15% of patients seen each day by GPs have back pain: more needs to be done!

Stephen Small with BMI team at GP event in Coventry

Stephen Small with BMI team at GP event in Coventry

Two weeks ago I got some interesting feedback from GPs during an IDD Therapy CPD event about the actual incidence of back pain in their daily surgeries.

Whilst 99% of back pain presentations I have heard begin with the usual “back pain is the second most common reason for GP visits” etc, etc, I was interested to know how that translated into a percentage of their daily appointments.

I was quite surprised.

The general consensus amongst the group of GPs was that back pain represented approximately 15% of their daily case load,  i.e. about one in seven patients.

Given the hundreds of different conditions people might come to a GP with, I had expected the percentage to be lower.

GPs are up against it here because patients with chronic back pain clog up the system.  GPs really have limited options and often the patient is dissatisfied.  Help please!

Given the pressure on budgets within the NHS and the costs to society as a whole, surely it makes sense to make back pain resolution and prevention a top priority?

This is particularly important when we consider that societal lifestyles are appalling for disc health and spinal function and in addition, we are all living longer!

As far as the IDD Therapy programme was concerned, there was universal interest from the GPs:  some were extremely positive whilst one said “Listen, if we have a chance to help some patients, then there’s very little to lose and everything to gain.”


Author: Stephen Small
Director Steadfast Clinics Ltd

Hamstring Injury Treatment – Doing more with new Thermedic FAR Infrared Therapy

Having had my share of hamstring injuries, I know that the biggest pain is not the physical pain, but the pain of not being able to play your sport.

The risk of injury recurrence with any injury is very strong because for the competitive sports man or woman the desire to play can lead to an overwhelming temptation to play again too soon.

This is particularly the case with hamstring injuries and is especially aggravating because good hamstrings are so essential for running (fast!).  Incomplete healing, scar tissue, inflexibility and muscle imbalance with the quads mean that recurrent hamstring problems are a common (and expensive) problem.

So, can clinicians do more to help their patients with hamstring injury treatment?

Following the acute injury phase, it goes without saying that good blood flow to the injured site is essential to carry oxygen, nutrients and repair cells for efficient healing.  Stretching during the re-modelling phase of healing is essential to ensure that new collagen fibres are laid down neatly. 

Evidence shows that applying heat increases the extensibility of hamstrings1 and improves myofascial relaxation2 , thus applying heat before stretching muscles is beneficial.  Heat causes vasodilation: a widening of the blood vessels which in turn leads to more blood going through the injured area.

The problem to date has been in finding a comfortable and effective heat application for the hamstrings to help with healing and to help with the return to sport.

pw150_2%20close%20upThe new Thermedic Thigh is the ideal treatment tool for hamstring injuries.  It includes a cold pack to limit bleeding in the injured site whilst the support provides compression during the acute phase.

But the main benefit for athletes is a unique carbon-fabric FAR infrared heat element which delivers resonant energy into the tissues.

Mains powered, Thermedic has three temperatures and has been show to increase blood flow in tissues and joints; by 204% in the knee and 49% in the abdomen3.  The exact amount of increased blood flow in the hamstring hasn’t been measured but we might reasonably assume that the amount be somewhere in between.

At the same time FAR infrared has been shown to increase fibroblast proliferation and collagen regeneration, which are key components of healing4 .

Thigh ThighAnother significant benefit of Thermedic FAR infrared over standard heat products is that skin temperatures do not reach burning levels.  Thus, it is possible to apply FAR infrared for longer periods meaning that there is a sustained increased flow of blood through the injured site.

So, rather than 5-10 minutes of superficial warmth, with Thermedic it is possible to increase the blood flow for longer periods for a greater therapeutic effect.  This may have interesting implications for angiogenesis in the injured tissues but that question is for a phd student somewhere!

The key thing is to try the Thermedic Thigh on your hamstring and feel the difference compared to ANY other heat application.  When you feel this difference yourself, you can appreciate why Thermedic is becoming so popular for hamstring injury rehabilitation and many other painful conditions and injuries.

To order a Thermedic Thigh visit www.Thermedic.co.uk

Author Stephen Small
Director Steadfast Clinics Ltd

1 D. Funk, A. M. Swank, D. Treolo, K. J. Adams.  Efficacy of Moist Heat Pack Application Over Static Stretching on Hamstring Flexibility.  Journal of Strength and Conditioning Research, 2001, 15(1), 123–126

2 T. Muraoka, K. Omuro, T. Wakahara, T. Fukunaga, T. Fukunaga, K. Kanosue, Passive mechanical properties of the human muscle-tendon complex at different temperatures.  Journal of BiomechanicsVolume 39, Supplement 1 , Pages S197-S198, 2006

3 B.Y. Liau, A. Yang, T.K. Leung, M.C Ou, C.K. Ho and Y.S. Lin.  Inhibiting Effects of FAR-Infrared Ray-Emitting Belts on Primary Dysmenorrhea.  International Journal of Photoenergy, Volume 2012, Article ID 238468

4 Toyokawa H, Matsui Y, Uhara J, Tsuchiya H, Teshima S, Nakanishi H, Kwon AH, Azuma Y, Nagaoka T, Ogawa T, Kamiyama Y. Promotive effects of far-infrared ray on full-thickness skin wound healing in rats.   Exp Biol Med (Maywood). 2003 Jun;228(6):724-9.

Google search results for Physiotherapist vs Osteopath vs Chiropractor in the battle for the hearts and minds of back pain sufferers.

What does Google tell us about back pain and the different professions?

Google back painWhen people are in pain, they go online.  Working with Google Adwords, I decided to look at the search volume and see whether the search patterns revealed anything interesting about what people are looking for.

I began by taking the three main professions which treat musculoskeletal conditions: physiotherapists, osteopaths and chiropractors and then I looked at the search volume for specific conditions.

Google displays results in two columns, the first, for the world and the second, local to where you are – in this case the UK.  Here are the results:







physiotherapy clinic






chiropractic clinic






osteopathy clinic



back pain



low back pain



herniated disc



slipped disc






neck pain



shoulder pain



shoulder injury



knee pain



knee injury



sports injury






Of course there are thousands of keyword permutations but these are the broad searches.

When people look for a clinician they do so because they have a condition.  Each profession has specialities but back pain is the number one reason that people visit a clinic.

Based on conversations with clinicians over the years, I would put forward the following general percentages as back pain-related patient visits for each profession globally:

Physiotherapy: 40-50%
Osteopathy: 60-70%
Chiropractic: 70-80%

The profession-related search reveals three interesting things for me. 

1/ When people need help, they are looking broadly for a profession.  The type of treatment is a commodity ie I just need a physiotherapist, chiropractor or osteopath.

2/ People are looking for information about back pain and they are looking for private treatment in very large numbers (you don’t need to search if you just go to your GP to get treatment/ referral)

3/ Clinics need to plant the name of their clinic in the minds of future patients so that when they do get pain, they won’t search generically, they will search for their clinic!

There are up to 10 times as many physiotherapists in the UK as osteopaths and chiropractors, but large numbers of patients are looking for osteopaths and chiropractors over physiotherapists.

If we take it that a search for a clinician is in essence a search for treatment for a condition, then applying some percentages we can see more dramatically that osteopaths and chiropractors are getting a disproportionate amount of search traffic for back pain for the number of clinicians in those professions compared to physiotherapists.


UK Search

           % of Patients with Back Pain  
















This is search for broad terms only and the numbers may not be entirely accurate but they do give a ball park figure.  Combining the chiropractic and osteopaths (although I know the two professions are very different!) their combined search number of 196,500 is greater than the search for physiotherapist, 184,000.

What can we infer from this?

Quite a number of things but two things for me.

1/ The numbers show that in broad search terms for the professions, osteopathy and chiropractic are winning the day in the hearts and minds of back pain sufferers.

2/ With an ageing population, clinics can do worse than be the best for back pain … and arthritis.

Stephen Small
Director Steadfast Clinics

Steadfast Clinics is a dynamic medical company which helps clinicians do more for back pain sufferers and helps to grow clinics with the IDD Therapy spinal decompression programme.

For details request an information pack using the form below or visit www.SteadfastClinics.co.uk to read clinician testimonials and more.

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