Posted by Rupert Clements of C1 Chiropractic Health Centre.
I’ve had my application to become a BUPA Registered practitioner accepted. So, I’m now seen by the system to be a competent and capable practitioner and able to treat anyone with BUPA cover. Took a while but I am glad as it will make a difference.
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I am BUPA recognised, at last.
Wednesday, December 2nd, 20091 in 6 patients are misdiagnosed in NHS hospitals and by GPs
Wednesday, September 23rd, 2009The case rests, m’Lud:
http://www.telegraph.co.uk/health/healthnews/6216559/One-in-six-NHS-patients-misdiagnosed.html
Epley Manoeuvre, or maneuvre for you over there, done by your chiropractor works
Monday, September 7th, 2009There, done it. My patient from last week came in today and said “Great, I’ve not felt dizzy all week-end”. Now I know this may just be luck, timing or placebo but it seems to me that if you follow the protocol you do get success. Give it a go.
Benign Paroxysmal Positional Vertigo – what can my chiropractor do to help?
Monday, September 7th, 2009Benign Paroxysmal Positional Vertigo, or better BPPV, sounds crazy but it is what it says on the tin, it’s just that the language on the label could be Russian for all it mans to you or me. However, benign is a good word, it is one of those words you want to hear when anyone is talking about medical things about you, and I suspect we are all pretty familiar with it. Paroxysmal means that the condition occurs in attacks rather than as a steady problem. Positional means it’s all related to what you do with your body, in particular with your head. And vertigo is a nasty feeling of relative movement, usually spinning, between you and your surroundings and has recently been described to me as “I feel like I’m falling backwards and to the right”.
Now it may be benign but it can still be horrible with you, in some cases, stuck in bed because any movement causes you to throw up. In the later stages it leads to episodes of vertigo each lasting less than 60 seconds but all of this may settle after a couple of weeks. However, sometimes, it does not.
There is a beautiful test for it called the Dix-Hallpike test. And here it is in this cracker of a link:
I recently had a patient with undiagnosed, or more accurately un-treated vertigo. After a detailed history to rule out the other forms of vertigo I subjected her to this test and her reaction was a case-book response. I asked her to sit on the bench and rotate her head to the right. I then lowered her back towards the end of the bench where her head hung over the edge a bit. There was a second where nothing happened giving her enough time to say: “I feel OK” and then her eyes went crazy and she then went very quiet for about 20 seconds before saying “Ugg, that felt horrible”.
The problem was a post-traumatic one for her as she was involved in a nasty crash some time ago (2 years!). The condition is caused by ‘debris’ in the semicircular canals of the ears which move about in response to gravity and so stimulate the position detecting structures in your ears giving a false reading. This is a bit like motion sickness where your eyes are out of synch with your body.
The cure is a bit tricky. You can’t open these structures up and wash the debris out, at least not yet, and you can’t take drugs to dampen down your nervous system as you’ll spend most of your time flat on the floor. However, luckily, there are slight bulges at the ends of each of your canals that with some cunning manoeuvres you can get the debris to float (sink?) into and not stimulate your canals. The manoeuvre is the Epley manoeuvre. Now, this is a tricky manoeuvre and should be done by someone on you, so in this case by me, her chiropractor, not by you with a bit of paper in your hand. And I’d suggest that if you are about to do it on a patient then practise on a well friend first off a couple of times to get it right. Once you’ve got the hang of what you are doing then lay it on.
Prevention of low-back pain at work – what really works?
Monday, August 24th, 2009Low-back pain at work – what really does prevent it happening?
Well, I’ve banged on about it enough to my patients and now, as always, I’ve been proved right.
Firstly, you have got to understand that you are built on the design brief of Palaeolithic Man. In this massive design brief slapped down by God (or what ever supreme deity you want, such as ‘The Force’) there was no chapter on sitting on your butt and peering into a computer for 8 hours on the trot and there was no annex that that covered ‘Future proofing’ the structure. No, the main pages would have covered: ‘Running fast for a short distance to avoid predation’ and ‘Walk/Running for a long distance to improve chances of killing mammoth’.
So, your work posture is a real challenge to your body as it is a demand that is wildly outside the design brief, similar to using your car to climb trees, so no wonder it hurts.
The next point is that no manner of fancy chair, desk height re-alignment is going to make THE difference – yes, it will be less-bad for you than a really crappy one but you’ll still be in the region of bad and it will never be the answer. (And the best would be a height changing desk that allows you to stand at the thing every now and then – search the web). So, get a decent desk, a decent chair (IKEA £50 is what I am using) and save the money on some of the ‘orthopaedic products’ out there.
Why do I say this? Well look at this bit of really solid recent research:
The paper is called:
High-quality trials on preventing episodes of back problems: systematic literature review in working-age adults
It was produced by Bigos SJ, Holland J, Holland C, et al. from Department of Orthopedic Surgery at the University of Washington and published in the serious Spine Journal in 2009; 9: 147-168.
The study looked at clinical or educational approaches (exercise or education), personal appliances (back supports or shoe inserts), ergonomic equipment (lift assists etc.), changes in physical activities or work duties and administrative or social interventions such as work policies or social changes. All trials included had high quality scores, 90% investigated workplace settings, and 50% involved health care workers and, eventually, 20 prospective controlled trials were included and evaluated. Of these 20 rigorous trails 5 measured objective outcomes and the remaining 15 measured only subjective outcomes.
At the end of the day Exercise was the only intervention found to be effective. 7 out of 8 exercise trials reported statistically significant reduction in back pain and 5 of the 7 successful exercise programs included 45-60 minutes of supervised exercise, twice per week for 3-12 months (most also encouraged additional exercise without supervision).
The exercise techniques included McKenzie (Google that one), active and passive back extensions, core stabilization, “Williams” exercises and Mensendieck trunk exercises (again, Google).
NO other intervention was found effective in reducing back pain.
And, negative results were found in all studies on ergonomic/back education, stress management, lumbar supports, shoe inserts, and programs for reducing lifting tasks.
So, the story is that the exercise that your Palaeolithic ancestor did is exactly the stuff you need to do to survive doing strange things with your back to prevent it going wrong. No wonder we advocate core stability, rehab and sports therapy at C1. We can get you right but you must keep yourself there.
So stop putting your faith in futuristic looking mesh back multi adjustable seats and desks made from dolphin-friendly ethically resourced wood and get some core stability into you and then go for a run.
Makes sense, yes?