steroid injections to reduce the inflammation and hefty painkillers says Sophie. ‘But the operation could still be on the cards if the pain returns, which I want to avoid at all costs. Pilates may be good for back problems, but I know better than most that it depends on which class you attend.’

To find out more about back pain and spinal rehabilitation call to speak to or arrange an appointment with one of our qualified chiropractic specialists. They will advise what may or may not be appropriate for your condition.

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Market Harborough Chiropractor – back pain in children

Written By davecasey6719@gmail.com, On

Children are suffering from rise of the ‘Gameboy Back’

Surgeons and chiropractors say increasing numbers of children are suffering spinal problems caused by prolongued use of gaming consoles. Chiropractors are seeing increasing numbers of children in their offices. The main way to avoid future surgery on the spine is to keep its flexibility throughout life. Regular chiropractic treatments combined with expert advice and therapeutic exercises in their offices are now the mainstay of the ongoing war against back pain.

With back pain considered to be the modern epidemic costing governments billions in healthcare and losses to industry, we can no longer rely on waiting for the onset of back pain before we act. Small community based chiropractic clinics such as the Market Harborough based chiropractic clinic and the Melton Mowbray Chiropractic clinic will be at the forefront of this battle.

Doctors say that increasing numbers of children are developing serious spinal problems, such as degenerated discs, because they slump for such long periods. This is serious because disc degeneration usually occurs later in life not in children, this may result in a future of advanced back problems and further cost to medicine as a whole.

Orthopaedic experts say children and teenagers are being left with injuries and curvatures because of a phenomenon they have dubbed “Gameboy Back,” after too many hours hunched over addictive computer games. Chiropractors  say that increasing numbers of children are developing serious spinal problems, such as premature disc degeneration, because they slump for such long periods.

Experts  say  prolongued period on games consoles, and time hunched over smartphones, is damaging the posture of children, and would leave some with lifelong problems. Writing in the Dutch medical magazine, Medisch Contact, orthopaedic and spinal surgeon Piet van Loon said doctors were seeing increased numbers of cases linked to use of computer consoles.

Essentially, it’s like growing bonsai trees: bone responds in the same way as wood. If you force it in a certain direction over a prolonged period, that’s how it ends up growing. If a young spine is kept flexible as it grows chiropractors hope to prevent back pain continuing into adult life.

The experts said the simplest test for “Gameboy Back” is to see if children can bend over and touch their toes. Those with curvature of the spine would not be able to flex sufficiently to reach, they said. Obviously this is a rather crude test of spinal function, but an expert chiropractic examination would give a professional assessment of spinal health.

Chiropractors said that people who play computer games have a tendency to either slump, or to curve their spine in a C-shape for hours on end. Children often sit in front of a computer game in a posture that is very bad for their backs, putting pressure on discs, muscles and ligaments. They can become so immersed in the plot of a game that they don’t notice any pain or discomfort.

We see the same results in office workers slumped over computers all day. Industry has made huge efforts to reduce the onset of back pain related to desk work, but this could be all in vain if the younger generation are damaged before they even start work.

In the population overall we need to take back pain more seriously and attempt to maintain a healthier spine throughout life not just let degeneration get hold in the first place. This must start at the earliest opportunity and we must start in childhood to begin this process.

For a professional opinion and further advice contact one of the qualified chiropractic experts at the Market Harborough or the Melton Mowbray clinics

 

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Archway children clinic

Written By davecasey6719@gmail.com, On August 15, 2013

The Chiropractic Clinic situated at the heart of Market Harborough is often an archway or a bridge if you like for problems with childhood spinal problems. If a child suffers with back pain we don’t want to rely on painkillers alone, due to their side effects. Chiropractic care can be an archway leading to pain relief without the side effects of painkillers.

The younger we can see back problems the greater the chance we can prevent a future complicated with chronic back pain. Spinal health has to be the future for us all, instead of waiting for years of accumulated wear and tear finally leading to back pain and the related disability. It will become increasingly important as the health service buckles under the increasing demand placed on it, that we start to become more proactive and seek effective treatment rather than waiting on longer and longer waiting lists.

Why not see if chiropractic care can help with your childs back pain.

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Market Harborough Chiropractor back pain treatment

Written By davecasey6719@gmail.com, On August 12, 2013

Although Back Pain Improves With Care, It Often Persists For A Year Or Longer

For people receiving health care for acute and persistent low-back pain, symptoms will improve significantly in the first six weeks, but pain and disability may linger even after one year, states a large study published inCMAJ (Canadian Medical Association Journal). This contradicts the long standing belief that back pain will recover in six weeks. For decades this misconception has underpinned the treatment of back pain suggesting that is a simple back sprain and not a chronic deconditioning syndrome.

Low-back pain is a common condition that results in significant health care costs, disability and absenteeism in workplaces. However, there are differing views on how quickly and how completely people recover from this condition. Traditional approaches seem to prolong suffering and increase the overall financial burden associated with back pain.

Researchers from Australia and Brazil examined data from 33 studies (11 166 participants) to understand the clinical course of pain and disability in people receiving care for low-back pain. The study looked at more studies than previous reviews, which allowed more precise estimates of the clinical course of acute low-back pain as well as persistent low-back pain.

At one year, the patients who initially presented with acute low-back pain still experienced some pain and disability, the typical improvement in their pain was only about 50%.

It is great that people improve with care, but arguably there is room to do better, particularly for people with persistent low-back pain. Generally, when people see results like this they want to blame the clinician, but I think that is short-sighted. One of the principal reasons we have not made more progress in the back pain field is that research agencies do not take back pain research seriously. Around the world, back pain research is hugely underfunded relative to the burden of the disease. It’s time for that to change.”

At our chiropractic clinic in Market Harborough and Melton Mowbray we totally agree with these findings and the majority of our patients have been long term sufferers. This makes treatment more complicated and prolonged but with focused treatment and rehabilitation programmes we see great improvement.

 

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Market Harborough chiropractor on pudendal neuralgia

Written By davecasey6719@gmail.com, On August 5, 2013

Pudendal nerve entrapment

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed. Pain is positional and is worsened by sitting. Other symptoms include genital numbness, fecal incontinence and urinary incontinence.

The term pudendal neuralgia (PN) is used interchangeably with “pudendal nerve entrapment”, but a 2009 review study found both that “prevalence of PN is unknown and it seems to be a rare event” and that “there is no evidence to support equating the presence of this syndrome with a diagnosis of pudendal nerve entrapment,” meaning that it is possible to have all the symptoms of pudendal nerve entrapment  without having an entrapped pudendal nerve

Symptoms

There are no specific clinical signs or complementary test results for this condition. The typical symptoms of PNE or PN are seen, for example, in male competitive cyclists (it is often called “cyclist syndrome), who can rarely develop recurrent numbness of the genitals  after prolonged cycling, or an altered sensation of ejaculation, with disturbance of  urination and reduced awareness of defecation.Nerve entrapment syndromes, presenting as genitalia numbness, are among the most common bicycling associated urogenital problems.

The pain is typically caused by sitting, relieved by standing, and is absent when lying down or sitting on a toilet seat

If the perineal pain is positional (changes with the patient’s position, for example sitting or standing), this suggests a tunnel syndrome sitting pain relieved by standing or sitting on a toilet seat is the most reliable diagnostic parameter.

Imaging studies using MR neurography may be useful.

Causes

PNE can be caused by pregancy, scarring due to surgery, accidents and surgical mishaps. Anatomic abnormalities can result in PNE due to the pudendal nerve being fused to different parts of the anatomy, or trapped between the sacrotuberous and sacrospinalis ligaments. Heavy and prolonged bicycling  especially if an inappropriately shaped or incorrectly positioned bicycle seat is used, may eventually thicken the sacrotuberous and/or sacrospinous ligaments and trap the nerve between them, resulting in PNE.

Treatment

Optional treatments include behavioral modifications, physical therapy, analgesics and other medications, pudendal nerve block, and surgical nerve decompression.A newer form of treatment is pulsed radiofrequency.

Physical therapy

There are stretches and exercises which have provided reduced levels of pain for some people. There are different sources of pain for people since there are so many ligament, muscles and nerves in the area. Sometimes women do pelvic floor exercises  after childbirth. However, there have been cases where the wrong stretches make the constant pain worse.

Some people need to strengthen the muscles, others should stretch. There have been cases where doing stretches have helped bicyclists. A helpful stretch for some is bending over and touching your toes. However this is a bad exercise for people with low back pain.

Another stretch includes bringing your knee to your chest on the compressed side while laying on your back. One more possibly helpful stretch for bicyclists include sitting in the lotus position and moving your head to the ground supporting yourself with your hands and keeping your buttocks up.

Chiropractic adjustments to the lower back have also helped some patients with pudendal nerve issues.

Medications

There are numerous pharmaceutical treatments for neuropathic pain associated with pudendal neuralgia.

Injections

Alcock canal infiltration with corticosteroids is a minimally invasive technique which allows for pain relief and could be tried when physical therapy has failed and before surgery.

Pulsed radiofrquency has been successful in treating a refractory case of PNE.

Surgical

Decompression surgery is a “last resort”, according to surgeons who perform the operation.

The surgery is performed by a small number of surgeons in a limited number of countries. The validity of decompression surgery as a treatment and the existence of entrapment as a cause of pelvic pain are highly controversial.

While a few doctors will prescribe decompression surgery, most will not. Notably, in February 2003 the European Association of Urology in its Guidelines on Pelvic Pain said that expert centers in Europe have found no cases of PNE and that surgical success is rare:

Pudendal nerve neuropathy is likely to be a probable diagnosis if the pain is unilateral, has a burning quality and is exacerbated by unilateral rectal palpation of the ischial spine, with delayed pudendal motor latency on that side only. However, such cases account for only a small proportion of all those presenting with perineal pain.

Proof of diagnosis rests on pain relief following decompression of the nerve in Alcock’s canal and is rarely achieved. The value of the clinical neurophysiological investigations is debatable; some centres in Europe claim that the investigations have great sensitivity, while other centres, which also have a specialized interest in pelvic floor neurophysiology, have not identified any cases. Three types of surgery have been done to decompress the pudendal nerve: transperineal, transgluteal, and transichiorectal. A follow-up of patients of this surgery after 4 years found that 50% felt their pain had improved to various extents, although control patients were not followed up for comparison.

If surgery does bring relief of symptoms, patients will mostly experience it within 4 weeks of surgery.

If you would like to see if chiropractic treatment could help you please call either the chiropractic clinic in Melton Mowbray or Market Harborough

 

 

 

 

 

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