Bupa and Axa PPP cover our chiropractors and physio’s in Brighton

Bupa accpetedHere at Sundial Clinics, Brighton we often get asked if patients can claim their fees back from their health insurance companies. Most of the time, you can.

At Sundial we have chiropractors and physiotherapists who are recognised by both Bupa and Axa PPP.   Both these private health insurers have a restricted list of recognised practitioners in each speciality.  To become recognised, there are a number of requirements, including being in practice for more than 5 years  and having references from medical consultants. We also have to adhere to strict guidelines on quality assurance, patient satisfaction and probity.

If you are thinking of making a claim on your health insurance for chiropractic or physiotherapy then it’s worth checking your policy to see if there is an excess and to check the limit of the cover. You will then need to call your insurer to get a claim number which you can pass on to us. We can claim your fees back from your insurer directly or you can pay us and can claim back the fees yourself. You may also need to be referred by a GP in order to make a claim. This is usually straightforward and GPs are generally happy to do this.

If you need an MRI scan or an x-ray, this will often be covered as well. Things that aren’t covered include extra services such as massage and products such as nutritional supplements and orthotics.

Pre-existing conditions

Most health insurance companies will not accept a claim for pre-existing conditions. If you have back pain that comes and goes, it can be difficult for an insurer to assess whether or not this is a pre-existing condition or whether the back problem completely resolves and each presentation is in fact a new episode. If you have any doubts as to which sort of back pain you have then please get in touch as we may be able to help in providing the insurer with accurate information.

Sometimes an insurer will suggest another practitioner in your area. If, however, a practitioner is on your insurers approved list, you can choose to see who you like. If you have any queries, please give us a call.

 

Axa PPP

Simply Health WPA

Back pain treatment needs a rethink

photo (1)Back pain patients in Brighton and Hove might be able to access chiropractic and osteopathy on the NHS next year. The local Clinical Commissioning Group is currently considering this option. This will give local residents access to a wider range of treatments than are available currently.

An article in the British Medical Journal two years ago suggested that back pain treatment needs to be changed. The opinion piece, entitled We Need to Rethink Front-Line Care for Back Pain was authored by a team including Dr Nadine Foster, Professor of Musculo-skeletal Health in Primary Care at the Arthritis Research Centre at Keele University. I saw Dr Foster speak at the recent BCA conference on this topic.

Dr Foster says that patients with back pain are not well managed by GPs who get little training in common muscle and joint problems. We know from other areas such as North East Essex that uses chiropractors and osteopaths alongside physiotherapists to provide back care, that given a choice more than half of back pain patients would prefer to go to a chiropractor or an osteopath rather than to the physiotherapist.

This echoes recommendations from the new Harvard Medical School booklet entitled Low Back Pain: Healing Your Aching Back, which endorses chiropractic care as one good option for back pain treatment. The booklet says chiropractic care ’improved short and medium-term pain more than other treatments including exercise physical therapy and medication’. People who saw chiropractors also reported being less disabled compared to people who received standard medical treatment. The report also states that chiropractic care tends to be satisfying and effective for acute low back pain.

Many patients now demand access to treatment not widely available on the NHS, including chiropractic. As more areas commission chiropractors and osteopaths to provide specialised spine care around the UK is clear that chiropractors and osteopaths can help treat back pain safely, effectively and cost effectively. Hopefully the back pain patients of Brighton and Hove won’t have to wait too much longer to be able to access this care themselves.

Richard helps lead breakthrough in antibiotic treatment for back pain

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

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 leg pain 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

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?

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

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 Gurdenet 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

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 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

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

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