Welcome to Your Osteopath Newsletter

Every two months we will bring you the latest news from the osteopathic profession as well as up-to-date advice on health topics relating to osteopathy. It won't be too technical; it will be straightforward, informative and - we trust - useful. If you have questions about any of the treatments mentioned below, then just contact us. We hope you enjoy it.

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Top Story

Not clear about the full range of health conditions that an osteopath can treat? Well, some useful, objective guidance is now available following the publication of a review of the evidence for the claims made for manual therapies, including osteopathy.

Osteopaths, like any other profession or organisation, can't make claims that are untrue in their advertising or marketing - otherwise they will breach the codes of the Advertising Standards Authority (ASA) (as set out in the British Code of Advertising, Sales Promotion and Direct Marketing).

The General Osteopathic Council (GCoS) reports in its latest Osteopath magazine that the General Chiropractic Council commissioned a report to review the evidence-base for a wide range of conditions frequently mentioned by osteopaths and other manual therapists. The review, The Effectiveness of manual therapies: the UK evidence report, by Gert Bronfort and others, includes evidence summary tablesand is available on the GOsC public website and its online �o zone'.

The Osteopath reports that "The review finds there is evidence to support the use of manual therapies for the effective treatment of a range of primarily musculoskeletal disorders."

So, the next time your osteopath assures you that he can treat a condition, don't just take his word for it, look it up at the GOsC website (www.osteopathy.org.uk).

Online advice

You get a lot of free healthcare advice on the internet. Some of it comes from private health companies and insurance firms - companies that may well have your best interests at heart, but who also have a financial stake in your healthcare decisions. That's what makes the website run by NHS Direct - a public body - so fantastic: high quality healthcare advice on tap, 24 hours a day, and no questions about its motives.

The organisation's latest initiative is a pilot scheme for three Online Patient Decision Aids (OPDA) designed for patients who are facing difficult decisions about medical tests or treatments, and who don't know which will be best for them.

The first phase of the pilot is an OPDA for patients with osteoarthritis of the knee, along with two other already developed Decision Aids for patients with an enlarged prostate or localised prostate cancer. All three will be trialled in the NHS across eight pilot sites over eight weeks from the beginning of June 2010.

Using the aids, patients can review all the information, including the pros and cons of the treatment options available, and can view filmed interviews with people who live with the conditions, before completing a short questionnaire to assess their treatment preferences. The questionnaire can then be used to support
joint decision making between the patient and their clinician.

If the pilots are successful a further six OPDAs will be placed online.

NHS Direct says that the long term aim is to develop a national multi-media NHS �wrap' for OPDAs using the organisation's existing online health and symptom checker systems.

Of course, if you prefer speaking to a human being, remember that your osteopath is always on hand to provide some expert advice.

Case Study

The Case: Alex, a 57 year old bank worker, gradually begins to feel pain in his left buttock, radiating into the back of his left thigh and groin. He is at a loss to know why, as he hasn't done anything out of the ordinary, but the pain is slowly getting worse. It's now six months since the symptoms began as an occasional stiffness or ache, and now he struggles to get going after any period of sitting. Pain used to be intermittent, now it seems to be never ending.

He consulted his GP who suggested a course of pain killers and anti-inflammatory medication. Initially he felt some improvement, but the drugs made him feel drowsy and after a few weeks seemed to be causing stomach pain. He stopped the medication, but the buttock pain was still there, and now was worse. He returned to his GP who arranged for an x-ray. The results weren't what Alex was hoping for - osteoarthritis of his left hip joint.

He saw a consultant at the hospital, who told him he was too young for a hip replacement and suggested some physiotherapy and more pain killers. He had another twelve week wait in front of him. Nothing was helping; he was getting desperate. His quality of life was completely changed. Worse still, he could no longer manage his twice weekly round of golf. His golfing partner suggested he try an osteopath.

The Diagnosis: After taking a full case history and making a full examination his osteopath is able to confirm that he does have an osteoarthritic hip joint. It is explained to him that osteoarthritis is simply degeneration or wear and tear of the cartilage surface in the joint and everybody can expect some degree of it as they get older. It is more likely to affect the joints that we have used most in our various lifestyles, but this is not always the case, and some people seem to be more affected than others for no apparent reason.

The Treatment: Alex's osteopath uses direct soft tissue, articulation and manipulation techniques to try to increase movement in his hip joint. It is explained to him that his muscles have tightened up around the joint in protection and this is what is causing much of his pain. With further osteopathic soft tissue techniques his muscles are stretched and loose much of their tension giving relief from the constant pain. Alex is given some advice on exercises and what to avoid in his daily routine.

The Outcome: Alex realises that at some stage he will still need to have his hip replaced, but his regular osteopathic treatment is keeping him going, and hopefully he can have a better quality of life as he waits for the day when his hip finally gives up and he's deemed old enough to have the surgery. Even his golf has improved!

Body Talk

What is it? Whiplash is a commonly used term when describing an injury to the neck due to a sudden excessive forward and backward bending motion, usually associated with road traffic accidents. This movement is also known as hyperflexion and hyperextension. Injury occurs when the neck is flexed and then extended beyond its normal range of motion. Although whiplash is usually associated with neck injuries, any part of the spine can suffer a whiplash injury. The force being applied to one part of the spine and whipping throughout its length, similar to the cracking of a bull whip.

Symptoms: Immediately following an accident there may be no symptoms. Symptoms usually begin within a few hours, or over the following couple of days, but in some cases it may be several days after the collision before the onset of symptoms, which may then subside within a few days, or may persist for many months. The most common symptoms are:

Neck pain/stiffness
Pain in the shoulders
Pain between the shoulder blades
Pain in one or both arms
Headaches
Muscle tenderness
Low back pain
Fatigue
Dizziness
Vision problems
Ringing in the ears (tinnitus)
Poor concentration or memory
Sleep disturbance

What are the injuries? The violent hyperflexion and hyperextension movement causes stretching and tearing of the muscles and ligaments of the neck. The pain experienced after a whiplash injury is mainly the result of tightening of the muscles that are responding to the tears the muscles and ligaments have received. By tightening, the muscles act as a splint to limit movement and prevent further injury. These tightened muscles often lead to the neck, shoulder, upper back pain and headaches typically experienced after a whiplash injury. Usually, the injuries to a person's neck, head, and other body structures caused by a whiplash are to the soft tissues. Soft tissues consist of muscles, ligaments and tendons.

Treatment: Injuries to soft tissues can be treated. Your osteopath will be able to assess the extent of any injury and advise accordingly. With osteopathic treatment most soft tissue injuries will heal fairly quickly, but if the injury is more extensive it may take up to 6 months to completely heal. If the whiplash has also damaged the spinal joints and discs then the prognosis may be lengthy, and in some cases a full recovery cannot be guaranteed.

Healthcare in the News

If you don't know what an �App' is, then well done. If you do, then not surprisingly you can find several of them on osteopathy. Type �osteopath' into the App search function on your iPhone and you will find several osteopathy-related applications. Most are guides to finding osteopaths - in France and Switzerland - but there is one guide to osteopathy for osteopathic students and professionals that may be of more general interest.
Can stress cause back pain?, asks the BackCare charity. The short answer is yes. "Stress is a major contributor to many health problems including back pain. When we are under a lot of stress the body releases stress hormones into the body whlch can have an adverse effect. In terms of back pain these stress hormones can cause muscles to tighten which reduces blood flow and therefore provision of nutrients and oxygen to the tissues in that area and the result is spasm and a build up of waste products and eventually muscle pain and weakness. A recent study in the journal Spine showed that patients suffering psychological distress were three times more likely to develop back pain." For more, see www.backcare.org.uk
AXA PPP estimated that British football fans would consume 774 billion calories in snacks, 95 billion calories in drinks and almost 3 billion units of alcohol during the World Cup. The company said UK adults were likely to watch on average 15 of the 64 World Cup games and that each adult would consume more than 20,180 calories in snacks, which is equivalent to 72 Mars bars, 37 Big Macs, 32 roast beef dinners or almost a stone in weight of cheddar cheese. The estimates were made before the premature exit of the English team, so presumably they don't include vast quantities of humble pie...
The British School of Osteopathy (BSO) reports that one of its patients acknowledged its help through Paul O'Grady's BBC Radio 2 show. Long standing BSO patient Keverne Weston sent in a letter to the show for its regular "Thank You' feature. Keverne wrote; "I have been attending the British School of Osteopathy in Southwark, with various aches and pains for many years. The clinic does a wonderful job providing patients with treatment by students who are supervised by tutors. They have helped me greatly and for a fraction of the cost one would normally pay. I have been treated by literally dozens of students, and encountered several tutors and receptionists and without exception, they have been painstaking - no pun intended - caring and, most importantly, charming."