Osteopathy Matters

The Veedee

laurencekirk@live.com (laurence kirk) — Mon, 22 Mar 2021 11:03:34 GMT

Vibration for Pain?

I’ve been collecting and displaying a few old and curious historical devices previously used in the treatment of musculo-skeletal(MSK) pain. The ‘Veedee’ vibratory massager, produced around the turn of the 20th century by J.E. Garratt, 96 Southwark Street, London S.E., was not only used for MSK pain but also claimed to treat colds, digestive complaints and flatulence through ‘curative vibration’.

The name is thought to be a foreshortening of Veni Vidi Vici’. (I came, I saw, I conquered), presumably with reference to pain and illness.

The device was very fashionable for a time, however, when applied as in the illustration left, it requires a considerable amount of effort to maintain any vibration and the sensation itself is somewhat unpleasant. I do not intend to re-introduce it into my practice!

The device was marketed around the world. An interesting and amusing article relating to its use and the type of ailments that exponents advocated it for can can be found by visiting this page at the National Archive of Australia and viewing a newspaper report of a demonstration in Adelaide in 1914.

Vitamin D and COVID-19

laurencekirk@live.com (laurence kirk) — Mon, 15 Feb 2021 09:04:49 GMT

The Protective Effect of Vitamin D

It seems that vitamin D may have a greater role to play in boosting our immune function than was previously thought. New research also indicates that a high dose Vitamin D supplement given to COVID 19 patients admitted to hospital may be as effective at reducing symptoms and preventing admission to intensive care as dexamathasone, cutting deaths by up to 60%. In addition, it is known that BAME communities in the UK often have low vitamin D status and this may in part be behind their greater apparent susceptability to COVID-19. Even before the pandemic many authorities had been suggesting that we should all take a vitamin D supplement during the autumn and winter months when sunshine is in short supply

( Spector Tim D, Levy Louis. Should healthy people take a vitamin D supplement in winter months? BMJ 2016; 355 :i6183 )

Tier 5 lockdown in January 2021

laurencekirk@live.com (laurence kirk) — Tue, 05 Jan 2021 11:17:35 GMT

Clinic to remain open during tier 5 lockdown 2

Following advice from both the Government and our professional body, as of January 2021, we remain open for patient visits and treatment during the latest Tier 5 lockdown, subject to the usual precautions. Please do feel free to contact us if you have any queries or concerns

Cinnamon for Xmas

laurencekirk@live.com (laurence kirk) — Sun, 22 Nov 2020 15:12:59 GMT

A Hidden Benefit of a Christmas Spice

Christmas is looming and ‘mix up Sunday’ for baking the traditional Christmas cake, and allowing it to mature, has already been and gone. Cinnamon features widely in both traditional spiced drinks and cakes and pastries. It has a distinctive festive taste but recent research has indicated an unexpected possible side benefit from regular consumption.
A study carried out at Tel Aviv University appears to indicate that the beta protein tangles which accumulate in the brain, eventually leading to Alzheimer’s disease, are modified and untangled when afflicted mice are fed an extract of cinnamon bark 1,2 The cinnamon extract resulted in improved cognitive ability, when given to the afflicted mice, so much so that their performance was close to the unaffected control group.
Finding a drug or medication which has the ability to remove or modify these tangles has been the ‘Holy Grail’ of Alzheimer’s research, if the research is transferable to human populations it will be truly remarkable that an ancient, and now everyday, spice might hold an answer to a distressing and otherwise untreatable condition.
It might be interesting if a human population, which traditionally consumes large amounts of cinnamon as part of their normal year round diet, could be identified and shown subsequently to have a dramatically reduced incidence of Alzheimer’s.
It’s probably far too early to raise hopes, and like many substances, excessive consumption of large amounts of cinnamon, e.g in capsules, may be harmful. (Some types of cinnamon also contain coumarin and other substances which can be toxic to the liver if consumed in large regular amounts). Used as it has been for thousands of years, in small amounts as a spice, it is safe. So we can all in the meantime enjoy our mulled wine and stollen, and raise a glass to the potential power of cinnamon.

1. Frydman-Marom A, Levin A, Farfara D et al . Orally Administrated Cinnamon Extract Reduces β-Amyloid Oligomerization and Corrects Cognitive Impairment in Alzheimer’s Disease Animal Models. PLoS ONE 2011

2. Saeideh Momtaz, Shokoufeh Hassani, Fazlullah Khan, Mojtaba Ziaee, Mohammad Abdollahi , Cinnamon, a promising prospect towards Alzheimer’s disease, Pharmacological Research,Volume 130,2018, 241-258,

Lockdown and the Clinic

laurencekirk@live.com (laurence kirk) — Sun, 01 Nov 2020 22:30:11 GMT

The Clinic Remains Open Through Lockdown

We all realise that these are very difficult times, and all of us are still adjusting to what is no longer a 'new' normal. It is frustrating and stressful but we have to do our best to keep going. I thought it important to re-assure you that, as healthcare professionals, we are permitted to remain open for face to face visits by continuing to maintain the safeguards that we already have in place including PPE, regular cleansing and online and in person triage.

It is important to emphasise that you should not attempt to book an appointment if you have been advised to self-isolate or if you are suffering from any symptoms suggestive of COVID, including for example, loss of taste or smell, new cough or breathlessness, or any chills, temperature or fever.

If you do recognise that you are suffering any of the symptoms above, or are unsure about your health please do call 111 or visit https://www.nhs.uk/conditions/coronavirus-covid-19/ for more information and do stay at home in the meantime

Hopefully we can all look forward to something more optimistic on the other side of lockdown. Thank you

Mind Your Mood

Tue, 20 Oct 2020 17:06:00 GMT

Do you look how you feel?

The biopsychosocial model of healthcare is not a new concept, and many osteopaths will be familiar with the work of Wadell and Main and their 'yellow flags ', and the potential effect of adverse 'mood' on patient recovery and prognosis. This contrasts with the effects described by Norman Cousins in his classic account of the 'healing power of comedy'
Indeed, as long ago as 1911 one of the original osteopathic pioneers: Louisa Burns, was keen to research the physiological relationship between the mind and body. Ms Burns carried out a number of experimental studies and published the results. An excerpt is shown below, which although very much of its time, still poses some interesting questions.
Nearly a 100 years later in 2010 Davis et al published the results of a study looking at the effects of Botox injections on the emotional experience. Participants were given positive and negative video clips to view (rather than the 'gloomy words' used in Burns' day) Those subjects who had received Botox were more affected by the negative video and more likely therefore, to be a little 'gloomy' as a consequence. So, an inability to engage facial muscles fully in response to external stimuli may have a direct effect on mood and potentially also on well being.

L ouisa Burns

Effects of Gloomy Ideas

The blood pressure, pulse, respiratory movements, reaction time and dynamometer tests were taken, then words from one of the “gloomy” lists were pronounced, and the subject asked to give a synonym or related word in answer. Fifty words are usually about as much as the average person wishes to endure in such a test

The results of these experiments may be grouped as follows:

Blood pressure decreased, sometimes by thirty or forty mm., but usually ten or fifteen mm. of mercury.
Pulse decreased, with occasional irregularities.
Respiratory movements become irregular, sometimes with frequent sighings.
Reaction time increased, sometimes almost doubled, for gloomy words; the usual increase is about .5 sec. per word.
Dynamometer tests show decrease of strength of both hands, but especially the right, during and after the pronunciation and replies of the “gloomy” list.
The gloomy lists are about as follows:
•    dark    •    forlorn    •    worry    •    pity
•    sorrow    •    labor    •    falter    •    hard
•    dull    •    silent    •    dying    •    moody
•    ill    •    stupid    •    sickness    •    failure
•    weak    •    fatal    •    peevish    •    restless
•    weight    •    shroud    •    torn    •    sleepy
•    dark    •    grave    •    worry    •    silly
•    mean    •    weeping    •    hopeless    •    false
•    blue    •    aches    •    heavy    •    frozen
•    sad    •    weary    •    broken    •    tomb
•    alone    •    poor    •    sorry    •    decay
•    faded    •    old    •    grief
•    timid
A few people who were subject to slight hypochondria were employed as subjects. The gloomy list had not the least effect upon their physiological activities. Apparently the gloomy trend of thought is usual with them.
Louisa Burns, M.S., D.O., D.Sc.O. 1911 Studies in the Osteopathic Sciences: The Physiology of Consciousness: Volume 3

Kindness Revisited

laurencekirk@live.com (laurence kirk) — Tue, 13 Oct 2020 09:32:53 GMT

Kindness is not a Weakness

Kindness' as a taught objective does not feature prominently, if at all, in the curricula or course outlines of many osteopathic or medical institutions.

This may seem anomalous, since as far as the recipient is concerned, kindness is one of the most notable qualities of an effective practitioner [. W G Pickering: Kindness, prescribed and natural, in medicine. J Med Ethics 1997;23:116-118]. We may be guilty of over emphasising the 'cold' scientific and quantitative elements of practitioner-ship at the expense of the 'warm' or more qualitative elements of human interaction.

In some quarters there even appears to be a perception that 'kindness' is somehow a weak, non-scientific and archaic quality far removed, in clinical education, from the cold acquisition of specific academic and clinical skills. But, as practitioners, we are aware that kindness is a powerful factor and acts to not only enhance the therapeutic relationship, but also benefits the 'giver'. Indeed, Buddhist teaching has long advocated the merit of 'metta' a loving kindness and compassion. In addition, Professor Paul Gilbert has recently published 'The Compassionate Mind' which, from a western psychotherapeutic approach, reinforces the very same notion that kindness and compassion do seem to confer benefits on both the giver and the receiver.

Clichéd as it may be, many of us feel that we have a genuine vocation to help others and have long recognised that there is much more to clinical effectiveness than the mantra of evidence based practice alone would imply.

To paraphrase John Launer: “I’m not a clever osteopath, but I am a kind one.”[2. John Launer: On kindness. Postgrad Med J 2008;84:671-672.]

Back to the Future

laurencekirk@live.com (laurence kirk) — Fri, 09 Oct 2020 07:57:22 GMT

Inactivity and Back Pain

There has been an assumption, which appears to have some face value, that disability from low back pain (LBP) may be greater as a result of inactivity. A recent article suggests a complex interrelationship between obesity, inactivity and chronic back pain. Previous reviews had suggested that there was only a weak link with acute LBP, but a demonstrable and significant correlation for chronic LBP

It may also seem self evident that a lifetime of relative inactivity could predispose to a greater risk of LBP. Waddell famously described LBP as a late 20th century epidemic and a healthcare enigma, and it shows no sign of letting up in the 21st century.

Given our increasingly sedentary lifestyles, a number of researchers have tried to investigate a potential direct ink between weakness in the lumbar paraspinal muscles and increased risk of LBP. A Finnish study has demonstrated that, although obesity is still an independent risk factor for LBP, in obese subjects who are active the risk is reduced. A further study highlights the 'u' shaped realtionship between LBP, inactivity and excessive activity. To paraphrase Goldilocks it seems that the objective should be 'neither too much, nor too little'

So, to safeguard their future, it would still seem prudent for all of us to continue to recommend structured physical activity and specific exercise for individuals with LBP when appropriate.

Copper and Brass handles make a comeback!

laurencekirk@live.com (laurence kirk) — Tue, 16 Jun 2020 17:04:47 GMT

Copper has strong antiviral properties

Public buildings in the Victorian and Edwardian eras tended to be fitted with brass or copper door furniture and handrails. Interestingly, it appears that they were unwittingly aiding public health. It is now clear from research that pathogens including viruses and bacteria are unable to survive for more that a few hours at most on even a dry, unlacquered copper or copper alloy surface. In contrast corona viruses may persist for days on other surfaces including stainless steel, which is ironically considered by many to be more hygienic.

Recent research has also looked at nasal sprays containing copper salts and has concluded that they may help to 'knock out' viral particles in the nasal passages, as well as applications within hospital settings.

The Use of Copper as an Antimicrobial Agent in Health Care, Including Obstetrics and Gynecology

Linda P. Arendsen, Ranee Thakar, Abdul H. Sultan

Clinical Microbiology Reviews Aug 2019, 32 (4) e00125-18; DOI: 10.1128/CMR.00125-18

https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_59.pdf

Clinic re-opening 1st June!

laurencekirk@live.com (laurence kirk) — Fri, 29 May 2020 11:38:27 GMT

The ducks are all lined up and we're ready to re-open

We are very pleased to announce that the clinic will re-open for face to face visits on Monday the 1st June following new advice from our professional body and insurers, now that the lock down measures have eased. Up until now physiotherapists, chiropractors and osteopaths were only advised to see 'emergency patients'; generally considered to be those with problems which would require emergency referral for swift medical intervention and couldn't otherwise be assessed remotely. Our insurance would potentially not cover us to treat in the circumstances as even seeing 'emergency' patients with the required PPE was considered to still be at the limit of acceptable risk.

For that reason all but a small minority of local practitioners took the very hard decision, based on sound advice, to forego any income, and focus instead on keeping their patients, and the local community safe.

Now that we have returned to practice we are obliged to work differently and screen for symptoms of Covid-19 prior to interacting with patients. We will do everything we can to maintain a safe environment, including wearing the required PPE with revised sanitising and cleaning regimes. All of your local practitioners are looking forward to seeing you once again and helping to relieve any pain or discomfort that you've been struggling with over the last few weeks.

Clinic Re-Opening Soon!

Sun, 24 May 2020 10:10:35 GMT

We've been getting all our ducks in a row for you!

Following the latest advice from Public Health England, The General Osteopathic Council and the Institute of Osteopathy (The NHS, our registering body and professional body respectively) the practice has been busy putting various protections in place, re-organising the way we book appointments and obtaining the necessary PPE., to prepare for re-opening.

There will be a number of new procedures that we have to follow, in order to keep you safe, but we are all looking forward to seeing you again.

If you have any queries or concerns please do get in touch via the contact page on this site or alternatively by telephone, email or our Facebook site. The start up date will be confirmed in the next few days, it could be as early as the end of next week but it is, of course, subject to change if the general situation alters in any way.

Covid-19 Practice Temporarily Closed

Tue, 21 Apr 2020 17:30:22 GMT

Temporary Closure Of Practice

Caring for you……..Given the serious concerns regarding onward transmission of the Corona virus, and following advice from our professional body, we have taken the decision to temporarily close the practice.

In the meantime, you will find regular free updates, hints, tips and advice and videos on maintaining healthy necks, backs and joints via the Greenhill Practice FaceBook site:

https://www.facebook.com/stratfordosteopath

UPDATE:

As of 12th May 2020 The Greenhill Practice still remains temporarily closed for face to face interactions. This decision was not taken lightly and was based on advice from both our professional and registering bodies as well as NHS England.

Following the latest, rather sketchy, government advice we are awaiting further clarification as to when we will be permitted to open on a limited basis. To this end we have now completed risk assessments, training and produced protocols as well as acquiring the necessary PPE in readiness to open when we are given the green light..

We are happy to continue to offer you free advice via telephone, Skype or Messenger to help with any persistent aches or pains you may be struggling to manage, or we can point you in the right direction for further assistance.

We are living through an unprecedented time and although everyone at the practice is keen to return to normal operation as soon as it is permitted, we are also keen to minimise the risk to you and yours.

We hope this re-assures you but please do not hesitate to ask us if you have any other concerns or queries.

In the meantime, stay healthy and stay safe, and we look forward to seeing you all again on the other side

Warmest regards

Laurence, Liz, Sarah and Helen

We hope this re-assures you but please do not hesitate to ask us if you have any other concerns or queries.

Kind regards

Laurence, Liz, Sarah and Helen

The Greenhill Practice Team

Cracking News!

Mon, 20 Apr 2020 17:45:23 GMT

Further research on the phenomenon of cracking joints

Researchers at the University of Alberta have been investigating the phenomenon of ‘joint cracking’ . They were able to visualise changes on an MRI and for the first time showed a sudden increase in contrast on a T” weighted image immediately after the crack released gas within the joint. This may mean that fluid is being drawn across the joint surface and could account for some of the benefits associated with manipulation. Pardon the pun, but the mechanisms of joint manipulation are multi-faceted and may include both local and central effects i.e. mechanical and neurological/psychological. Previous posts on this blog have focused on the mechanisms of joint manipulation, but thankfully it looks like these researchers are hoping to continue to investigate the process.

Resveratrol and Disc Repair

Mon, 20 Apr 2020 17:45:23 GMT

A number of recent studies have shown that resveratrol, a naturally occurring polyphenol compound found in red grapes and Japanese knotweed, may have great potential for the treatment of nucleus pulposus mediated pain. The studies have demonstrated some startling anti-inflammatory and anti ageing/catabolic effects effects on cells tested in the laboratory and anti-inflammatory effects in living subjects.1, 2, Apoptosis is the term used to describe programmed cell death, it appears that resveratrol may have the potential to block or retard this process.3

The dosage requires to have an effect is not clear as yet, although the concentration of resveratrol in the introduced invasive weed Japanese knotweed is higher than that in red grapes. It would be inadvisable to consume large amounts of either as, without processing, the Japanese knotweed would have a unfortunate laxative effect.

Given my own history of disc injuries, I will be conducting a small scale, non randomised or controlled study on myself- watch this space for further information!

Wuertz K, Quero L, Sekiguchi M, Klawitter M, Nerlich A, Konno S, Kikuchi S, Boos N (2011)Descriptive and mechanistic investigation of the anti-inflammatory and anticatabolic effect of resveratrol in intervertebral discs (IVDs) in vitro and of the analgetic effect in vivo. Spine (Phila Pa 1976). 36 (21), E1373-84. ↩

Wang D, Hu Z, Hao J, He B, Gan Q, Zhong X, Zhang X, Shen J, Fang J, Jiang W (2012) Age (Dordr). ( ), .SIRT1 inhibits apoptosis of degenerative human disc nucleus pulposus cells through activation of Akt pathway. ↩

Li X, Phillips FM, An HS, Ellman M, Thonar EJ, Wu W, Park D, Im HJ The action of resveratrol, a phytoestrogen found in grapes, on the intervertebral disc.(2008) Spine (Phila Pa 1976). 33 (24), 2586-95. ↩

Aspirin, an old medication re-purposed?

Mon, 20 Apr 2020 17:45:23 GMT

Aspirin or Acetyl Salicylic acid was first synthesized in 1897 as an improvement on the original natural pain medication used for milennia and extracted from willow bark (Salix Alba)

A new study seems to confirm the potential benefits of taking low dose aspirin for a different reason, and even at the rate of just one or two doses a week. This further reinforces a raft of research over the last ten years which all seems to point in the same direction. The initial research from the University of Oxford was met initially with scepticism and incredulity because of the extent of the potential benefit. Subsequently, further research has corroborated the results. This latest review shows that aspirin use was associated with a huge 27 percent reduced risk of colon/rectal cancer, 33 percent reduced risk of esophageal cancer, 39 percent reduced risk of gastric cardia cancer (in the part of the stomach that connects to the esophagus), and a 36 percent reduced risk of stomach cancer. It aslo indicated a 38 percent lower risk of gallbladder and bile duct cancers, and 22 percent lower risk of pancreatic cancer.

The researchers caution that taking aspirin to prevent any cancer "should only be done in consultation with a doctor, who can take account of the person's individual risk. This includes factors such as sex, age, a family history of a first-degree relative with the disease, and other risk factors. People who are at high risk of the disease are most likely to gain the greatest benefits from aspirin."

There also appear to be a range of other potential health benefits, and it is therefore remarkable that so little publicity has resulted, possibly due to aspirin being out of patent and costing just 60p for a bottle of 100 75mg tablets.

Aspirin and the risk of colorectal and other digestive tract cancers: an updated meta-analysis through 2019

Bosetti, C. et al. Annals of Oncology, 2020 V olume 31, Issue 5, 558 - 568