Acting as a human guinea pig to experience advanced spinal mobilisation capability of IDD Therapy

IDD Therapy is the fastest growing conservative spinal treatment.  Thoughts about the application of spinal mobilisation got me thinking about how we might make use of the parameters of treatment for different therapeutic objectives.  

In this video I act as a human guinea pig to set a treatment with an increased level of spinal mobilisation and extended duration of distraction.  That sounds more dramatic than it was since treatment is very safe, although I was slightly nervous!

IDD Therapy is a programme of treatment involving a series of one minute distraction and mobilisation cycles to decompress targeted spinal segments.

Part of the mobilisation is a patented oscillation capability at the point when the joint is distracted. Typically, this oscillation force is set at 10lbs and applied for one minute at a moderate frequency.

The computer software in IDD Therapy gives clinicians the unique ability to adjust the oscillation in line with principles of manual therapy, whether Maitland, Harmonics etc.

Oscillation Frequency & Amplitude

Differing frequency and amplitude of oscillation/mobilisation (60 seconds)                                                               Low Freq’cy      Moderate Freq’cy          High freq’cy               10lbs oscillation            20lbs oscillation

In this video, I explore what a higher oscillation force feels like by increasing the oscillation force from 10lbs to 20lbs (amplitude) at the point when the joint is distracted under tension.

Since the oscillation force has a bigger distance to travel between high tension and low tension, it is necessary to decrease the frequency, ie the number of cycles, to allow time for the distraction force to go up and down within the range of the oscillation.

This reduces the number of cycles of oscillation in a 60 second high distraction. Therefore the duration of the oscillation at the high distraction is increased from one minute to 90 seconds.

Thus the joint is opened for longer and at the same time, the joint and surrounding soft tissues are exposed to more significant distraction and mobilisation forces.

I have received many IDD Therapy treatments and observed that the combination of longer distraction at high tension and greater degree of oscillation results in a greater feeling of decompression.

The treatment feels more powerful and remains comfortable. The next day after treatment, I could feel greater range of movement, improved posture and less stiffness in the lower back.

Whilst IDD Therapy is typically given as a course of treatments for chronic disc-related conditions, IDD Therapy is used as a tool when clinicians need something more than hands alone to increase range of motion and soft tissue function in the lumbar spine.

Author: Stephen Small
Director Steadfast Clinics Ltd
www.steadfastclinics.co.uk  www.iddtherapy.co.uk

Short video demonstrates limitations of anterior-posterior spinal mobilisation for herniated discs.

The latest dynamic spine models allow us to see the effects of forces on intervertebral discs.

Manual therapy typically uses an anterior-posterior directional mobilisation to treat spinal segments.

IDD Therapy treatment comprises a targeted longitudinal distraction, with a longitudinal oscillation/ mobilisation at the point of maximum joint distraction.

IDD Therapy 25 minute treatment graph

This decompresses the discs and works soft tissues simultaneously in a way which is not possible with the hands alone.

Author: Stephen Small
Director, Steadfast Clinics Ltd
www.steadfastclinics.co.uk

Clinics in the community – get visible to be seen and remembered.

For clinics without natural footfall or street visibility then you have to work harder.  As we come into the summer there are fares and local events where you (or your team) can be out and about promoting the clinic. 

Community Marketing

Get out and about to be seen by your community.

If you are engaging in building your brand through other media, local people will already have an imprint of your brand in their minds, so this is a moment for them to meet you.

My sisters live in Leicester and a couple of weeks ago sent me this when out and about at a local street festival. You don’t need to be there yourself.
You have team members who could get out there for you or you could even pay someone to talk to people and engage people to come in.

The best part is, they often only cost £30. If not events – often for free or a modest fee, local supermarkets will let you have a table with a banner.

Author: Stephen Small
Director, Steadfast Clinics Ltd
www.SteadfastClinics.co.uk

Spinex Disc Clinic – the new name for non-invasive disc treatment in London

All physiotherapists, osteopaths and chiropractors treat intervertebral disc problems.  And yet, pain consultants up and down the country have waiting rooms full of people with back pain and neck pain, caused by disc-related problems.

Spinex Disc Clinic

Spinex Disc Clinic – Edgware Road London

Spinex Disc Clinic, a specialist back pain clinic in London helps patients caught in the back pain no-man’s land where standard manual therapy and exercise haven’t worked, and where they need something more for their pain without resorting to injections and/or surgery,

Causes and consequences. 

When it comes to back pain, cause and consequence are quite similar.  The cause of your back pain might be a herniated or slipped disc.  However, the real cause of your herniated disc is one of a number of factors such as the compression of the disc from poor posture over a long period of time, combined with a lack of exercise and so on.

So the cause of the pain is actually the consequence of changes in the body which lead to the disc problem.

All clinicians treat the causes of pain, but first of all they treat the consequences of the causes of pain.

Where Spinex Disc Clinic and other IDD Therapy Spine Centres come in, is when the consequences of the causes of pain e.g severe compression and restricted mobility, are such that manual therapy alone is not able to address the problem.

The first things to do therefore is to take pressure off the disc and improve tissue function, then the focus can be on addressing the real causes which led to the problem.

In some ways it’s like obesity treatment.

The cause of obesity is a calorie surplus each day built up over time.  The consequence of that is excess weight/ fat.  First the person has to work hard to get rid of the excess fat and then they make lifestyle changes to ensure they stay at a healthy weight.

Now, the person will make the lifestyle changes as part of the process of losing weight but they have to work harder than normal because they need to burn more calories to cut the excess.

When it comes to disc treatment, for some patients lifestyle changes alone (improved strength, more activity, better posture etc) are not enough to undo the consequences / causes of the pain.

Spinex Disc Clinic is primarily focussed on those patients with disc problems who need something more than manual therapy.

Clinical Director Sally Lansdale is a highly experienced osteopath who finally resolved her long standing problem with a series of IDD Therapy treatments.

[youtube=http://www.youtube.com/watch?v=HYSH9JM4XBI]

Since then she has had two clinics offering IDD Therapy and now Spinex Disc Clinic is the evolution of those clinics now located in North West London, just off Edgware Road.

For more details about Spinex Disc Clinic, visit www.SpinexDiscClinic.com 

Low Back Pain Treatment – Inflammation, IL-6 and the new FAR infrared treatment connection.

I recently posted an article regarding drug-based Rheumatoid Arthritis treatment targeting the IL-6 protein.

I was interested in the potential implications of a study by Wong et Al (1), showing that as well as pain relief, post knee surgery patients treated with FAR infrared exhibited reduced levels of the proinflammatory IL-6 protein.  I raised the question whether the new FAR infrared modalities be an effective treatment aid for Rheumatoid Arthritis.

FAR infrared and IL 6 protein

http://www.ncbi.nlm.nih.gov/pubmed/22339105

“This study demonstrated that the FIR can lower the NRS of pain and thus reduce the discomfort experienced by the patient. Findings indicated that effective application of FIR decreased the serum level of Interleukin-6 (IL-6) and Endothelin ET-1, which represent the subjective indicator of pain.”

Working so heavily with low back pain and IDD Therapy spinal decompression treatment, this got me thinking about inflammation, IL-6 and low back pain.  What are the potential applications of new infrared modalities as a cost-effective tool to ease inflammation and reduce low back pain … without the need for steroid injections and anti-inflammatory medication?

With regards to Low Back Pain, we observe on many occasions that patients using Thermedic infrared pads report pain relief beyond what might be expected from a standard conductive heating aid.  I have written at various times that the humble “heat pad” offers more profound benefits than we might think, see evidence.

Looking at some of the research into IL-6 and back pain, Heffner et al (2) show that higher levels of IL 6 are associated with chronic low back pain (CLBP) and sleep disturbance:

“Individuals with CLBP had more sleep disturbance than controls. Circulating IL-6 levels were similar for the 2 groups; however, in adults with CLBP, poorer sleep quality was associated with higher IL-6 levels, and both sleep and IL-6 related to pain reports.”

Burke et al show that there are high levels of proinflammatory IL-6 in the nucleus pulposus of painful intervertebral discs:

“We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay. There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively). The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.”

Kraychete et al (4) show that:

“…  patients with chronic low back pain due to disc herniation presented higher levels of TNF-alpha and IL-6, but not of IL-1 or sTNF-R.”

Thus whilst looking at the Wong et al study showing reduced levels of IL-6 for knee pain post surgery using infrared,  we can also see that elevated levels of IL-6 are associated with CLBP.

Could Wong et al help us to explain more fully the observed benefits of FAR infrared for relieving low back pain?

TherMedic is a new technology which uses a mains powered carbon-fabric element which emits FAR infrared.   It replaces lamps.  Worn against the body TherMedic provides a localised constant infrared heat/energy source.  Evidence shows both thermal and non-thermal effects from the resonant energy for pain reduction for a variety of conditions.

Most of the evidence comes from Asia where the technology is developed and being applied to many medical conditions.  We expect that European academic interest will develop as awareness of the new technology and its applications spreads.

PW140-Lower-Back-Thermography-heat-only   l220103-heat-pad_jpg   l220103-temp-control_jpg

Regular users of Thermedic for low back pain report “not being able to live without their TherMedic” infrared pad.  Patients with sciatica report that their pain has disappeared which is surprsing for something viewed as a simple heat pad and used on the lower back.

PW140-TherMedic-Lower-Back-PackShotRather than simple pain relief from heat and increased blood flow which “feels nice”, might Thermedic infrared have a deeper effect by helping to reduce levels of inflammation-causing IL-6 in LBP?

There is clearly a lot to explore, but as you look into the new FAR infrared fabric application for low back pain relief, you will see that there is a lot more than meets the eye.

Convention has it that heat should not be applied when there is inflammation.

Having heard from people suffering with inflammation but reporting relief when using TherMedic Infrared, could the new infrared turn some of that conventional thinking about heat and inflammation on its head?

Author: Stephen Small
Director www.steadfastclinics.co.uk  www.thermedic.co.uk  www.iddtherapy.co.uk

1) Wong CH, Lin LC, Lee HH, Liu CF. The analgesic effect of thermal therapy after total knee arthroplasty.  J Altern Complement Med. 2012 Feb;18(2):175-9. doi: 10.1089/acm.2010.0815.  http://www.ncbi.nlm.nih.gov/pubmed/22339105

2) Heffner KL, France CR, Trost Z, Ng HM, Pigeon WR Chronic low back pain, sleep disturbance, and interleukin-6. Clin J Pain. 2011 Jan;27(1):35-41. http://www.ncbi.nlm.nih.gov/pubmed/21188850

3) Burke JG, Watson RW, McCormack D, Dowling FE, Walsh MG, Fitzpatrick JM. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002 Mar;84(2):196-201. http://www.ncbi.nlm.nih.gov/pubmed/11924650
4)  Kraychete DC, Sakata RK, Issy AM, Bacellar O, Santos-Jesus R, Carvalho EM. Serum cytokine levels in patients with chronic low back pain due to herniated disc: analytical cross-sectional study. Sao Paulo Med J. 2010;128(5):259-   62. http://www.ncbi.nlm.nih.gov/pubmed/21181064