Category: Uncategorized

June 2020 – by Stacey Cox

Migraine is a primary headache disorder manifesting as reoccurring attacks, usually lasting 4-72 hours and involving pain of moderate to severe intensity (HIS 2004). The exact cause of migraines is unknown, although they’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain. This is thought to begin as an electrical phenomenon in the cerebrum, which goes on to affect the blood vessels and biochemistry and then cause neurogenic inflammation.

Acupuncture effectiveness for Migraines

There have been many controlled trials of acupuncture for migraines, the results of the latest reviews are quite consistent. Acupuncture is to be at least as effective as a prophylactic drug therapy with little contraindications or side effects (Linde 2009, wang 2008, Sun 2008, Scott 2008).

How acupuncture can treat Migraines

Provide pain relief
Acupuncture stimulates nerves which are located in the muscles and tissues this then leads to a release of endorphins and neurohumoral factors, which simply put changes the processing of pain in the brain and spinal cord. (Zhao 2008, Zijlstra 2003, Pomeranz 1987).

Reduce inflammation
Acupuncture promotes the release of vascular and immunomodulatory factors, which modifies the body’s immune response or functioning of the immune system (Kim 2008, Kewovsji 2007, Zijlstra 2008).

Reduce the degree of cortical spreading depression
Cortical spreading depression is an electrical wave in the brain associated with migraines. The aura phase that precedes migraine headache in about 20–30% of migraine sufferers may be a direct consequence of the events of CSD (Shi 2010).

Reduce plasma levels of calcitonin gene related peptide (CGRP) and substance P.
CGRP plays an integral role in the pathophysiology of Migraines as it’s activity spikes during Migraine attacks (Shi 2010). Many Migraine drugs aim to suppress the activity of these neuropeptides.

Modulate extracranial and intracranial blood flow
Abnormal changes in the blood vessels of the brain contributes to Migraines (Park 2009).

Affect serotonin levels in the brain
Serotonin narrows the blood vessels of the brain. When serotonin and oestrogen levels change, the result for some is a Migraine (Zong 2007).

March 2020 – by Ross Gemmell

Osteopathy, Physiotherapy and Chiropractic are three primary health care professions concerned with improving the physical well-being of patients, particularly as they overcome injuries, illnesses or disabilities.

Here at Northallerton Osteopaths we believe it is important for patients to have a good understanding of the difference between an Osteopath, a Physiotherapist and a Chiropractor before they choose which treatment option would be best for them. We believe it is helpful for patients to have an understanding of the three disciplines, their treatment goals as well as their treatment approach which is why we have put this guide together for our patients to read..

Osteopathy

What is Osteopathy?

Osteopathy is the recognized and established science of human mechanics; a system of diagnosis and treatment which lays the main emphasis on the structural and mechanical problems of the body. It primarily focuses on the musculoskeletal system, but does offer help for some circulatory and digestive problems.

Osteopaths believe in a holistic approach to healing and endeavor to find the cause of a problem. They believe that all bones, muscles, ligaments and connective tissues must work harmoniously together. As a result they often treat the neighbouring joints and structures to the problem, not just where pain is. They believe in treating the patient as a whole rather than treating only the symptoms.

Osteopathy Degree

To be an Osteopath, you have to have undertaken a 4-5 year Osteopathy university degree and be registered with the General Osteopathic Council (GOsC). Some Osteopaths complete an undergraduate degree before doing their 4-5 year Osteopathy degree.

What can an Osteo help with?

Back Ache
Back Pain
Sciatica
Arthritic Pain
Muscle Spasm
Muscle tension and inability to relax
Joint Pain
Shoulder Pain
Headaches arising from the neck (cervicogenic)
Migraine prevention
Hip Pain and Knee Pain from Osteoarthritis
Elbow Pain
Tennis/Golfer’s Elbow
Frozen Shoulder
Generalised Aches and Pains
Lumbago
Neuralgia
Fibromyalgia
Digestive problems
Circulatory problems
Rheumatic Pain
Cramp
To Aid Relaxation

How does an Osteo work?

Due to their training, Osteopaths are highly skilled in their sense of touch, otherwise known as ‘palpation’. Where other health care practitioners may rely on diagnostic measures such as X-Ray and MRI scans, Osteopaths often rely on their sense of touch to diagnose and treat patients. Osteopathy is very much a hands-on profession, treatments vary from patient to patient but may include.

• Soft tissue massage
• Joint articulation with varying degrees of subtlety
• Rhythmic stretching
• Joint manipulation
• High-Velocity-Thrust manipulation (HVT)
• Muscle Energy Technique (MET)
• Exercise prescription

Physiotherapy

What is Physiotherapy?

Physiotherapy, also known as ‘Physical Therapy’ is the physical approach to promote, maintain and restore physical health. Physiotherapy aims to restore movement and function when someone has been affected by illness, injury or disability.

Physiotherapy is a treatment where the patient is encouraged to participate in his or her care through physical exercise.

Physiotherapy Degree

To be a Physiotherapist it is usually a 3 year undergraduate Physiotherapy degree at university. However you can do a 2 year postgraduate Physiotherapy degree if you have a degree in a relevant subject such as; Sports Science, Biological Science or Psychology. To practice Physiotherapy in the UK, by law you must be registered with the Health and Care Professions Council (HCPC).

What can a Physio help with?

Broadly speaking, physiotherapy aims to improve conditions that affect the following four systems of the body.

1. Neurological (Stroke, Parkinson’s disease, Multiple Sclerosis)
2. Musculoskeletal (Back pain, Muscle pain, Fractures, Post-Operative)
3. Cardiovascular (Cardiovascular diseases, Heart attack, Stroke)
4. Respiratory (Asthma, Cystic Fibrosis, COPD)

How does a Physio work?

Physiotherapists will work with their patients in a number of ways;

• They will offer education and advice to the patient
• They encourage the patient to participate in his or her care through physical exercise and prescribed exercises
• They may treat patients actively through manual therapy & other techniques

Education and advice

Physiotherapists can play a key role in the management of conditions affecting the Neurological, Cardiovascular, Musculoskeletal and Respiratory Systems as they offer education and advice. Prescribed exercises and lifestyle management would also be included in the education and advice offered by a physiotherapist.

Manual therapy

Whilst it is less common for a NHS Physio to offer hands-on manual therapy, some Physiotherapists still use manual therapy to mobilise the soft tissues of the body. The end goal is to relieve pain and stiffness, improve general circulation, promote motivation and ensure relaxation.
Some Physiotherapists may undertake additional specialist training to perform thrust manipulations to the spine, however for Osteopaths and Chriopractors this training is included in their 4 year university degrees.

Other Techniques

• Acupuncture (Dry Needling)
• Electrical nerve stimulation
• Ultrasound

Chiropractic

What is Chiropractic?

Chiropractic treatment typically focuses on the patient’s spine and most people will seek out a Chiropractor for problems with their back.
The philosophy of Chiropractic treatment is that joint misalignment causes back pain as it compromises the body’s central nervous system. Chiropractors are therefore concerned mostly with the position of joints and often use diagnostic tools such as X-Ray and MRI scans assess this.

Chiropractic Degree

To be a Chiropractor you must have undertaken a 4 year Chiropractic university degree and be registered with the General Chiropractic Council (GCC).

What can a Chiro help with?

Chiropractic treatment is similar to Osteopathy as they are both manual treatments. Chiropractors sometimes use massage to manipulate the body’s soft tissues but generally speaking they are mostly concerned with ‘adjustments’ to the spine. The Chiropractor may use moderate force while working on the bones and muscles around the spine. Chiropractors typically make spinal adjustments by performing short quick thrusts on the patient’s spine.

As with osteopathy and physiotherapy, your practitioner will also advise you on a range of diets, exercises and nutrition to help prevent a further recurrence of your condition.
As well as back, joint, hip and foot problems, it has been suggested that chiropractic therapy may be useful in the treatment of the following conditions.

• Headaches
• Migraine Prevention
• Tension and inability to relax.
• Uncomplicated mechanical neck pain

How does a Chiro work?

Treatment involves spinal manipulation, and a Chiropractor will often make small ‘adjustments’ to the position of the lumbar vertebrae to relieve pressure and alleviate pain. These adjustments are what cause the familiar cracking or popping noise associated with Chiropractic treatment, the audible ‘pop’ noises are caused by small pockets of gas in your joint fluid.

Chiropractors sometimes also use small hand-held tools to treat back and neck pain. The Activator Method involves using a small spring-loaded instrument called an Activator Adjusting Instrument that delivers a single thrust at the determined site to correct a malfunctioning joint.

February 2020 – by Ross Gemmell

We are often asked what is the difference between an osteopath and chiropractor. To tell the truth, we have more similarities than differences.

Similarites

Both professions;

• Focus on the diagnosis, treatment and prevention of disorders within the musculoskeletal system.
• Use hands-on manual therapy to treat the patient
• Are specially trained to deliver thrust manipulations to the spine, which may produce an audible ‘click’.
• Give exercise and posture advice to further promote their patient’s recovery
• Require a minimum 4 years university training

What differs is the philosophy of Osteopathy and Chiropractic.

Differences

What they treat

An Osteopath will take a more holistic approach and view the body as a whole, and believes that all bones, ligaments, muscles and connective tissues must work harmoniously together. A Chiropractor would mostly be concerned with treating the spine, but may treat the shoulders, hips and knees.
How they assess

A Osteopath is trained to develop a highly sensitive sense of touch (palpation), and uses their hands to observe the structure and function of problem areas.
A Chiropractor often uses diagnostic equipment such as X-Ray and MRI scans to determine the position of the spine and it’s joints.
An Osteopath is concerned with how joints and their neighbouring structures move, whereas a Chiropractor may be more concerned with their position and ‘alignment’.

How they treat

An Osteopath will use a wider variety of techniques. As well as the spinal manipulations, they also utilise more gentle ‘indirect’ techniques such as functional, positional release and cranial techniques to observe subtle strains throughout the body and address them accordingly. They also frequently use soft tissue massage and stretching techniques.
Some Chiropractors may work on the muscles, however they are primarily concerned with manipulating the spine, known as ‘adjustments’.
A Chiropractor may also use a small hand-held tool to treat back and neck pain. The Activator Method involves using a small spring-loaded instrument called an Activator Adjusting Instrument that delivers a single thrust at the determined site to correct a malfunctioning joint.

Treatment length and frequency

An Osteopath treatment is usually 30-45mins.
A Chiropractor session tends to be shorter at 15-20mins and mostly involves ‘adjustments’.
Osteopath treatments tend to be around one a week initially, and as the condition improves the patient will attend less and less frequently dependent on their individual needs and pay as they go.
Chiropractic sessions are sometimes sold as courses, in the example of 10 sessions being required, they are sold as a block and the patient may visit 2-3 times per week for several weeks.

To conclude, the philosophy of both Osteopathy and Chiropractic are open to interpretation to the individual practitioner, there are many Osteopaths practising like Chiropractors, just as there are many Chiropractors practising like Osteopaths. No one profession is better than the other, both are highly skilled practitioners when it comes to dealing with problems areas in the musculoskeletal system and you should expect an excellent service from either professional.

Summary

Osteopathy

• Primarily treats the musculoskeletal system (MSK) of the body and injuries/conditions arising from here
• Some Osteopaths may treat respiratory and digestive ailments
• Has a wide array of techniques, including but not exclusive to soft tissue massage, joint articulations, spinal manipulations (clicks)
• A primary complementary or alternative medicine (CAM) not usually offered on the NHS
• Hands-on therapy to detect, treat and prevent dysfunction of the bones, muscles, ligaments and joints of the MSK
• Views the body as a unit and as a whole. Treats neighbouring joints and structures
• Holistic approach and treats all joints and areas of the body, looking for the cause of an issue
• Go by what they feel through palpation
• Requires 4-5 years university degree training
• Registered with the General Osteopathic Council (GOsC) and have their title as an Osteopath protected by law
• Cranial techniques are used by some osteopaths, where they can detect extremely subtle strains throughout the body

Chiropractic

• Deals primarily with spinal manipulation, known as ‘adjustments’
• Most chiropractors do less work through the muscles and other soft tissue structures of the MSK
• Treatment works primarily with the spine, however can be used to treat the shoulders, hips and knees
• Chiropractors believe if the structure of the spine is healthy, then the nervous system is healthy
• A primary complementary or alternative medicine (CAM) not usually offered on the NHS
• Often tools are used such as the Activator Method
• Requires 4 years university degree training
• Registered with the General Chiropractic Council (GCC) and have their title as a Chiropractor protected by law

February 2020 – by Ross Gemmell

Osteopathy and Physiotherapy have plenty of similarities. They both aim to improve the physical health and quality of life for the patients that they see.

However, what can differ is the way that they go about this and the type of patients that they may see. Whilst there is some crossover and certain conditions can be successfully treated by either professional, it is important you understand the difference between the two as your condition may be better suited to one profession over the other.

Lets have a look at how they differ.

Job Role

Osteopaths are specialists when it comes to dealing with the Musculoskeletal (MSK) system. This means they often see people who are experiencing pain or injury such as; back pain, neck pain, hip pain, sports injuries and muscular spasm. Some Osteopaths also deal with digestive and respiratory ailments.

Physiotherapists work with injuries of the MSK as well, but they also focus on conditions arising from other systems of the body (Neurological, Cardiovascular and Respiratory). This means that they also deal with conditions such as MS, Parkinson’s disease and COPD, or help patients as they recover from a Stroke or Heart attack.

How they work

Osteopaths are trained to develop a highly sensitive sense of touch and use ‘palpation’ to diagnose and treat their patients. This makes Osteopathy a very hands-on profession and they use techniques such as soft tissue massage, joint mobilisation and spinal manipulation to improve the structural and mechanical problems of the body. To complement this, an Osteopath will prescribe home exercises to the patient if they deem it necessary.

Whilst Physiotherapists do use hands-on techniques, it is less so in comparison to Osteopaths, particularly with the NHS. Physiotherapists working in the private sector may use more hands-on techniques, but this is generally dependent on the individual. Physiotherapists will use a wider range of techniques that do not require any hands-on involvement such as exercise prescription, ultrasound, hydrotherapy and electrotherapy to name a few. Physiotherapy is also known as ‘Physical Therapy’, and as a result exercise prescription is often at the core of a patient’s rehabilitation. This means that the patient is encouraged to participate in physical exercise as part of the treatment process.

The philosophy of Osteopathy is that the body is a unit and should be treated as a whole. This means it is common for Osteopaths to treat neighbouring joints and structures if they feel it is relevant to do so. As a result they look for the cause of an issue rather than only treating where the pain is.

For the MSK system, Physiotherapists commonly monitor specific muscle groups and parts of the body rather than the whole body. However, they also believe in taking an holistic approach to dealing with their patients.

Qualifications

Both Osteopaths and Physiotherapists are highly skilled and trained in their own rights, and you should expect an excellent service from whomever you see.

To be an Osteopath you need to have an accredited Osteopathy degree, which usually lasts 4-5 years and also be registered with the General Osteopathic Council (GOsC) by law.

To be a Physiotherapist you need to have an accredited Physiotherapy degree and be registered with the Health and Care Professions Council (HCPC) by law. A Physiotherapy degree usually lasts 3 years, however you can take a 2 year postgraduate Physiotherapy degree if you already obtain a degree in a relevant subject such as; Sports Science, Psychology or Biological Science.

Summary

Osteopathy

Primarily treats the musculoskeletal system (MSK) of the body and injuries/conditions arising from there
Some Osteopaths may treat respiratory and digestive ailments
Primarily a hands-on therapy to detect, treat and prevent dysfunction of the bones, muscles, ligaments and joints of the MSK
Has a wide array of techniques, including but not exclusive to soft tissue massage, joint articulations, spinal manipulations (clicks)
Views the body as a unit and as a whole. Treats neighbouring joints and structures
Holistic approach and treats all joints and areas of the body, looking for the cause of an issue
Trained in diagnosis
Trained to develop a highly sensitive sense of touch (palpation)
A primary complementary or alternative medicine (CAM) not usually offered on the NHS
Requires 4-5 years university degree or masters training in Osteopathy
Registered with the General Osteopathic Council (GOsC) and have their title as an Osteopath protected by law

Physiotherapy

Offers rehabilitation to all the major systems of the body, including MSK, Neurological, Respiratory and Cardiovascular
Is the physical approach to promote, maintain and restore physical health
Involves patient participation in their rehabilitation via physical exercise
A means of restoring balance, independence and strength after severe trauma, injuries and operations
Other techniques such as manual therapy may be used
A course of physiotherapy is typically tailored to the area of the body where the symptoms are
Physiotherapy is freely available on NHS
Requires 3 years university degree training in Physiotherapy
Some Physiotherapists can do a 2 year postgraduate Physiotherapy degree instead if they already have an undergraduate in a relevant subject (i.e Sports Science, Psychology)
Registered with the Health and Care Professionals Council (HCPC)