Richard helps lead breakthrough in antibiotic treatment for back pain

Written by Sundial Clinics Friday, 10 May 2013 03:27

Richard Hollis

Back pain treatment breakthroughs are rare. Yesterday the most important breakthrough in back pain care in a generation was announced.  It has been found that antibiotic treatment may hold the key for millions of back sufferers.

A top research team found that some chronic, long-standing back pain is caused by an infection.  The researchers estimated this accounts for up to 40% of long term back pain sufferers and could save the NHS millions of pounds a year.

Richard Hollis, chiropractor at Sundial Clinics in Brighton, also practices at London centre set up by the Danish research group who identified this condition. Richard is currently the only practitioner in Sussex certified to identify and help manage treatment for this new condition.

Peter Hamlyn, a consultant neurologist and spinal surgeon at University College London yesterday said “Make no mistake this is a turning point, a point where we will have to re-write the textbooks.” He added, “It is the stuff of Nobel prizes.”

Sundial chiropractor Richard said “These back pain sufferers typically didn’t respond to treatment and not only do we now know why, for most of these sufferers there is a cure”

Richard added “In years to come I expect this treatment, MAST, will become standard for people with Modic disease. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics which would save the NHS about £250m let alone the savings from decreased medication and time off work”.

For more information or to book an appointment to see if this new treatment can help you, ring Sundial Clinics on 01273 696414.

For information on certified clinicians and MAST treatment see here.

Reference

Brighton Chiropractor and physiotherapist working together

Written by Sundial Clinics Monday, 12 November 2012 04:36

Chiropractors and physiotherapists work together surprisingly often. One of the great advantages of having a team of practitioners at Brighton’s Sundial Clinics who can treat back or neck problems and sports injuries is that the best combination of treatments can be given. Sometimes this will mean deciding which type of practitioner is best suited eg Low back problems are typically seen by our chiropractor and calf strains by our physiotherapist. There are times when seeing both a chiropractor and a physiotherapist is the best solution, an approach called “co-management” writes Sundial chiropractor, Richard Hollis.

Here are a couple of case studies of recent clients at Sundial Clinics here in Brighton, who have benefitted from seeing both a chiropractor (in these cases me!) and our physiotherapist, Quentin.

Case 1

Mr A had 3 weeks of right Achilles tendon pain which had begun after overstretching playing football. It was recommended that physiotherapy would be the best option and Quentin diagnosed a right Achilles strain and began treatment with laser, massage, taping and exercises. After 10 days progress was a little slower than anticipated, so after discussion with Mr A, it was agreed that the injury may benefit from some dry needling (also known as Western Medical Acupuncture) to help decrease inflammation, decrease pain and help stimulate healing. This is a treatment that I am qualified in and was able to apply some needles the next time Mr A had an appointment with Quentin by booking a little time out in my diary. We followed up the next week and Mr A reported a 60% improvement and treatment was repeated. Improvement continued and Mr A has now returned to playing football.

Case 2

Mrs B was seeing me for right sided sciatica which after a short course of treatment was 90% improved. She mentioned at an appointment that she had unfortunately slipped on some leaves a few days before, landed on an outstretched right arm and now had right shoulder pain, with limited shoulder movement. I examined her shoulder and concluded she had strained a muscle called supraspinatus, part of the “rotator cuff”. I recommended that she should see Quentin for some physiotherapy advice and that I would see her again as planned in 2 weeks and could discuss the progress physiotherapy had made with her shoulder. At the next appointment her sciatic pain was resolved and her shoulder had improved by 80% with physiotherapy and that Quentin expected it to be completely resolved by the following week.

If you are unsure who you should see first, a chiropractor or physiotherapist, then book in for a free check and we will suggest who would be the ideal practitioner to sort out your problem.

Preventing Back Pain on Holiday and Chiropractor Treatment Abroad

Written by Sundial Clinics Tuesday, 17 July 2012 10:43

Back pain on holiday is very common. One of the biggest causes is lack of activity and an already stiff spine. Mobilising the spine and a few simple exercises are often enough to prevent back pain from spoiling your holiday.

In daily life we are often fairly active even if we work behind a desk.  Travelling to work as well as getting up and moving around when we are there keeps us mobile. On a summer holiday however we may spend hours lying on a sun bed, sunbathing or reading. Sun beds are notorious for poor support for the back. The odd plop into the pool to cool off does little to help counter this.

At the end of a long and inactive day we tumble into bed where the back can be in for more punishment. Hotel beds are often unsupportive allowing your back to sag. Sometimes the bed is too hard and your back has to adapt to the mattress rather than the other way round. Back pain is the result.

What can you do to prevent back pain on holiday?

Your back is designed for movement and hates being still. First thing in the morning, before it is too hot, go for a half hour walk or swim to wake up your back muscles and mobilise the back joints that have stiffened up over night.

If you spend a lot time on a sun bed then vary your position frequently. Move to other furniture throughout the day so you are not on the sun bed for more than an hour at a time, less if you are getting back pain already. Changing to a chair every now and again can help a lot.

Through the day do these back exercises every couple of hours. The exercises will keep the back joints mobile and muscles supple.

Any other activities are also likely to help. If the resort has any aquarobics, fitness classes, yoga or Pilates then sign up and give it a go, your back will love you. More vigorous exercise like tennis, cycling and water sports can also help.

Hotel beds and back pain

Back pain is often caused by a poor mattress. If the bed is too hard putting a duvet under the bottom sheet can help soften it up a bit. It the mattress sags or is too soft then pulling it off the base and onto the floor may improve matters. If all else fails then complain and ask for different bed.

Treatment for back pain whilst abroad

If these tips are not helping enough then the most accessible help is likely to be a deep massage. Massage is widely available in resorts but it needs to be quite firm rather than gentle and relaxing for the most benefit for back pain.

For more serious back pain you would benefit from seeing a local chiropractor. To check for the nearest qualified chiropractor in Europe go here and for the rest of the world go here. If you have seen us before we can email your notes to the local chiropractor to help you get the best treatment. Here are some tips on choosing a good chiropractor.

Of course if you are on holiday in Brighton and want a local chiropactor, give us a call.

Pre-holiday chiropractic check-ups

If your spine is already a bit stiff before you travel you are much more likely to get pain whilst you are away. We recommend a pre-holiday check-up even if you are currently pain free. A bit of prevention can go a long way in keeping you pain-free.

More

Best holiday luggage for bad backs

10 Top Tips for Preventing Back Pain on Holiday

Preventing Injuries on Holiday

Keep Hydrated to Prevent Joint Pains

Back pain, will a chiropractor get it better?

Written by Sundial Clinics Monday, 11 June 2012 09:34

If you go to see a chiropractor for back pain treatment in Brighton one of the important questions you want answered is “Will  a chiropractor help me get better?”  This is an important question for chiropractors too. If our treatment is not going to be effective we want to refer you quickly to another treatment.

This is a hot topic in the research at the moment. Back treatment studies are popping up all over the world trying to answer the question “who is likely to get better when they see a chiropractor for back pain?”

It is a hard question to answer because there are lots of different causes of back pain, people have different lifestyles, respond to care differently and some people don’t do their exercises!

So what are the results from these studies going back 25 years. Back sufferers who do worse tend to have more severe pain for a longer period. So far no surprises. People who have more than 30 days pain in the last year are more likely to carry on having pain. Being in work seems to help and curiously so does moderate alcohol consumption in more longstanding back pain.

Perhaps the most interesting findings are that your expectation of whether you will get better affects whether you will get better. If your clinician expects you to get better you are more likely to do well too. So being optimistic and being given a good prognosis help you get rid of back pain quickly.

Also if your back pain improves well in the first few treatment visits with a chiropractor then that means you are likely to have a better outcome. In fact if you have a recent bout of back pain between 60% and 80% of people are significantly better after 4 visits. These results are broadly similar for other conditions like neck pain, disc problems and whiplash.

28% of people will see a GP for back pain. And 10% of people now seek care from practitioners like chiropractors for back pain. In some areas chiropractic is available on the NHS but, sadly, not in Brighton.

Oh and one last thing. People did better if they felt that they got enough time with the chiropractor. So if you feel you would like more time at your next appointment just mention it when you book and we will happily give you a longer appointment at no extra fee.

If you haven’t been in before but would like to know if our physio’s or chiropractors in Brighton can help you then give us a call for free check. We’d love to see you.

References

Proceedings of College of Chiropractors Annual Conference, RCOG, London, Feb 1st 2012

Chiropractic on the NHS

Written by Sundial Clinics Tuesday, 21 February 2012 10:20

Do you think chiropractic should be available on the NHS? A new study shows how effective chiropractic on the NHS can be. The research into a pilot scheme in Essex has just been published and it shows that more than 99% of patients referred were satisfied with their care. Interestingly chiropractors worked alongside osteopaths and physios to get these favourable results.

When a patient went their GP with back or neck pain they were assessed and could be referred into the manual therapy program. They were sent to their choice of chiropractor, osteopath or physio and were seen within 2 weeks. Gone were the long waiting lists for referral to other NHS services.  Gone was sole reliance on a fistfull of drugs and a photocopied leaflet of exercises. Patients had a series of about six sessions of manual therapy, guided exercises exercises and advice.

Two out of three of these patients showed good improvements in their pain levels and daily activities. Importantly, nearly half had had pain for a year or more with very little relief. Finally they found something to help them.

Of the 696 people who went along to these therapists most reduced their medication as well.

Brighton Chiropractors and Physio’s Working Together

Here at Sundial we have chiropractors and physio’s working alongside each other too. Although we are wholly in the private sector at the moment we support getting NHS cover for our patients. For this reason we support the Health Care Bill which is attracting so much controversy at the moment.

If you want chiropractic more widely available on the NHS ask your GP to consider it.

References

Evaluation of a general practitioner referral service for manual treatment of back and neck pain

Mark Gurden^{et al}

Primary Health Care Research & Development Primary Health Care Research & Development, FirstView Article : pp 1-7

Check list for choosing the best chiropractor in Brighton

Written by Sundial Clinics Thursday, 5 January 2012 10:35

Choosing a chiropractor is easy, choosing a good chiropractor takes a bit more thought. Here are a few tips to make the process more straightforward.

As with choosing any professional service, recommendation by someone who has been is best. Ask around amongst friends and family. There are a million visits a year to chiropractors in the UK and several in Brighton so chances are someone you know has been to one. It is worth asking them why they went to see a chiropractor in the first place and how they got on.

All chiropractors in the UK have to be registered with the General Chiropractic Council by law. You can check the register here to make sure they are on it. If they aren’t – don’t go.

You might also like to check if they are members of the British Chiropractic Association. The BCA is the oldest, largest and most reputable association in the UK and its members adhere to the highest standards of care and professionalism. You can check their register here (chiropractic-uk.co.uk). Their website also has lots of useful tips and advice about what to expect when you visit a chiropractor.

All the Brighton chiropractors at Sundial are GCC and BCA registered.

Most chiropractors stick to treating muscle and joint problems for which there is good evidence for effectiveness. If a chiropractors website makes bold claims to treat all sorts of other conditions without good evidence then best choose someone else. If you want to know what chiropractors can treat effectively then this recent research may help by Bronfort.

If a chiropractor recommends that everyone have an x-ray then this is not considered good practice. X-rays can be very helpful in certain circumstances but useless in others. Good clinical decision making is more important than universally x-raying all new patients.

Most chiropractors will treat you in a private room. We think this is necessary for confidentiality and a more personal approach. Some chiropractors will use an open plan room with several treatment tables and patients in there at once. This may be down to your personal preference. Treatment fees should be lower for this sort of care but often they are the same as for clinics using only private rooms. Be sure to check.

A range of treatments should be available and you should be given a choice. Sometimes there are good reasons to recommend one form of treatment over another, but this should be clearly explained. We have physio’s, massage therapists, acupuncturists and podiatrists as well as chiropractors here at Sundial.

You should not be required to attend health education classes. Here at Sundial, we feel that if anything needs explaining, it is best done on a one-to-one basis to make sure that you get the advice that is specific to you and that you have the opportunity to ask questions.

The number of sessions you need should be made clear at the start and you should start to feel an improvement within the first few sessions. If you are not improving as we both would expect them a full reassessment will be carried out and another approach to treatment will be recommended.

Fees should be clearly laid out in advance and you should not be required to pay large up-front fees. Here at Sundial you will have the option to pay in advance and receive a discount and be refunded any fees you do not use.

We hope this has been helpful. If you have any questions then feel free to email us or call for an appointment for a free check-up, no strings attached.

Do orthotic insoles help with knee pain in runners? Leading Brighton Chiropractor answers

Written by Sundial Clinics Monday, 31 October 2011 08:16

Knee pain is common in runners and a common cause is the patella or knee cap. Pain caused by the patella is often called patello-femoral syndrome or PFS for short. The pain can be severe enough to stop runners going out but also occurs in other sports people and non-sports people alike.

Chiropractor and physio treatment in Brighton

The research on PFS treatment is poor. The studies that have been done are often of poor quality and come up with conflicting results for all sorts of treatment and this can be confusing not only if you are a runner looking for something to help but also if you are a physio or a chiropractor treating these common knee problems.

One of the recent reviews (1) looking at all the evidence for orthotics in the treatment of PFS, sometimes called Runners Knee, found little difference between the groups given orthotics and those given flat insoles which were supposed to do nothing. The other trial which met the criteria compared physio exercises and orthotics. Again not much difference was found between the 2 groups. Delving deeper into the 2 trials reveals why the orthotics groups did not do so well as groups in other trials – but more of that below.

Another study (2) into patello-femoral pain found that orthotics may indeed help. In fact more than three quarters of the runners involved improved. The authors concluded that orthotic or orthoses as they called them may have had a significant effect. This study was excluded from the larger review because it did not meet all the inclusion and exclusion criteria. For example some of the patients were only 12 years old and the study was not a randomised controlled trial.

The difference with this small study and the previous review is that the runners were analysed much more carefully. Their feet, ankles and knees were measured and an orthotic prescribed if they had the right sort of problem.

Chiropractic treatment may help

There are many different causes of PFS. One cause is thought to be over-pronation or excessive flattening of the arch after the heel strikes the ground. If you have over-pronation and it is contributing to PFS then you may respond well to the correct orthotic. If you have PFS from another cause, a weak thigh muscle for instance an orthotic will be a waste of time. In this case a pelvic joint manipulation by a chiropractor may help as in this study (3).

A correct diagnosis of the knee pain is essential for the correct treatment to be applied. A thorough examination should reveal the cause of the problem so that the right treatment can be applied. Too often clinicians use a one size fits all approach that is doomed to fail. This may well also explain why some studies don’t show an improvement whereas others do.

Orthotic buying advice

You can spend a fortune on a custom made orthotic and except in rare cases it is completely un-necessary. Other trials comparing custom made orthotics, often costing several hundred pounds, with much cheaper off-the-peg versions fail to show a difference in the outcome of symptoms.

We have found Superfeet insoles an effective and cost-effective option. They cost between £25-32 and are available on an unconditional money back guarantee from the manufacturer. So even if you don’t have faith that they might work for you it is worth giving them a try but only if you over-pronate. Many running and hiking shops as well as clinics sell them.

For more information you might like to look at a presentation given in June 2011 to the European Chiropractors Conference in Zurich here

Matthew Bennett DC

Sundial chiropractor working with Brighton and Hove Albion and previously with the British Alpine Ski Team.

References

1.Hossain M, Alexander P, Burls A, Jobanputra P. Foot orthoses for patellofemoral pain in adults. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD008402. DOI: 10.1002/14651858.CD008402.pub2.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008402.pub2/full

2.The Lower Extremity 5(2): 95-102, 1998. Copyright © 1998. Reprinted with permission from Elsevier and the American College of Foot and Ankle Orthopedics and Medicine. Journal of the American Podiatric Medical Association http://www.japmaonline.org/content/93/4/264.abstract

3. Journal of Manipulative and Physiological Therapeutics Volume 22, Issue 3, March-April 1999, Pages 149-153

http://www.jmptonline.org/article/S0161-4754(99)70128-4/abstract

4. A comparison of rearfoot motion control and comfort between custom and semicustom foot orthotic devices. Davis IS; Zifchock RA; DeLeo AT. Journal – American Podiatric Ass, Sep 1, 2008; 98(5): 394-403

Counselling & Chiropractic in Brighton, by guest contributor Diane Hedge

Written by Sundial Clinics Saturday, 22 October 2011 02:44

Just as chiropractic allows your body to start its own healing process, so counselling can help you recognise how the way you think and feel impacts on your physical health.

It’s part of our language to recognise the body/mind connection, as in:  “He’s a pain in the neck.”  “It’s a headache”.

What counselling can do is help you tune in to the message that your body is giving you.  It allows quiet and reflective space to acknowledge what may be the real source of your pain.  Stress, anxiety, depression and grief don’t just happen in our heads, they’re right in there at a cellular level, in the gut, in our breathing, in our stiff backs and necks.  When we start to listen to what our bodies are saying, we can work with it.  I often say to clients:  “If you treated your car like this, what would happen?”  And their rueful response is often “It’d be broken down at the side of the road.”

The most body-focussed counselling is psychodynamic.  It works on the principle that our history is stored in our feelings.  So, instead of dismissing “random” thoughts and feelings as illogical, you’ll be encouraged to be respectful of the source of those feelings.  Very often we run on old software without realising it.  Counselling allows us to “map” old patterns of behaviour.  And knowing the map means we can recognise when what we feel is in the now or belongs to us, say, when we’re growing up.  That insight is empowering, gives us choices in how we run our lives.

Brighton Chiropractors and Counsellor working together

Your chiropractor, of course, is there to treat your body.  He/she will, as part of that, be asking how you are “using” your body.  Are you hunched over a computer for much of the day?  Do you have to drive a lot?  What are the stressors (physical and emotional) in your life? How do you handle them?  In short, listen to your body – it may be trying to tell you something.

Diane Hedge mbacp

Counsellor & Psychotherapist

www.brighton-hove-therapy.com

Back Pain in Children – top tips for prevention

Written by Sundial Clinics Tuesday, 18 October 2011 10:02

It is incredible to think that even children can get back pain but it’s true. At Sundial we did free half-term kids and teachers chiropractic checks in Brighton. 32 per cent of six and seven year olds get back ache at some time according to research by the British Chiropractic Association. This rises to 45 percent by the age of eleven. To highlight this issue the focus of last year’s BackCare Awareness Week, 17th-23rd October, was school children and their teachers.

One of the main reasons school children are prone to getting back strains is because they are carrying heavy school bags. Now school lockers are no longer available in most schools, children have to carry a bag with the full day’s books as well as all the other stuff that they need. Some kids carry all their books around for the whole week and then games bags as well. An adult wouldn’t put up with it.

Not only are the bags heavy they are often not very well designed. A hand strap sport type bag or book bag means all the weight is carried on one side of the body. A better option is a shoulder strap ideally carried across the body. The option, however, is a rucksack with both shoulder straps used and has been shown to reduce back pain by a third.

School Chairs Cause Back Problems

Schools themselves can also do more to prevent back problems in their students. Budget constraints mean that classroom chairs are often cheap and nasty providing poor support and no adjustability. If an adult was provided with a similar design of chair they would refuse to work in it for more than a few minutes with out screaming for a better one. Indeed, employers have a legal duty to provide a decent chair which is fully adjustable and supportive. Schools have no such duty.

Brighton Chiropractor Interviewed by BBC

The fashion of having children seated in groups around circular tables also adds to back strain some children have their back to the teacher and are constantly twisting round to see what is going on at the front of the class. Chairs that swivel would make this much safer. See an interview with Brighton chiropractor, Matthew Bennett by BBC Newsround on this issue here.

It is not just poor chairs that are associated with more back pain in school kids. The length of lessons themselves is also associated with more back aches. The longer the lesson the more aches and pains children reported in a study at the University of Surrey. Researchers visited classrooms and looked at what children were sitting on and how they perched on chairs as well other factors like length of lessons and how much movement was allowed. They found that if children sat in a flexed posture they had an increased incidence of low back pain. If the children did not move much and sat still they had an increase in upper back and neck pain.

Lifestyle Factors

A recent survey by Ofcom showed that computer game use and watching DVD’s has actually declined in teenagers it has been replaced by other screen based entertainment such as iPads and laptops to browse the internet as well as texting. In fact most teenagers do these things whilst also watching television. It is not just teenagers who are glued to screens, 40 percent of five year olds use an internet enabled computer at home.

But does this digital overload lead to health problems. Previously boffins in Scandinavia found that increasing television watching led to an increase in back ache in children. Certainly sedentary lifestyles have been associated with more back pain in children but does screen time also lead to obesity. The answer is maybe.

Studies are unclear whether gaming and computer use are one cause of obesity. Still, it is probably a good thing if children are running around rather than sitting around. Weak core abdominal and back muscles are more likely in children who get back trouble. It seems however, that you can have too much exercise if you are a child. High level sport and training is associated with more pain.

If a child does get a bout of back pain it will usually disappear in a few days. For a third of kids this doesn’t happen however and they go on to have longer term or recurrent symptoms.  It is important to take steps to reduce the postural stresses and other lifestyle factors that can aggravate the spine and if symptoms are not resolving to get a chiropractic check up.

At Sundial we are doing free half-term kids and teachers checks and have reduced our treatment fee to £24, saving £10 per visit. For a video showing treatment of a six year old go here.

Top Ten Tips to Prevent Back Pain In Children

1. Use a back pack and use both shoulder straps
2. Ask the school if they have ergonomic chairs
3. Don’t sit on the floor to play computer games, use a chair
4. Don’t allow long periods of laptop use in a poor posture
5. Limit television to 1-2 hours maximum per day
6. Ideally use a PC rather than a laptop
7. Set up the computer screen so the top is at eye level
8. Consider a office swivel chair at a desk for homework
9. Build in active games and moderate levels of sport
10. Get a chiropractic check-up if back or neck pain persists

Further information

http://sundialclinics.co.uk/2008/11/

http://www.advms.pl/?q=system/files/53_52SBockowski.pdf

http://www.ft.com/cms/s/0/779f55c2-5110-11dc-8e9d-0000779fd2ac.html#axzz1b7a3nwEv

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=40136

Troussler B et al. Back pain in school children: A study among 1178 pupils. Scandinavian Journal of Rehabilitative Medicine, 1994, Vol 26, 143-146.

Lifting Training Video From the Archive Starring Brighton Chiropractor

Written by Sundial Clinics Monday, 17 October 2011 11:40

Nearly 20 years Matthew took part in a training programme to help a national pub chain reduce injuries due to lifting. He helped put a seminar series and video together to help publicans and their staff prevent back pain on the job. Roy Castle and Geoff Capes were the talent. Matthew says “It was a gruelling 16 hour day of shooting. The director couldn’t make his mind up about how to do it and the shots took ages to set up. Geoff and I were getting tired and cranky by 10pm but Roy was as cheerful at the end as he was at the start of the day.”
Here it is.