This has to be one of the most comprehensive explanations of simple low back pain.
It explains the different types of low back pain, how we chiropractors and health care professionals classify it, what sort of nasties we're ruling out when we assess you, and most importantly, what YOU can be doing to help yourself!
Definitely worth watching...
Things are hotting up at the London 2012 Olympics. Only a few more days until the Opening Ceremony...
This week, the doors of the Athletes Village will open. Athletes and their support teams from 204 countries will start arriving. And, for the first time, chiropractors will be there!
Within the Athletes Village is the state of the art Polyclinic. Open 24 hours a day this multidisciplinary clinic is kitted out with some of the most sophisticated equipment in the country and staffed by highly skilled specialists - including, for the first time ever, chiropractors. It is expected that a high proportion of the anticipated 200 competitors visiting the polyclinic each day will be suffering from musculoskeletal injuries - sprains, strains, muscle injuries and joint pains - exactly the sort of problems that we chiropractors excel in treating. So, it is expected that the team of chiropractors are going to be kept busy, providing care from 7am - 11pm every day, with 24 hour emergency 'on-call' cover as well!
The state of the art Polyclinic in the Olympic Village
The team of chiropractors will be working alongside other musculoskeletal healthcare specialists - orthopaedic surgeons, neurologists, sports injury physicians - as well as other core services like dentistry, optometry, and physiotherapy. Together, this team of medical specialists will help to ensure that athletes are in their peak condition for this most important time in their sporting careers.
Richard Brown meets Lord Coe
Richard Brown, chiropractor and President of the British Chiropractic Association is one of the chiropractors who has taken time out of his busy practice and professional schedule to be treating the athletes. He had the opportunity to meet Lord Coe, Chairman of LOCOG, who voiced his support at the presence of chiropractors at the Olympics, and who said that his own career would have been far shorter, had it not been chiropractors.
Hopefully, Richard and the other chiropractors in the Polyclinic will be able to keep the competitors in tip top condition; here's hoping that they enable Jessica Ennis and a few of her fellow competitors to bring home some shiny medals...!
A debate has been published today in the British Medical Journal (8 June 2012), questioning the safety of neck manipulation. The story has been picked up by a number of national newspapers, and has been discussed on live radio and television programmes. Regrettably, many of these focus on the negative, so often the case with sensationalist journalism. I hope that I will be able to provide a more realistic, accurate and balanced view.
Neck manipulation has been shown to be safe and effective and benefits thousands of people suffering from neck pain and headaches. In fact, the risk of a stroke after treatment is the same whether you see a GP and get a prescription, or see a chiropractor and get your neck adjusted. (http://www.ncbi.nlm.nih.gov/pubmed/18204390)
Manipulation of the neck is at least as effective as other medical treatments and is safer than many of the drugs used to treat similar conditions. (http://www.ncbi.nlm.nih.gov/pubmed/17258728)
The term chiropractic is often mis-used for treatment carried out by non-chiropractors. This leads to over-reporting of incidents blamed on chiropractors, including in the BMJ. In one report of 24 cases attributed to chiropractors, not one was shown to be a chiropractor. (http://chiromt.com/content/14/1/16#B21)
Chiropractors are highly trained in spinal care and manipulation. In one UK study undertaken in 2007, of 50,000 neck treatments reviewed, not one single adverse event was reported. (http://www.ncbi.nlm.nih.gov/pubmed/17906581)
The cherry-picking of poor quality research needlessly raises alarm in patients and does little to help people suffering from neck pain and headaches to choose the most appropriate treatment.
I hope that this has allayed any fears or worries about the safety and efficacy of spinal manipulation when carried out by a trained, professional pair of hands. However, should you have any further concerns or queries - please, just ask!
I'm always being asked 'what is the difference between a chiropractor and an osteopath?' My standard response is 'there are more similarities than differences; the training and teaching is very similar, the problems that we treat are the same, but the actual treatment methods and techniques may differ. It's a different way to skin a cat!' Having said which, there are huge variations within each profession and the technique used often depends on the individual practitioner (out of the myriad that they are taught!). There are some chiropractors who work in a very osteopathic way, and some osteopaths who work in a very chiropractic way!
However, I've had a look at both professions and hopefully will provide a more thorough explanation...
What do we study...?
Both chiropractors and osteopaths undergo a 4 or 5 yr degree course at University and study all the basic biomedical sciences (anatomy, physiology, biochemistry, pathology, biomechanics, nutrition, pharmacology etc), together with the hands-on clinical stuff (physical examination, orthopaedics, neurology) and the various different treatment techniques (manipulation, mobilisation, soft tissue work, rehabilitation etc.) Students have to complete 2-3 years in the teaching clinic (real patients with real problems under supervision from clinicians) and complete a clinical research dissertation prior to graduating. On graduating, many of the associations require completion of a year-long Pre-Registration Training Scheme before they can be fully registered.
There are several different Universities and Colleges in the UK that offer chiropractic or osteopathy, as well as those elsewhere in the world. All courses and colleges should be accredited with the appropriate educational and regulatory body.
How are we regulated...?
Both professions are regulated and protected in the UK by the General Chiropractic Council (GCC) or General Osteopathic Council (GOsC) respectively, who set and maintain the Code of Practice and Standards of Proficiency. Both regulatory bodies require all practitioners to register with them, and it is illegal to call yourself an osteopath or chiropractor, or to practise as one, if you are not on the appropriate Register. The GCC and GOsC require renewal of registration on an annual basis, and will check to see that the applicant has met the mandatory Continuing Professional Development (CPD) requirements, is in good health and good character, is in a 'fit state' to practise and has appropriate indemnity insurance. They can and do prosecute bad people, strike them off the register, or put restrictions of practise on them!
In addition to this, individuals may join an association (eg the British Chiropractic Association, British Osteopathic Association). Each different association has its own membership criteria, (some more stringent than others, so may be a useful indicator in the 'quality' of the practitioner). The associations provide a number of different services and support for the practitioner, for instance indemnity insurance, business and clinical advice and legal support.
The College of Chiropractors is another body; subdivided into regional and educational faculties, its primary role is the provision of postgraduate education, courses and seminars. Attendance at these can be used not only to meet the annual CPD requirements, but also to gain further post-graduate qualifications.
So, what do we actually do...?
Both chiropractors and osteopaths specialise in the diagnosis, treatment and management of conditions that affect the neuromusculoskeletal system and the affect that these may have on the overall health and wellbeing of the whole body. Both chiropractors and osteopaths use 'hands on' techniques (including manipulation, adjustment, mobilisation, soft tissue work, fascial release techniques, myofascial dry needling) to mobilise joints, ease muscle tension, reduce pain and restore neurological function. Most chiropractors and osteopaths will advise on rehabilitative exercises and stretches, posture and ergonomics, diet, nutrition and general exercise and lifestyle in order to promote recovery, prevent recurrence and improve overall health and wellbeing of the patient.
Whilst traditionally thought of as just working on the spine (admittedly, we do tend to specialise in this!) both chiropractors and osteopaths treat the whole body. Hence, as well as treating problems affecting the neck, and low back pain we are proficient at treating problems affecting all the joints (including hip and knee pain, shoulder and elbow injuries, sports injuries, repetitive strain and over-use problems).
Does it work and is it safe...?
By taking a thorough medical and case history, and performing an extensive physical assessment, chiropractors and osteopaths are trained to pick up problems or complications that might prevent, or interfere with treatment. If this is the case, they are able to refer you on to the appropriate specialist, usually via your GP. The most appropriate type of treatment will be used for each individual patient, and techniques can be modified and adapted as necessary, so are safe and effective for people of all ages, shapes and sizes.
The efficacy of chiropractic or osteopathy is supported in a number of peer-reviewed research studies, (particularly when assessing manipulation in the management of chronic or acute, low back or neck pain), but as in all areas of medicine we need more research!
And, finally, which one's best...?!
Both chiropractic and osteopathy are safe and effective in the management of problems with the muscles, joints and nerves. Both require a long period of initial and continued training, both are stringently regulated. As in any profession, regrettably there are unscrupulous individuals, and some practitioners may be better or worse than others. When advising whom to see, I always recommend that people should ensure that the practitioner is registered with their regulatory body, and ideally go with a 'word of mouth' recommendation from someone who has been a patient there before. At the end of the day, the appropriate qualified professional, whether chiropractor or osteopath, should be able to provide safe, professional, responsible and ethical care of patients.
Eich Ceiropractydd yng Nghlinig Ceiropracteg Llangefnii