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

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.


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 

Sciatica or Back Pain? – Google statistics show us what people are actually looking for.

Working with clinics treating herniated discs with IDD Therapy spinal decompression, I am interested to see back pain statistics and trends around the subject of back pain.

Whilst “Back Pain” is the number one musculoskeletal condition people visit their doctor for, is it really back pain they need help with or does Google search traffic data reveal something not factored into the statistics?

Here below you can see the UK monthly search volume for certain keywords.

Google adwords Back Pain Searches

As can be seen, for every “back pain” search in Google, there are over three times as many searches for ‘sciatica’.

What about globally?

Google sciatica search results global

Again we see the same trend.

This throws up some questions which someone probably has the answers to (appreciating that sciatica and back pain are closely related): 

Is back pain more prevalent than sciatica?
Is the pain of ‘sciatica’
less bearable than ‘back’ pain?
Is it the latter which prompts proportionally more people to search for info/help with sciatica than back pain?

What do you think?

Author: Stephen Small, Director Steadfast Clinics Ltd
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Steadfast Clinics Ltd – Expanding IDD Therapy spinal decompression treatment for intervertebral discs and Thermedic Infrared Therapy Systems for joint pain and soft tissue healing.

Leominster Osteopaths, Four Years of IDD Therapy Spinal Decompression for Back Pain, Neck Pain and Sciatica

Leominster Osteopaths was the second clinic in the UK to provide IDD Therapy for their patients.

With some great results and an expanding practice, the clinic is attracting patients from far and wide to get relief from chronic disc-related problems.


Stephen Small and Mark Roughley

Stephen Small of Steadfast Clinics is pictured here with Leominster Osteopaths Clinic  Director Mark Roughley.

For more information about IDD Therapy treatment at Leominster Osteopaths, visit

Back Pain – “All In The Mind”? ‘Upright’ MRI vs ‘Supine’ MRI Insights For Back Pain Treatment

We often hear stories of patients complaining of ‘severe’ back pain which when examined under MRI scan reveals very little, if anything, that may suggest a cause of pain.

At this point it is often suggested that the back pain is more of a psychological issue than a mechanical problem: “It’s all in your mind!”.

Last weekend at the Back Pain Show I was talking to one of the Upright MRI providers – Medserena who are opening in London.

In the past, one of the selling points of the upright MRI scanner was that it is more comfortable for patients compared to traditional MRI scanners where the patient has to lie down and enter a very narrow tunnel.  For some people, the “lie-down” scanners were simply too claustrophobic, hence the appeal of an open / upright MRI scan.

Upright MRI scan

Upright MRI scans are more expensive than “lie down” scanners since the equipment is quite different (much bigger and more costly).  This can deter both self-pay patients and insurance companies from paying for upright scans.

Of course the clinical benefit of the upright MRI scan for low back pain is not so much the comfort, but the ability to see what happens to vertebral structures when they are under load ie when the patient is erect and load bearing (standing up) or sitting upright, rather than supine and non-load bearing (lying down).

Here below are some examples of scans comparing the spine of the same patient on the same scanner supine vs erect and the differences in revealed spinal pathology.  The results are impressive:-

Upright MRI Scans vs Supine Scans

As can be seen, there are important differences in pathology which are only revealed when the scan is carried out with the patient upright with the spine under load.

There are only a handful of upright MRI scanners in the UK and this raises some new questions in my mind about the role of MRI scans and implications for treatment schools of thought.

In an earlier post I raised the question that older back pain trials may have been flawed because they were conducted without the benefit of a scan to confirm pathology and thus the ability to appropriately tailor treatment tools to the underlying pathology. (see post)

Now, the question could be:

“Do insights from the results of Upright vs Supine MRI scans raise questions about the proportional significance of the biopsychosocial components of back pain vs mechanical components of back pain?”

What the above comparisons and others like them show is that it is possible for the load bearing effect on spinal pathology to go undetected with Supine MRI scanning in some cases.  

When a spinal pathology is detected with an Upright MRI scan, there may be times when alternative treatment plans with an emphasis on functional restoration may be more appropriate.

Images courtesy of Medserena Upright MRI Ltd.
Opinions of the Author.

By Stephen Small