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.

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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 

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
LinkedIn Profile
www.steadfastfastclinics.co.uk   www.iddtherapy.co.uk
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.

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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 www.leominsterosteopaths.co.uk

Spinal injections for back pain relief – Is there a disconnection from rehabilitation?

I recently gave a talk to a group of about 40 physiotherapists, osteopaths and chiropractors where I posed this question and asked for a show of hands.

There was universal agreement that there was a significant disconnect.

Looking at how to improve back pain treatment outcomes for both patients and over stretched healthcare budgets, there appears to be a significant opportunity to improve outcomes from spinal injections by making spinal rehabilitation an integral part of the post-injection treatment plan.

Patient pathways

There is a lot of debate about the merits of spinal injections.  The Cochrane Review (1) concludes “There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain”.

Yet many clinicians report that patients do benefit which is backed up by the same Cochrane Review “it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy.”

As with many back pain treatments, it is difficult to get a black and white answer since there are so many variables in play.

The typical pathway for a patient who develops chronic low back pain (or neck pain) looks something like this:

Self-prescribed pain medication
GP visit, pain medication and advice to remain active
GP visit
Manual therapy and exercise (physiotherapy)
GP visit
Consultant referral
Spinal injection
Consultant referral
Injection, possible surgery,
self-management (aka get on with it because we have no more options for you)

Self-pay patients typically bypass their GP and go straight to a physiotherapist, osteopath or chiropractor.  Private patients who are referred to a consultant often receive a spinal injection without first having a course of rehabilitation.

As a former member of the Society of Back Pain Research Committee said on stage at their annual meeting a few years ago, “I have a clinical intuition that they (spinal injections) are effective … and patients ask for them”.

Working with so many different clinicians, the problem appears to be that once a patient sees a consultant and is given an injection, many are simply sent home with little more than a recommendation to remain active, to do exercises and to possibly see a physiotherapist.

Given the costs of injections and clinical time, is this an efficient use of resources?

Manual therapists often dismiss injections because they do nothing to address the underlying condition believing them to be a band aid at best”.  Yet the purpose of the injection is not to cure the problem: it is to relieve pain to help the patient get on with their life.

If a patient can then be more active then the body has a chance to heal itself.

However, in the many cases where patients remain in pain it is perhaps in part because there is no proper rehabilitation.  Then the issue we have is what kind of rehabilitation will they get? 

If it is in the NHS, then the sort of rehabilitation a patient might access is exactly the same physiotherapy treatment which failed to address the problem in the first place.

Einstein’s definition of insanity is over quoted but to keep doing the same rehabilitation and expect a different outcome is surely insane … and an inefficient use of valuable resources.

Many spinal injections are given in the private sector.  One neurosurgeon I know sees approximately 1,500 patients a year.  He operates on 3% and gives an injection to around 20%, i.e. around 300 patients.

If a patient has an injection they leave hospital and then if they need follow up, they return to their consultant.  In some circumstances patients will receive a further injection.  If the injection hasn’t worked then the patient is more likely to become a candidate for surgery.

After all, conservative methods failed to resolve the problem.  Yet, I can’t help but feel that many of the spinal rehab programmes for patients who reach a stage of requiring (wanting) injections are simply not intensive enough.

Working with and talking to many clinicians, I often hear that if a patient is not better within four to six visits, then it’s time to look at other options.  It has become accepted dogma.

When IDD Therapy spinal decompression was originally developed, the clinicians who looked at back pain suggested in part that if they could work one on one with patients for eight hours a day, they would get much better results.

When people seriously embark on a diet to lose weight or train for a sporting event, they approach their goal with a level of commitment and intensity that is quite different to an approach to back pain rehabilitation.

Perhaps those involved in spinal rehabilitation should examine intensive programmes of spinal rehabilitation which are an agreed condition if a patient wishes to have an injection.

IDD Therapy spinal decompression programme offers such a programme for patients with disc related issues.  It is one method and undoubtedly not the only method.  A case study recently received from one provider detailed a 33 year old male office worker with a six month history of neck pain and headaches.

The patient received two injections during this time and felt no change.

He then embarked on a twice weekly course of cervical IDD Therapy.  After three weeks and six treatments, the headaches were gone and VAS pain was down to 1/10.  A further two weeks saw VAS pain at zero and no headaches.

That is a total of 10 treatments over a six week period.

All clinicians will have an opinion on the efficacy of injections.  The author believes that some people benefit from injections whilst for others there is no benefit, particularly without rehab.  However as with all back pain treatments, the difficulty is being able to predetermine who will benefit and who won’t!

There are significant costs to providing injections for back pain.  However as the British Pain Society point out, the unintended consequence of discontinuing pain interventions may be that more patients then access more costly interventions such as spinal surgery.

In the meantime, it would seem to make sense to reconnect spinal injections to a more intensive programme of spinal rehabilitation to help some patients return to a more active lifestyle.  If you have a comment, do share for others.

Staal JB, de Bie RA, de Vet HC, Hildebrandt J, Nelemans P. Injection therapy for subacute and chronic low back pain: an updated Cochrane review.Spine (Phila Pa 1976). 2009 Jan 1;34(1):49-59.
http://www.ncbi.nlm.nih.gov/pubmed/19127161

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

Steadfast Clinics is the international distributor of IDD Therapy spinal decompression, SDS SPINA, Accu SPINA devices, Thermedic FAR infrared therapy systems and HydroMassage machines.

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How do herniated discs occur and what are the best treatment options?

“Ouch….I’ve slipped a disc!” 

Low back pain affects over 80% of the population at some point in their lives and it’s the second most popular reason for visiting the GP after the common cold. It comes in many guises but a herniated or ‘slipped’ disc is one of the easiest things to succumb to and is one of the most difficult types of back pain to relieve. 

This article examines the ways in which herniated discs can occur and explains the treatment options available to help patients get back to their usual daily activities.

Contrary to popular belief, slipped discs are not just common to people who do manual work involving heavy lifting: many office-based workers succumb to disc problems as a result of sitting in one position for too long, putting pressure on the disc walls so that they weaken over time.

The spine is made up of 24 individual bones called vertebrae which are stacked on top of each Herniated Disc MRI scan - Pre IDD Therapy. Discs are the protective circular pads of connective tissue in between – the ‘padding’ which acts as shock absorbers, protecting the spine when we run or jump.

We cause small weaknesses in our spine all day long with prolonged sitting or standing in certain positions, for example at workstations or hunched over the ironing board.

The intervertebral discs are unlike other parts of the body in the sense that they have a limited nerve supply.

Very often we are not aware of the discs being under strain until the accumulation of months or years of stress has reached a point where small tears form in the outer disc wall. These tears can result in several months of nagging discomfort.

As a defence-mechanism against further damage, the body will often react to this situation with muscle spasm or at the very least, ‘muscle guarding’ which is when the long muscles of the spine tighten up. This causes compression of the discs and a lack of mobility in the spine. 

If this situation prevails, the tears can very often become worse and allow the inner jelly like part of the disc – the nucleus – to herniate outwards. This is referred to as a herniated, bulging or ‘slipped’ disc.

Disc problems can also cause pain in other areas of the body, the most common of which is sciatica, a grinding pain which travels down the length of the leg.  Sciatica can be caused by the bulging part of the disc squashes the nerve root next to the disc or when chemicals from a prolapsed disc irritate the nerve endings.  

Neck pain, headaches or numbness in the foot can also be a sign of a damaged disc. So, what are your options for treatment?

Your first port of call should always be a good osteopath, physiotherapist or chiropractor who will have experience in treating disc-related problems. With this type of manual therapy in most cases you should see a marked improvement in your condition in 6-8 weeks.

At the same time, if you are in so much pain that you can’t sleep then your GP can prescribe you painkillers and/or anti-inflammatory medicines which can be taken alongside physical treatment.

If you see no real sign of improvement after eight weeks of manual therapy, it would be advisable to get an MRI scan of your spine to confirm the possible causes of your pain and the location (level) of the spine affected.

If a disc problem is identified, a programme of treatment including IDD Therapy non-surgical spinal decompression may be recommended.

IDD Therapy is a computer-controlled mechanical treatment used by clinicians to gently and safely relieve pressure on specific discs, alleviate muscle spasm and increase mobility in the spine.
 
decompression[1]As part of the IDD Therapy programme, patients undergo a course of core-strengthening exercise to help them maintain their healthy spine.

In a small number of cases, patients with severe disc damage/degeneration may require invasive treatments including injections and/or surgery. Also, in rare circumstances, the patient may require immediate surgery, for example, when the bowel and bladder function is affected.

There are different types of surgery for a herniated disc, the most common is the microdiscectomy where fragments of the disc may be cut away.

Another common type of spinal surgery is the lumbar fusion where the vertebrae surrounding a disc are fused together.

Thus, there are now several treatment options available to patients with herniated discs and indeed, a wider array of effective non-surgical options allowing more patients to avoid invasive procedures.

For information about treatment options at Spine Plus or any other IDD Therapy providers, please use the form below.

Robert Shanks BSc (Hons) Ost
Clinical Director
Spine Plus
www.SpinePlus.co.uk
Spine Plus is a group of multidisciplinary clinics in London and Essex.

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