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A study has found that 100 million European workers suffer from chronic musculoskeletal disorders (MSD), with as many as 40% of affected workers having to give up their jobs. The study found that early detection and treatment reduces the burden on government budgets and improves the lives of European citizens.

The Fit for Work study by UK-based The Work Foundation estimated that MSDs cost the European Union countries 0.5% to 2% of GDP annually, which means up to €240 billion.

"MSDs clearly have a serious, negative impact on the EU workforce, as they were responsible for millions of lost working days - 9.5 million were lost in one year in the UK alone," said Stephen Bevan, managing director of The Work Foundation. "As Europe now struggles to emerge from the global recession, one consideration policy-makers should address is how labour productivity in businesses is being undermined by these often very painful conditions."

The report recommends a new method to evaluate the cost-effectiveness of treating illness in general, and MSDs in particular; one that considers more than simply the up-front costs of medical expenditure and incorporates wider considerations, such as work productivity.

As a result of the study, a Fit for Work campaign has been launched in the European Parliament in Brussels by two MEPs from Portugal and Bulgaria. The campaign has been endorsed by the Swedish Presidency of the European Union.

TUC general secretary Brendan Barber, quoted in the General Osteopathic Council's The Osteopath magazine, said; "This report highlights what trade unions have been demanding for many years, which is access to early rehabilitation for those with muscle and back problems."

www.fitforworkeurope.eu

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Complementary medicines

Should acupuncture, herbal medicine and Traditional Chinese Medicine (TCM) be subject to statutory regulation? That is the question that the Department of Health has been asking in a national public consultation: in essence, the choice is between statutory regulation - such as that governing osteopathy - or some other form of regulation.

The General Osteopathic Council (GOsC) - the body set up to regulate the profession following the Osteopaths Act 1993 - has responded to the consultation and recommended that the three treatment types should indeed be regulated.

"Basing our response on our knowledge and experience of the statutory regulation of osteopaths", wrote the GOsC in the latest issue of The Osteopath, "we argued that the nature of the treatment involved in acupuncture and the potential risks associated with some herbal medicines justified statutory regulation".

The Council said it had reached its decision despite its understanding that the Government would rather not regulate the medicines. "Whilst it is right that statutory regulation should be avoided where it is unnecessary, we argued that healthcare should never be the first port of call for a Government in ‘de-regulatory mode'", wrote the GOsC.

"In our view, only statutory regulation, including protection of title [for example, the fact that only a GOsC registered osteopath has the right to call him or herself an osteopath"> would establish the standards required for practitioners and provide a means of redress for patients who believe they have suffered harm as a result of the treatment."

The GOsC thinks, for instance, that the appropriate levels of English language should be set. "Like osteopaths, acupuncturists, herbalists and TCM practitioners do not work in isolation, but increasingly in multi-disciplinary clinics. An ability to communicate effectively with patients, other healthcare professionals and the emergency services is crucial", said the Council.

There is one area of complication, in the case of practitioners having more than one discipline - your own osteopath, for example, may also have qualifications in acupuncture and offer it as a treatment - they may have to choose a ‘principal' regulator, although they would also have ‘secondary regulators'. This would require extensive cooperation between the various regulation bodies.

The Department of Health is now preparing its response to the public consultation. YourOsteopath will bring you the results when they are made public. You can also read the GOsC's full response at: www.osteopathy.org.uk.

Case Study

Your Osteopath investigates how osteopaths know when your back pain is coming from somewhere else.

The Case: Bill is an active 67 year old, self-employed haulage contractor who never knew when it was time to slow down. He began to suffer from low back ache for no apparent reason. Initially it was of little consequence, but gradually got worse over a 9 month period. He ignored it. It didn't stop him doing anything, and he told himself it was just one of those things that will go away with time. But it is still there and is now getting worse. He's uncomfortable driving and his sleep is being disturbed. His wife is now losing her sleep as he tosses and turns all night long, trying to find a pain free position. She's had enough. She phones her osteopath and books her husband an appointment.

The Diagnosis: After taking a full case history, the osteopath discovers that Bill has a few other symptoms that he hasn't done anything about. Over the last year his bowel movements have changed. He just thought that his stomach was playing up a bit as he got older, and it didn't cause him any real problems. Now his osteopath seems to be asking more questions about his toilet habits than about his back. Does he suffer from constipation or diarrhea? Does he pass any blood in his stools, and was it bright red or dark in colour? Does his back pain alter with eating? Questions that seemed irrelevant to his back pain seem to interest his osteopath.

Bill's osteopath now makes a physical examination of his back and abdomen, and is not convinced that his low back pain is coming from his back. His osteopath thinks that his problem may be referred pain from his gut and refers him to his GP.

The Outcome: Some months later after attending hospital for further tests it is discovered that Bill is suffering from Irritable Bowel Syndrome and this resulted in him having muscle tightness in a band around his lower abdomen and back. Although his pain was not coming from his mechanical structure, his osteopath's prompt exclusion of this as a possible cause resulted in Bill's condition being quickly referred and an early treatment programme being put in place.

Body Talk

Scoliosis means a lateral (sideways) curvature of the spine. The term derives from a Greek word meaning to twist or bend, and was first described by Hippocrates in the 4th century BC. The curve can be to the left or right side, a "C" curve, or may be to both sides, an "S" curve. A scoliosis can vary from very mild and barely noticeable to severe.

It is possible to split scoliosis into two groups.

Functional or Postural Scoliosis. This is temporary and produced by the postural activity of some spinal muscles, and is usually the body's way of reducing the pressure in a certain area. It can be due to any sudden acute cause of lower back pain and is often accompanied with leg pain. Other causes of a temporary scoliosis are mainly due to compensation from an underlying condition such as a pelvic or hip joint problem, where the spine is held to one side in an attempt to reduce pain or allow better function of the area. This type of scoliosis is easily diagnosed as it will disappear when the patient lies down. In cases that go uncorrected over many years this type of scoliosis may become permanent due to possible bony changes and the shortening of soft tissues. Early osteopathic treatment is recommended to avoid irreversible change. This type of scoliosis is an osteopath's every day bread and butter! Treatment is usually to the cause of the scoliosis and therefore results in the straightening of the spine.

Structural Scoliosis. This is a permanent change and arises from an alteration in the body's bones or soft tissues. Osteopathic treatment of a structural scoliosis is to alleviate symptoms, promote spinal function and therefore reduce pain. As these curves are permanent, patients often need to attend for maintenance treatment to maintain their improvement and stop progression of their condition.
Within this group is the most common type of scoliosis- idiopathic scoliosis, meaning the cause is unknown. Around eight out of 10 scoliosis are idiopathic, and it affects around 3 in 100 people. Idiopathic scoliosis affects children, usually starting during the growth spurt of puberty and tending to continue to develop until the end of skeletal growth around 18 to 20 years of age. These are the most important cases, where early diagnosis is essential if marked or severe deformity is to be avoided.

How do we check our children for idiopathic scoliosis?

Symptoms - there are usually none, until the curve is severe. First the difficult bit - get your child/teenager to stand still while you look at them! Look for one shoulder being higher than the other, a hip that seems to bulge out to one side; or if there seems a difference in the way that each arm hangs by their side. Does their shirt seem to hang unevenly, or is their waist band sitting at an angle?

At an early stage of development it needs a trained eye to spot, but osteopaths spend their whole lives observing and examining backs, and therefore will be able to see a developing scoliosis at a very early stage. An idiopathic scoliosis cannot be cured by osteopathy, but treatment, often including exercises under parental supervision, can result in a more acceptable curve in adult life. Depending on the extent of the curve, surgery may be the only option, but early diagnosis is essential, and if caught at this stage a scoliosis may be monitored and hence early intervention is possible, with a better outcome likely.

If in any doubt ask your osteopath to check your child. Just have a casual chat when you're next on the treatment couch. It may be one of the most important conversations you have for your child.

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Osteopathy in the News

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Osteopathic and Health Links

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