Physiotherapy Clinic Solihull – IDD Therapy back pain treatment at Broad Oaks Health Clinic

Broad Oaks health Clinic is the longest established physiotherapy clinic in Solihull, West Midlands, UK.

Having been aware of IDD Therapy and the SDS SPINA, clinic director Mark Webb upgraded his old traction unit to offer the advanced IDD Therapy spinal decompression programme. What a difference!

Before …

Traction Bed

After …

SDS SPINA IDD Therapy at Broad Oaks Health Clinic

Broad Oaks Health Clinic IDD Therapy

 

 

 

 

 

 

 

 

 

 

 

For more information about IDD Therapy, back pain treatment and physiotherapy in Solihull, contact Broad Oaks Health Clinic on 0121 705 3509 or visit www.broadoakshealthclinic.co.uk.

Chronic Back Pain Treatment With IDD Therapy And The History of MRI Scan Usage

This article considers the role of the MRI scan when treating low back pain with IDD Therapy.

Herniated Disc TreatmentIt raises the possibility that early back pain studies conducted without MRI technology were in part flawed since without consideration of the underlying condition, how would it have been possible to create and direct an appropriate treatment regimen?

When back pain and neck pain remains unresolved, clinicians now use MRI scans to help diagnose or confirm the cause of someone’s pain.

As an example, IDD Therapy treatment providers take advantage of MRI scan technology for three reasons.

1/ Rule out contraindications to treatment
2/ Identify the underlying pathology
3/ Confirm the spinal level to be targeted for treatment 

IDD Therapy treatment uses a computer-controlled, cyclic pulling force to distract and mobilise targeted spinal segments in an axial plane.

sds spina treatment lrThe application of distraction forces is safe, however it is essential to ensure there are no contraindications, such as a vertebral fracture or metastasis (cancer).  (A full list is available by contacting Steadfast).

The scan helps to confirm whether IDD Therapy may be appropriate and the most common conditions treated include herniated discs and degenerative disc disease.  The MRI scan helps the clinician to select the level to be treated e.g L5S1 disc and to understand the severity of the condition.

IDD Therapy treatment protocols detail a set of angles which when applied, enable clinicians to distract targeted spinal segments.  Shealy & Bourmeyer 1997(1)  first observed that applying distraction forces at different angles enabled them to open the disc space 5mm-7mm.

Whilst dermatomes and clinical diagnosis help clinicians, without an MRI scan to confirm the diagnosis, it is very difficult for the clinician to be clear in the treatment plan.

Traditional traction had many flaws and the Cochrane Review confirms that traction as a single modality is not effective.  http://summaries.cochrane.org/CD003010/traction-for-low-back-pain

Common use of MRI scan technology developed long after use of traction was dismissed. Whilst traditional traction was never applied scientifically with measured angles, with sufficient force for sufficient time, significantly, traditional traction treatment was never applied with the knowledge of which level and what pathology was being treated.

If you are not aiming, how can you achieve your goal?   It would be like blindfolding an archer and pointing them in the general direction of the target.

So, with IDD Therapy it is, where possible, desirable to have an MRI to determine the condition being treated and then using the SPINA machine tool, to direct treatment to the targeted level.  Of course, if treatment is not responding adjustments can then be made.

The conclusion of the Cocchrane Review is interesting:

“A limitation of this review stems from the scarcity of high quality studies, especially those which distinguish between patients with different symptom patterns (with and without sciatica, with pain of different duration).”

Having spoken to hundreds of clinicians who used traditional traction, I am yet to meet a single one who used any kind of precise methodology in the application of the treatment (irrespective of the tool they were using).

Invariably it was, “we’d try a bit of traction and see what happened.”  Since they would not know the nature of the condition they were treating, how could they apply a method other than pull and hope?

This quite frankly is useless and we can ask it is any wonder that outcomes in clinics were so poor?!

The other benefit of the scan is to be able to see the size of a disc herniation or the degree of degeneration.  It is extremely difficult to structure a randomised controlled trial with a one-size fits all approach for back pain. 

IDD Therapy has a growing body of evidence to support it and more will be needed to help develop and refine treatment programmes.

Anecdotally, clinicians will confirm that larger disc herniations require more time for treatment than small bulges, whilst degenerative discs tend to require more treatments before improvements can be felt.

The use of the MRI scan is thus a key tool to enable clinicians to target and treat chronic low back pain more effectively.

For a summary of the differences between IDD Therapy Spinal Decompression and traditional traction, please use the form below.

(1) Shealy CN and Borgmeyer V. Decompression, Reduction, and Stabilization of the Lumbar Spine: A Cost-Effective Treatment for Lumbosacral Pain. American Journal of Pain Management. 1997. 7:63-65.

Author: Stephen Small
www.SteadfastClinics.co.uk

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Back Pain Treatment: How mechanical treatment can help manual therapists treat back pain.

I am often asked why committed manual therapists treating back pain use the mechanical treatment tool, IDD Therapy.

There isn’t a short answer as there is so much which goes into the IDD Therapy programme, however one reason relates to the actual physical limitations of the hands and body.

The spine is incredibly strong and in certain ways, it is impossible to comfortably decompress chronically stiff and immobile spinal segments with the hands alone.  I made this short video at my local gym to graphically illustrate when and how the IDD Therapy treatment tool comes to the aid of the manual therapist.

[youtube=http://youtu.be/4TbfCB65aq8]

It is important to stress that manual therapists use IDD Therapy for certain patients only.

This is not an industrial revolution style event of machine vs man.  Nothing can replace the sensitivity and dexterity of the hands, but there comes a time when patients need something more for their pain, which the hands-only treatment model cannot help.

IDD Therapy allows clinicians to comfortably distract and mobilise targeted spinal segments, with sufficient force and for sufficient time to have a therapeutic effect.  This is the essence of what sets IDD Therapy spinal decompression apart from traditional traction and why IDD Therapy is used by increasing numbers of manual therapists.

I should emphasise that IDD Therapy is not a stand-alone treatment.  It is a complete programme of spinal care which combines manual therapy, exercise and other modalities to help clinicians do more for back pain sufferers.

If you have any questions about IDD Therapy treatment, let us know in the box below or for more details visit European IDD Therapy representatives www.SteadfastClinics.co.uk

Posted by: Stephen Small

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IDD Therapy Spinal Decompression for the Herniated Disc: A Clinician’s View

Osteopath Robert Shanks is the co-founding Clinical Director of Spine Plus, a group of multi-disciplinary back pain clinics based in London and Essex. He trained with The British Medical Acupuncture Society and is also a qualified electrotherapist.

Robert’s area of special interest is chronic low back pain and neck pain associated with bulging or herniated discs.  He is an advocate of innovation and technological advances in spinal care and uses IDD Therapy non-surgical spinal decompression to treat his chronic disc patients.

I first became interested in mechanical spinal distraction in 2002 and I started using a home-made cervical traction device based on pioneering osteopath, Alan Stoddard’s model featured in a book from the 1950’s!  Yes, it sounds a bit Wallace & Gromit but it did the job more effectively than using my hands alone.  I then started using portable traction beds which featured a manual pump allowing for intermittent sustained traction.

The object of these devices was of course, to distract the spine in order to take some pressure off the disc(s) and any pinched nerves.  We used it as part of a standard 30 minute treatment session.  

Developments in spinal decompression have come a long way since those primitive traction devices.  Indeed, traction per se created a divide amongst clinicians in its heyday: there were those like myself who found the tool a useful addition to manual therapy and there were others who saw too many shortcomings for it to be fully effective.  

One of the key shortcomings of traditional traction was the imprecise nature in which the treatment was applied, for example, the traction force was aimed non-specifically at the entire vertebrae and not at the particular segment we were trying to treat.  Moreover, as the linear ‘pull’ was unnatural to the body, it could actually cause muscles to spasm, leading to an increase in pressure and pain!  This meant that in order to ensure relative comfort for a patient, the treatment tended to be administered in short bursts of 10 to 15 minutes with a low traction force – which proved ineffective for many chronic conditions.

Around 2008 I began hearing about Intervertebral Differential Dynamics (IDD) Therapy, a non-surgical spinal decompression treatment which appeared to address the failings of traction quite systematically.  These sophisticated IDD treatment machines were developed in the US in the late Nineties by a team of engineers and clinicians whose aim was to mechanically decompress the disc by improving upon traditional traction methods.Patient having IDD Therapy spinal decompression treatment

With modifications and revisions along the way and advances in computer technology, the team finally produced an FDA cleared class II decompression machine which, with computer-controlled forces directed at precise angles, was shown to distract targeted segments of the spine, e.g. L4/L5 from between 5 and 7mm – which had significant therapeutic implications. 

The decompression unit also included a unique oscillation feature capable of mobilising the joint at the point of maximum distraction – in much the same way as manual therapists mobilise other joints – but which given the strength of the spine, is difficult to do with the hands alone.  Moreover, because the device used a gently progressing pulling force (sinusoidal waveform) which mimics the natural contraction mechanism of a muscle, the muscle remained relaxed and lengthened throughout the slow and consistent stretch without going into spasm.  Thus patients could enjoy the necessary higher pulling forces for longer, whilst remaining completely relaxed.

I read all of the clinical research papers on IDD Therapy but I was more interested to see the treatment in action and hear the experiences of clinicians in the UK who were already using it as part of a specialised rehabilitation programme for their herniated disc patients.

The clinicians I spoke to viewed IDD Therapy as a structured programme with patients having a series of regular hourly treatments spread over a number of weeks.  The sessions consisted of some heat therapy to warm up the target area followed by 25 minutes on the IDD machine.  After the mechanical decompression, patients would have some cold therapy to prevent any temporary soreness caused by the soft tissues being worked in a new way.   Corrective exercise was introduced gradually as the programme progressed to help achieve lasting success.

I tried the treatment for myself on the latest IDD machine (the SDS Spina); I could really feel the differences which I’d heard and read about.  I decided to introduce the treatment at one of my clinics in April 2011.

In the last year the clinic has treated over a hundred patients with IDD Therapy.  These have tended to be patients with herniated or prolapsed discs whose symptoms of chronic back pain, neck pain and sciatica had prevailed despite standard manual treatments.  The clinical outcomes have been impressive: I would say that 70% of these patients have made good to excellent improvement.

A typical patient is 63 year old Rita from Chigwell who achieved an exceptional outcome with IDD Therapy after suffering for four years with an L1/2 disc bulge which surgeons would not operate on.  She had undergone countless manual treatments, facet joint injections and epidural injections without any lasting improvement.  After a series of IDD treatments she became pain and spasm-free and was able to return to work and carry out her daily household chores again.

Another patient had a considerable L4/5 disc bulge; after a programme of IDD Therapy the bulge had shrunk to less than a third of its size.

Although I have used IDD Therapy to treat acute pain, most IDD candidates have been in pain for several months, even years and have tried one or more manual treatments and/or injections without success.  For these patients, a programme of treatments spread over a number of weeks is necessary to achieve long lasting therapeutic changes to chronic conditions which have built up over time.

When patients first come to me, some are in so much pain that they are physically and emotionally exhausted and fearful of making the slightest movement.  Over the course of the IDD programme, we can help to change their outlook and expectations, setting them the realistic goal of becoming pain-free and being able to get back to their normal daily activities.  We track all patients with research tools such as the Oswestry Disability Index, Visual Analogue Scale and other objective outcomes measures.

IDD Therapy is an invaluable treatment tool to me.  It has finally enabled me to offer something meaningful for disc patients which, in my experience, is preferable to surgery and more therapeutic than epidurals, nerve root blocks and facet joint injections.  

It’s hard to find a negative side to the treatment: an IDD session takes longer than a standard 30 minute manual treatment but we cannot cut elements of the session without having a detrimental effect on our treatment goals.   By having IDD as a treatment tool to use alongside manual therapy, we are seeing more patients at the clinic and as our experience grows, we are better able to predict how to progress patients who of course, all have individual needs.

Since introducing IDD we have been able to treat several lumbar-surgery candidates; I know of patients who have been booked in for an operation and have tried IDD as a last resort and are now pain-free and active again.

Naturally, there are some patients who do not respond to treatment but generally speaking, my patients have had very good outcomes and from a personal perspective, it’s hugely satisfying to know that I have been able to do more for them.

Robert Shanks BSc (Hons) Ost
www.SpinePlus.co.uk

For information about IDD Therapy, call Steadfast Clinics on 01279 602030 or visit www.iddtherapy.co.uk