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Tewkesbury’s local experts in clinical chiropractic & remedial massage.

Call today on 01684 291 261 to arrange a free chat with Aidan (our chiropractor).
We'll let you know if we can help you, and if we can't, who can.

NB: This is a blog of our personal opinions, and is provided as a brief overview of things we think you might find interesting.

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  • The rotator cuff is a group of 4 muscles which hold your arm to your shoulder blade. Despite their group name they do not cause much movement of the joint, rotation or otherwise; rather they stabilise and control the movement caused by other, larger muscles.

     

    These muscles are particularly prone to overuse or repetitive injuries, traumatic tearing, or impingement from other structures. It can be cause by any repetitive action of the shoulder, fall onto the shoulder, or simply the process of aging. Often, the pain associated with this condition is experienced as an ache in the shoulder that increases to a sharper pain or catching pain with certain activities. Occasionally, pain may also be experienced in the upper arm, shoulder blade, upper back or neck. Weakness or a feeling of instability for the shoulder or arm, is often a hallmark of this condition. The POLICE protocol for tissue healing should be applied; with ice massage and the optimisation of the tissue load (rest, massage, gradual strengthening) being particularly useful forms of treatment for these conditions; whilst unresponsive cases may require steroid injections or even surgery.

     

    You can find out more here:

    www.physioadvisor.com.au/injuries/shoulder/rotator-cuff-tear

    www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/rotator-cuff-strain

    www.physio-pedia.com/Calcific_Tendinopathy_of_the_Shoulder

    Right shoulder from the front

    Testing for a possible rotator cuff tear

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Sciatica 16 November 2018 | Comments (0)

    Let’s take a look at sciatica.

     

    Sciatica is the term given to symptoms experienced from compression or irritation of the sciatic nerve; it is not a diagnosis so much as a collection of symptoms; so a diagnosis will still be needed before starting treatment. The sensation of sciatica will be familiar to anyone who’s banged their “funny bone”; but located in their buttock, leg, foot and sometimes the back. Different diagnoses result in different treatment plans and different expectations for recovery, same may resolve in days, whilst others may never resolve completely.

     

    Whilst most cases resolve within a couple of weeks; for those that do become chronic, the best thing you can do to improve the prognosis, is to start treatment sooner; which is a bit of a catch 22. As a rule of thumb, if the sciatica is significantly reduced after 5-6 days, then you shouldn’t need any treatment; if it is barely improved, or still worsening, then treatment might be a good idea, even if it’s just in the form of advice on how to manage the pain at home, and prevent it coming again.

     

    You can find out more here:

    www.chiro-trust.org/back-pain/low-back-and-leg-pain-is-it-sciatica

    www.nhs.uk/conditions/sciatica/Pages/Introduction.aspx

    Sciatica

    Pain from Sciatica

    Managing low back pain and sciatica

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Medical Imaging 09 November 2018 | Comments (0)

    Yesterday was the International Day of Radiology, so let’s take a look at medical imaging.

     

    First of all, I love a good X-ray or an MRI / CT scan.

    However, they are not always appropriate, and just like opioids, or statins, they have been overprescribed recently, and making the news.

    Medical imaging will show you the gross anatomy, and whether it is “normal” or “abnormal” or even “normally abnormal”. It will not tell you whether what it shows is clinically relevant; it just adds to the overall clinical picture.

     

    Imaging carries risks, whether the risks of radiation (X-ray / CT scan) or just the risk of false-positives; that is, an abnormal finding that is irrelevant to the patient’s wellbeing – until they find out, at which point it becomes a negative to the patient’s perception of their wellbeing.

    For example, a researcher called Brinjikji in 2014 found that, if you took MRI scans of a completely healthy people, ½ of all 30 year olds will have a degree of “disc degeneration”; ½ of 40 year olds would have a “disc bulge” and ⅓ of 50 year olds would have some “facet degeneration” (AKA osteoarthritis). This proves that these things can be completely normal, and not lead to any problems – which doesn’t mean that they can’t, just that it’s normal, and doesn’t have to be acted upon.

     

    Imaging of biomechanical complaints should NOT be done “just in case” or “to have a look”; imaging should NOT be done to reassure the doctor or the patient. For non-traumatic, non-complicated cases, the image is highly unlikely to change the treatment plan for the better; but might well change it for the worse. You may feel that your doctor isn’t listening to you when they opt not to send you for imaging, but it will generally mean that they’re simply following current guidelines.

    Imaging absolutely SHOULD be done in cases where there are red flags for a serious pathology (such as unexplained weight loss; loss of swallowing/bowel/bladder control; high fever; or loss of feeling/strength in the legs or arms). It SHOULD be done in patients who don’t recover as expected (such as failing to improve with less-invasive care; or failing to improve significantly after 2 months duration).

     

    You can find out more here:

    www.choosingwisely.co.uk

    www.choosingwisely.org/patient-resources/imaging-tests-for-back-pain

    Reliability of Reading MRI Scans for Low Back Pain

    Incidence of False Positive Findings in the MRI Scans of Symptom-free Individuals

    Colour MRI Scan of the Neck

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    Let’s take a look at plantar fasciitis.

                   

    Plantar fasciitis is the most common cause of heel pain, accounting for around four out of five cases.

    The plantar fascia is the thick band of tissue that connects the heel bone with the rest of the foot, forming the arches of the foot, and is essential in the spring mechanism when toeing off in gait. The plantar fascia can become damaged and thickened either by trauma, or through the micro-trauma of gradual wear and tear. The plantar fascia share fibres with the achilles tendon, and it is often a good idea to look at both of these areas for treatment, along with things like footwear, gait etc.

     

    The symptoms of plantar fasciitis can come on over the course of several hours to several days; and will often get worse with time; potentially leading to the formation of heel spurs. Patients typically experience sharp pain and tenderness in the heel, or sole of the foot; which can be aggravated by activity, or by prolonged rest. There are many, many potential causes of plantar fasciitis; and getting to the root cause of the issue for an individual can often be the single most useful piece of information for treating them. However, treatment with the POLICE principal of Protection, Optimal Loading, Ice, Compression and Elevation; specifically with ice massage, stretching and strengthening the muscles of the foot and ankle are also useful in most people; but they may have limited use on preventing recurrence.

     

    You can find out more here:

     

    www.physioadvisor.com.au/injuries/foot/plantar-fasciitis

    www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/plantar-fasciitis

    Plantar Fasciitis

    Self-Care for Plantar Fasciitis

    What Plantar Fasciitis feels like

    At Back In Action we also offer free consultations. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your free no obligation consultation.

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    Osteoporosis 19 October 2018 | Comments (0)

    Tomororw is World Osteoporosis Day so let’s take a look at Osteoporosis.

     

    Osteoporosis is a metabolic condition where the calcium leaches out of the bones, leaving them less dense, more porous and brittle; leading to an increased risk of fracture. Bone density is only really built up in the first 25 years of life, held stable for the next 15 or so, before reducing naturally with time; more rapidly with the menopause. Thus it is important for later-life health that teenagers and young adults have a diet higher in calcium (dairy, collards etc) and partake in regular weight-bearing exercise, preferably with a degree of impact (eg. running, boxing, dancing etc); as this will help stockpile calcium in the bones to start with. The same advice, with additional vitamin D and vibration training can help slow the leaching of the bones in those aged over 45.

     

    NB: Whilst chiropractic and massage cannot treat osteoporosis, or the fractures it can result in; this does not mean that we cannot treat you. You will need to let us know that you suffer from osteoporosis, so that we can make allowances within the treatment plan.

                   

    You can find out more here:

    www.iofbonehealth.org

    www.nhs.uk/conditions/Osteoporosis/Pages/Introduction

    www.physio-pedia.com/Osteoporosis

    Osteoporotic Changes Visible on X-Ray

     

    Bone Health Over Time - Osteoporosis

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