Tag Archives: Herniated disc

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

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 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.

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

Help for Back Pain Sufferers in Croydon with IDD Therapy Treatment

For back pain sufferers living in and around Croydon, help is at hand with advanced targeted treatment at one of the leading clinics in the area.

IDD Therapy Back Pain TreatmentIDD Therapy is a non-invasive spinal decompression treatment which treats targeted segments of the spine to help unresolved conditions, particularly where there is a disc-related condition such as a herniated disc (‘slipped disc’) and sciatica.

The Osteopathic Clinic of Physical Medicine is led by clinic director Paul Morrissey.  Paul has led the way in Surrey by introducing new techniques and treatments such Shock Wave, as well as establishing a fully equipped pilates centre.

Paul is part of a network of UK IDD Therapy providers and says:

“For several years I watched with great interest the developments in IDD Therapy non-surgical spinal decompression.

After experiencing the treatment for myself and hearing the positive experiences of other UK clinicians and their patients, I was keen to introduce the IDD Therapy programme at our clinic.

IDD Therapy helps patients suffering with persistent back or neck pain who are not making improvement with manual therapy alone. There is no such thing as a cure-all for back pain, but the IDD Therapy treatment programme offers real opportunities for patients who need something more their pain.”

Whether you have simple back pain or a complex condition, with Paul and his dedicated team, patients can be assured of being in safe hands.  For more details visit www.osteopathclinic.co.uk/idd-therapy or call Croydon 020 8662 1155.

For more information about IDD Therapy treatment in general, visit www.iddtherapy.co.uk .

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
http://www.SteadfastClinics.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