When we see patients at Bridge to Health we invariably give home exercises designed to work synergistically with hands-on treatment, and from time to time someone will ask how long they need to keep up with the exercises. The answer I give is often one they do not want to hear.

What I tell the patient is that there is a broad difference between exercise prescription and medication prescription: whereas medication is usually intended to have short-term effects such as control of infection, inflammation or pain, exercise is not a time-limited cure: it is long-term prevention, and the specific exercise is only the starting point of restoring necessary movement to a specific part of the body. When that motion can be translated into more wide-spread integrated exercise (eg. such as swimming), then there is a case for dropping those exercises. There is hardly any chance of an exercise (as opposed to medication) being beneficial in the short-term and detrimental in the long-term: it may become therapeutically neutral, but it is usually the case that the people who want to stop doing the exercises are the very ones who are unlikely to replace them with anything else.

The issue I am raising here is not about drugs and exercise: it is about attitude and understanding.  Most of the problems we have with our bodies come about due to a mismatch between our physical form and our lifestyle, and in most of those instances the problem is a lack of appropriate movement rather than a surfeit (the exceptions usually involve extremes such as weight training, impact sports, excessive stretching or high-endurance activity.) Most of the time, the problem involves insufficient regular gentle normal-range movement to maintain body tissue health, such as is often the case in chronic low back or neck/shoulder problems associated with deskwork and sedentary lifestyle.

So in answer to the question ‘when can I stop doing the exercises’, I could use stick psychology by saying: ‘when you’re happy for the problem to come back’, or perhaps for a more carrot-oriented answer: ‘when you are so interested and involved in regular gentle mobility exercise that they are effectively redundant’. The good news is that when you get it right, restoring normal motion often generates messages of comfort and ease that provide all the motivation you need to persist with those lifestyle changes.

Due to rising running costs, Bridge to Health is introducing a modest increase in treatment fees as of 1st March, 2011. This will amount to £5 on osteopathy or massage sessions, and £10 on nutritional assessments; the new prices will be as follows:

Osteopathy: £45 (£40 for Fitness First Uxbridge members, corporate clients and concessions)

Massage: £35 (30 mins) and £55 (1 hour)

Nutritional assessment and diet plan: £60

We understand that most people are feeling the pinch at the moment from price increases, the squeeze on the labour market and the government spending cuts etc., but our fees have been held steady for the last 3 years, and we will once again try to hold these prices for as long as possible.

Best wishes
Peter and Mathieu

Carpal Tunnel Syndrome is a condition affecting the junctional area between the wrist and the heel of the hand. This narrow space carries important nerves and tendons supplying the palm and fingers; when it becomes congested, there may be symptoms such as pain, numbness, tingling or weakness in the fingers or hand, or problems with manual dexterity. The congestion may be the result of a number of different general conditions involving fluid congestion, including pregnancy and rheumatoid arthritis, or it may be more local in nature. Careful evaluation of the cause needs to be made, as the appropriate treatment will vary accordingly.

Although Carpal Tunnel Syndrome is a common finding, it is also often misdiagnosed, such as in cases of problems with the base of the neck, where the nerves that supply the hand exit from the spinal column, or general tightness and congestion in the forearm itself, which is frequently found in deskbound computer operators.

Treatment

Standard medical treatment includes splinting, steroid injections or in severe cases, surgery, but it is worth starting with physical therapy such as osteopathy, because the treatment will be based on careful evaluation and diagnosis, and may prevent the need to consider more invasive methods.

Can an osteopath help?

Mathieu, Jessica and I are registered osteopaths in Ealing and Uxbridge. Please call either clinic – 020 8566 0767 (Ealing) or 01895 20050 (Uxbridge) – to speak directly to one of us about your symptoms, whether we can help and the options available (no obligation – read more about what to expect on your first visit here).

Frozen shoulder is the colloquial term for adhesive capsulitis.

What is Frozen Shoulder?
As the name implies, it is a condition affecting the capsule surrounding the shoulder joint, which is quite loose in order to accomodate the wide range of movement that your arms require. At rest, the necessary laxity manifests as an exta fold or pouch below the joint under the arm. The sides of this fold can become stuck together, no longer offering any reserve flexibility to the joint movement. This can exist as a stand-alone condition, but is often seen in conjunction with related issues such as injury, infection, immobility, diabetes, arterial disease or arthritic conditions.

Symptoms
The symptoms usually start with pain in and around the shoulder which may resolve, leaving stiffness on movement, especially preventing the arm being lifted above the head. This in itself does not easily distinguish it from a number of other conditions affecting the joint, ligaments or muscles nearby, and many more people are ‘diagnosed’ with Frozen Shoulder than actually have it. However, a trained manual therapist such as an osteopath should be able to distinguish between them by careful attention to case history and examination.

Recovery
It is not adviseable to treat prior to a clear diagnosis as the approach needs to be relevant to the individual condition, but in most cases there is significant improvement with appropriate treatment and exercise. The condition often self-resolves over a two year period, but suitable treatment can reduce recovery time to a fraction of that.

If you have been diagnosed with or you are in pain because of Frozen Shoulder ask your local osteopath if they can help. We are osteopaths in Ealing (telephone 020 8566 0767) and Uxbridge (01895 20050) – telephone either clinic to speak directly to myself, Jessica or Mathieu about your issue and the options available (I promise no obligation – click here to read more about what to expect on your first visit).

We frequently see patients who are convinced that they have a ‘trapped nerve’, but although the turn of phrase is highly descriptive, it is somewhat misleading.

On the face of it, it seems to make sense: it describes a feeling of sudden pain brought on by movement. It sometimes refers to low back or buttock pain, but perhaps more commonly to neck pain when turning the head.

The sensation occurs when a particular joint motion becomes impaired or difficult; under these circumstances, the body uses pain signals to inhibit movement and ensure that it is reduced to a more manageable speed or range. The nerves are working perfectly in the sense that they are telling you that there is a problem, but they are not the problem itself.

Osteopathy is a good choice of investigation and treatment for anything that feels like a trapped nerve because it strives to uncover the underlying cause that is producing the sensation. Treatment can then be specific and effective, rather than vague and hopeful.

There are exceptions, but often the catching sensation resolves as normal movement and activity are restored to the area in question. Diagnosis and appropriate treatment will also usually produce a more complete resolution than just waiting for it to recover; otherwise, the body simply gets used to the compromise and adapts to it, which may seem like recovery, but often results in recurring epsodes of similar discomfort. Over time, the accomodation can become more ingrained, and athough it is never too late to make a change for the better, the sooner the underlying problem is treated, the more complete the recovery is likely to be.

Can an osteopath help you? Bridge to Health are osteopaths in Ealing (020 8566 0767) and Uxbridge (01895 20050) – do telephone either clinic to speak directly to a fully qualified and registered osteopath. (click here to read more about what to expect on your first visit)

The term sciatica can be expanded to “irritation or inflammation of the sciatic nerve”.

The nerve roots emerge from various spinal levels in your low back and then gather together before running through your buttock region and down the back of your leg. If the nerve is irritated, symptoms can include loss of muscle power and/or sensory changes such as pins and needles, numbness or sharp pain. The affected area is usually the lower leg and/or foot. The nerve irritation can be associated with structural problems in the low back, such as a disc bulge, but the actual vertebral level of the irritation can vary widely and there are other possibilities such as pinching in the sacral or buttock region.

Many more people are told or believe they have sciatica than actually have it. For example, if you have low back pain radiating into the back of the leg, sciatica is one possibility but by no means the only issue. If your symptoms do not extend below the knee, it is less likely that the sciatic nerve is involved.

When you have your condition evaluated by an osteopath for the likely cause you will be able to get appropriate advice and/or treatment. Bear in mind that the term sciatica tells you nothing about where the nerve irritation is, or why it is happening. However, if your symptoms are severe, or are affecting the saddle area or you have disturbances to bladder or bowel function then you should treat it as an emergency (i.e. go to your nearest hospital’s Accident & Emergency).

An osteopath will consider your symptoms, your medical history and their examination findings in coming to a diagnosis as to what is happening to cause your discomfort. Treatment should then be specific and effective; occasionally, there may be cause for further investigation, but then you will be advised about appropriate action in the meantime. Even if you already have a diagnosis such as disc herniation, you may well benefit from treatment because an improvement to the function of the local musculoskeletal structures usually offers some relief and can speed up tissue recovery.