It was a pleasure and a privilege to attend the grand opening of the new Peter Maddison Rheumatology Unit at Llandudno General Hospital yesterday afternoon. Opened by the eminent Professor Maddison himself, together with his team of consultant rheumatologists, researchers and healthcare specialists, it was a great opportunity to see around the new unit.
The new centre has been specifically designed to meet the needs of the multidisciplinary team and its patients. Housed in a fully-refurbished wing of the Llandudno General Hospital, emphasis is placed on a patient-centred, evidence-based multidisciplinary approach to aid the complex management of rheumatological disorders - lupus, rheumatoid arthritis, scleroderma, Sjogren's syndrome - and many others. The unit has specific purpose-built rooms that can be used by research staff, clinicians, administrative staff and patient-focus groups.
The unit will be staffed by a team of healthcare professionals - rheumatologists, specialist nurses, researchers, physiotherapists, occupational therapists - so that rheumatology patients will be able to receive appropriate specialist care for their complaint all in the one location. This centralised hub will receive patients from across North Wales, covering the North Wales coast line, and the area encircled by Holyhead, Bangor, Caernarfon in the west, down the coast to Pwlheli, Portmadog, Barmouth and Dolgellau, inland to Machynlleth and Welshpool, and as far east as Wrexham. This will be ideal as patients will be able to see all the different specialists in one place, rather than having to attend for many different appointments with different people at different locations. It is one of the first multi-disciplinary rheumatology centres in the UK and it is hoped that similar units might be rolled out across the country.
I got a really stiff neck this morning when I was sitting in bed, reading my kindle and checking emails on my phone. However, I'm not alone - a recent study carried out by the British Chiropractic Association has revealed that nearly 44% of the British population currently suffering from back or neck pain - up by 12% since 2010.
It's just possible that some of this can be attributable to our daily activities - in particular the use of 'mobile technology devices' - smart phones, laptops, mp3 players and tablets in particular. Nearly three quarters (74%) of those questioned by the BCA typically use technology devices for work every day and a huge 88% of respondents continue using it in their own time. The broad capability and range of modern mobile devices available, coupled with significant advances in internet access, means that technology is incorporated into nearly every part of the daily routine. Not surprisingly, over half the respondents (52%) used a mobile device while walking, over a third (38%) use one on a tube or train, and over half (51%) have used a device whilst in bed.
It's really important that we recognise the impact that stooping forward, hunched over a small screen, peering at a tiny font or video can have on our bodies - and it's important that we do everything we can to minimise the potentially detrimental effect.
A few simple hints and tips for gadget users...
Have a look at this short video to ensure that your posture is correct - whether at your desk or in an armchair...
A recent study, published in the peer reviewed journal Spine, compared the efficacy of 'chiropractic manipulative therapy' (CMT) when combined with 'standard medical care' (SMC) for the treatment of acute low back pain (i.e. low back pain that had been present for less than four weeks) in comparison with standard medical care (SMC) on its own.
The findings were impressive - the researchers found that the group that had received chiropractic care (CMT) in addition to standard medical care (SMC) improved more than those who had just received standard medical care on its own. Those patients in the combined group reported that their pain was reduced more and they had greater improvement in physical functioning than those who had received just standard medical care (SMC).
Looking at the results in more detail we can see exactly how the participants were treated. Those under 'standard medical care' (SMC) received anything from a number of possible interventions including prescription of painkillers and anti-inflammatories, self-management advice, use of ice/heat packs, and sometimes referral for physiotherapy or the pain clinic. Those in the combined treatment group received any, or all of these, but also received chiropractic treatment - primarily chiropractic manipulation or adjustments. Using various different pain rating questionnaires, the participants were assessed on day 1 and then again after 2 and 4 weeks. Global improvements indicating that pain was completely gone, much better, or moderately better were reported by 73% of participants in the chiropractic manipulative therapy group (CMT) plus standard medical care (SMC) group, but by only 17% in the SMC group. Not only that, but the overall satisfaction with care was greater for those in the medical care plus chiropractic care group.
This is obviously great news for chiropractic - it supports what we've been saying all along - what we do really works and makes you feel better. More so than popping pills. However, these results do need to be taken in context - it was, admittedly, only a relatively small study and was of fit, active military personnel - but it is a good study that supports the benefits, and efficacy, of chiropractic treatment.
I recently read a fascinating article written by Richard Brown, chiropractor and President of the British Chiropractic Association, extolling the virtue of chiropractic treatment as a drug-free, non-surgical intervention for the management of spinal and musculoskeletal conditions. One of the core philosophical tenets of chiropractic is that it is a drug-free intervention. We chiropractors recognise the body's natural ability to heal and repair itself and the fact that, if looked after with appropriate diet and exercise, it will remain healthy and pain free. This key principal is neatly summarised in the New Zealand Commission of Inquiry's 1979 report:
"As we have seen, much is made by chiropractors of the drugless and non-surgical nature of their therapy. But modern chiropractors do not suggest that there is only one cause of disease; they admit there are limits to their expertise; and they acknowledge the need for medical intervention and medical monitoring. They do, however, place emphasis on the body's natural functioning and its natural recuperative powers.
In these matters of emphasis we see some value in the contribution that the chiropractic outlook can make to healthcare generally. There cannot be any fundamental objection to an attitude to healthcare which restricts drugs to cases where they are shown to be a matter of necessity rather than a matter of mere convenience. Nor can it seriously be suggested that anyone is unreasonable to believe that it is better for the body's disorders to be relieved if possible, by natural rather than artificial or chemical means".
Whilst more than 30 years old, this statement still holds validity today in our professional methodologies. Obviously, as spinal care experts, working in the modern, scientific world alongside other healthcare professionals, we chiropractors recognise the benefit and necessity for patients to sometimes take drugs and even undergo surgery. I am certainly not suggesting that anyone should stop taking any prescribed medications without appropriate medical advice, and indeed, at times I will refer my own patients to their GP to obtain appropriate pain relieving medication, understanding the fact that my patients' health and wellbeing is of paramount importance.
However, I am mindful of the fact that increasingly it seems that patients are turning away from drugs and surgery and are looking for an effective, research-driven form of natural healthcare. Something that gets to the root of the problem, and not just something that eases the pain or masks the symptoms. Added to which, ongoing scientific research and the media seem to increasingly highlight the complications, side-effects and contraindications for a number of commonly prescribed painkillers and anti-inflammatories, often readily doled out for the management of spinal and musculoskeletal pain.
It is not surprising then that people seek out a drug-free, but safe and effective alternative - like chiropractic.
This week, 15th -21st April 2013, is Chiropractic Awareness Week, and this year the focus is on parenting and posture.
We all appreciate the costs and demands that children place upon us - but I doubt that many people have considered the effect that they can have on health. Recent consumer research, commissioned by the British Chiropractic Association, found that 80%* of people in Wales have suffered from back or neck pain at some stage, and 77%* of these are parents. More than half of parents (60%*) say that their back or neck pain has prevented them from carrying or lifting their child at some stage. According to these new statistics, parents are not just limited in lifting and carrying their children. 34%* of parents said their back or neck pain has prevented them from carrying their child’s car seat or carry basket and 38%* say that back or neck pain has prevented them from playing with their child.
*commissioned by the BCA, March 2013
Nothing can take away the burden that having kids can, literally, place upon us! However, there are a few simple hints and tips that can help to ease the strain, and help you maintain a healthy back:
Carrying your baby or toddler
Playing with your child
Changing and Dressing
It's easy it is to put a strain on your back when looking after young children, constantly carrying them from A to B, bending down to pick up their toys, leaning over to change nappies and generally attending to them. For this reason, it is important to ensure that you are not damaging your back in the process, and this advice is valuable in showing that you can look after your health at the same time as looking after your children. After all, raising children is hard-work enough without having to deal with a sore back or neck!
For more hints and tips, take a look at these advice sheets:
Parents and Posture - Pregnancy
Parents and Posture - Home and Dry
Parents and Posture - Out and About
With spring approaching, the days lengthening and the wintry sun gradually warming up the air, we're beginning to come out of 'hibernation'. We're generally getting a little more active - out into the garden, spring-cleaning, attacking that DIY project in the house, or taking a bit more exercise than we have during what seems to have been a long winter.
Despite our enthusiasm, it's important to take things gently at first, letting the muscles and joints warm up. Every Monday morning, the phone in the clinic rings non-stop, with people who have 'overdone it' in the house or garden at the weekend. Whilst some gentle exercise is generally good for the back, overexertion can cause problems.
Try to ease yourself into it - do some gentle stretches and warm up exercises first (marching on the spot, shrugging the shoulders, circling the arms) to get the blood circulating through the muscles, and pace yourself. Do lots of different jobs, changing your posture and position regularly, rather than concentrating on the one thing for too long. Listen to your body too - if something is niggling or painful, stop and don't be tempted to 'work through the pain' - it is your body telling you something isn't right. If the niggle persists, or worsens, phone the clinic and get advice!
A simple, 3-minute stretching exercise routine is Straighten Up that will keep the body supple and loose if practised regularly.
Patients are always asking me what type of bed or mattress is best for their backs. Up until now, I've been reluctant to recommend a particular make or design - they can often be incredibly expensive and people can get 'sucked in' by the sales pitch - and the best bed for one person may not be the ideal one for someone else. However, the British Chiropractic Association and one of the leading bed manufactures, Sealy Posturepedic, have finally got together to provide some advice...
First, a few facts and figures*: On average, we spend a third of our lives in bed. 58% of the population complain that they wake up feeling stiff and achey - anything but refreshed! 25% of people wouldn't consider changing their mattress - even if it is more than 10 years old. (*BCA and Sealy Posturepedic 2012)
Time for a change? So, when is the right time to consider changing your mattress? Generally, if it is more than 8-10 years old, uncomfortable, torn, discoloured and a bit 'manky' it could do with an update! If you can feel the springs or you feel it is less supportive than before, or you find yourself rolling into your partner, again it could indicate a need for something new. We should wake feeling rested and refreshed, so another indication is if you find it difficult to get comfy, or you wake up feeling stiff and achey in the morning (although it might be worth having a 'check-up' with the chiropractor too as it might be you, not your bed!).
So, what next?
Research it - ask your friends, find out the make and model of a comfy bed that you've slept on (I even phoned up and spoke to the manager of a hotel in Berlin to find out the specifications of a particularly comfy bed!), check out internet forums and blogs...
Choice - choose a reputable retailer that stocks a wide range of brands and mattress 'types' (foam, sprung, pillow-top etc) and make sure you get an informed opinion from an experienced salesman (Sealy Posturepedic have a wide variety of mattress types and do know what they're talking about!).
Try before you buy - Since you're going to be spending a large proportion of your life in bed, it's important to test out each mattress - lie on it for as long as possible, wriggle about, try getting in and out of it, take your other half with you and see how it works for the both of you. If you are a different size and shape from your partner, or you feel them wriggling about during the night, it might be worth getting two separate mattresses, as what suits them might not be right for you.
Go large - go for as big a bed as possible. This will allow you the freedom to move and wriggle about - important, as if you stay in any position for too long you'll stiffen up and put pressure on the joints, even if it feels comfortable initially.
Don't settle for second best - you don't have to spend a fortune, but a better quality mattress will tend to last longer, so may be a more economical option in the long run. A second-hand bed might be tempting - but remember that the springs and fillings will deteriorate with time, and there is the potential 'yuk-factor' of the previous owners' dust-mites and shedded skin cells...
Sleep Easy - make sure you lie in a comfy position, on your side or back, keep moving about, use a mattress 'topper' if you want a softer feel to a firm mattress and stretch gently before you leap out of bed in the morning.
For more advice check out my previous blog, or the BCA's website...
I first saw this when I was at university, torn from a newpaper and pinned up, at a jaunty angle, on a corkboard outside our lecture theatre. It brought a smile to my face then, and again today.
The Value of a Smile
It costs nothing, but creates much.
It enriches those who receive, without impoverishing those who give.
It happens in a flash and the memory of it lasts forever.
None are so rich that they can get along without it,
And none so poor that they are not richer for its benefits.
It creates happiness in the home, fosters goodwill in a business and is the countersign of friends.
It is rest to the weary, daylight to the discouraged, sunshine to the sad and nature's best antidote to trouble.
Yet it cannot be bought, begged, borrowed or stolen for it is something that is no earthly good to anyone until it is given away!
So, if at any time others should be too tired to give you a smile, can we ask you to give one of yours?
For nobody needs a smile so much as those who have none left to give.
I wasn't surprised by the research findings that the so typically British 'stiff upper lip' may deter patients from seeing their doctor, as they are too embarrassed to disclose their symptoms or fear that they may be 'wasting the doctor's time'. These findings, part of a more lengthy study published in the British Journal of Cancer, may go some way to explain the surprisingly lower than expected cancer survival rates in the UK, when compared with other developed nations, despite access to highly trained medical staff and cutting-edge treatment interventions.
A survey of nearly 20,000 people in the developed countries of UK, Canada, Australia, Denmark, Norway and Sweden revealed that one sixth of British men and women over the age of 50 were embarrassed to share their symptoms with their doctor, and a third were reluctant to visit for fear of being 'time wasters'. This could delay diagnosis and hence commencement of treatment - and early intervention is often the most critical factor in a successful outcome for the treatment of many cancers.
Fortunately, since we chiropractors primarily deal with problems affecting the musculoskeletal system, rarely do people present with cancers, or symptoms that might lead me to suspect anything more sinister. However, I am all too familiar with people's reluctance to disclose potentially important information that might help me to make the correct diagnosis and hence establish an appropriate treatment plan. All too often they might think that something in their history isn't relevant to their particular, current problem, or they might feel a little embarrassed or awkward about discussing things with me. However, I would urge all patients to provide me with as much information as possible - every consultation is totally confidential and we aim to provide you with a comfortable, relaxed, private environment. There isn't much that shocks me, and chances are, I've probably heard or seen similar before!
Whilst we chiropractors mainly treat the joints, muscles, nerves and soft tissues, we spend many years at University studying all the medical sciences, so we are trained to recognise and diagnose all sorts of illnesses and problems, not just those affecting the musculoskeletal system. So, if I were to pick up on something that I thought wasn't within my scope of practice, I would refer you on to your GP, or appropriate healthcare professional for further investigation (obviously with your permission).
Personally, I'm just like everybody else; I still squirm with embarrassment and sit there, on my clammy hands, giggling like a nervous schoolgirl, when having to discuss even the most minor of ailments with my GP. I even worry that I'm wearing 'sensible' clothing when seeing my own chiropractor! I faff around, delay making the appointment, fidget in the waiting room - and then feel so much better once it's done!
So, be brave and grab the bull by the horns. If you're worried about something it is far better to deal with it sooner rather than later, and if it is something serious, the sooner you get help the better! At least you'll have a definite answer to what the problem is - and this has got to be preferable to the sleepless nights, worrying and wondering and imagining the worst...
As so perfectly demonstrated by this poor little penguin and his unhelpful, mocking friends, venturing out in this cold, icy weather can be treacherous! Even a simple slip on an icy pavement can result in at least a jarred back, grazed knees or a banged bottom (not to mention a dented ego!) - or worse still a fractured wrist or even hip which may take months to heal (my husband is looking at 3 months in a cast after fracturing his scaphoid - a very small bone in the wrist! OK, we were snowboarding!!!). However, whilst it is tempting to stay snuggled up indoors, this is not always possible and even in the cold weather our bodies benefit from a little bit of fresh air and exercise.
With a few simple, sensible precautions you can avoid the fate of the penguin...
Now, how about another look at that penguin...
Eich Ceiropractydd yng Nghlinig Ceiropracteg Llangefnii