I get asked a lot of questions about physiotherapy assessment. What do we do at my clinic? How do I assess? How do I teach assessing?
In my previous blog A Different Perspective On Your Physiotherapy Assessment, I mentioned that the first and most important thing is to have a safe, quiet environment that builds a connection and trust. If you don't feel that with your physiotherapist, you're not going to want to proceed to any kind of medicine or treatment and your outcome won't be as successful. There won't be that connection.
To recap, the most important thing for the patient is that the physiotherapist has created a sacred space, a quiet office, where the phones are switched off, the computer is not a distraction, and you eyeball each other to get that connection. And then your physiotherapist listens to your story. And how you describe what's going on with you. And then, in that moment of connection, your physiotherapist can get glimpses of the real authentic self behind the story, who you really are.
Once your physiotherapist glimpses the story of the problem, he or she can start to elicit some background which is past medical history. So we'll ask questions like the health of your family to see if there are relevant genetic links. We may also explore your beliefs and values and more about your family so we'll know how difficult it is for you to attend and for you to have the necessary treatment. We may touch on your past experiences of treatment because if you've been scared or let down previously, you're going to have very different expectations. We need to address that head-on.
And then, of course, my favourite four keys questions (see my first book ‘The Four Keys To Health’ available on Amazon), which looks into your mindset, lifestyle, fitness and what you eat. All these help us assess how well your immune system is working, and your general health, which helps refine our treatment prescription.
That, in a nutshell, is the first part of the physiotherapy assessment.
In my next blog ‘The Subjective Physiotherapy Assessment – Part 2’ I will continue on this journey of helping you understand how to really get the most out of this process.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
Physiotherapy Treatment For Vertigo Caused By BPPV
Vertigo is a problem that affects around half the population at some point in their lives and is more common as we get older. Fortunately, the symptoms usually only last for a few seconds to a minute or so, but the symptoms are very unpleasant including:
• Nausea and vomiting
• Dizziness
• Fainting
• A sense of rotating
• Inability to stand or walk
What Causes Vertigo
It is widely accepted as the most common cause of vertigo is BPPV (Benign Paroxysmal Positional Vertigo) and this is linked to the 3 semi-circular canals in the inner ear. The role of these canals is to sense the position of the head in the 3 axes of up /down, right / left, forward/ backwards. If any incorrect signals occur, the brain doesn’t know where your head is and gets confused.
Faulty signals are caused by very small chalk crystals becoming loose and getting into the semi-circular canals. These loose crystals then move in the canals, stimulating faulty signals.
The types of movement which most frequently initiate a vertigo attack are rolling over in bed, getting out of bed, sitting up after lying flat or looking up or down.
Vertigo Treatment
Left untreated, vertigo will usually resolve itself but may take several months. Fortunately, treatment is fairly simple and painless and typically no more than 3 specialised Physiotherapy treatments are needed over a couple of weeks.
David Paling, a senior physiotherapist and our clinical lead can diagnose and treat BPPV.
If you or someone you know is suffering from vertigo, then physiotherapy treatment with us should seriously be considered.
Call the clinic now on 01889 881488 and ask for an assessment with David.
Most people have heard of acupuncture and understandably assume that if a treatment involves a needle, it must be acupuncture. This is akin to saying that everybody who uses a knife must be a surgeon. Our task here is thus to look in depth at all the ways that needles are used, so that you better understand what the differences are and thus eliminate the confusion surrounding this type of treatment. By doing so, it will also hopefully help you gain confidence to try this form of treatment in the future and help you seek out the best type of practitioner for your problem.
History
Historically, the use of the needle for treatment started in the east, most probably in China, many thousands of years ago. Thus, there have been thousands of years to refine and improve the understanding of acupuncture in Chinese Medicine, the latter being a complete medical system which looks at the whole body. It regards illness as the body being out of balance and thus seeks to identify why it is out of balance and then treats to redress this.
What Is Acupuncture?
Today’s acupuncture uses very thin needles, much thinner than a hypodermic needle. These are inserted in the body at prescribed Chinese points which have a known therapeutic effect, or directly into an area of muscle spasm or pain. The needles are generally inserted and then left for anything up to 30 minutes.
Electro-Acupuncture
Electro-acupuncture was originally developed for use as analgesia in surgery. However, the benefits of electro–acupuncture were soon recognised for the control and treatment of pain. Research is still ongoing to better understand the best settings to use and the technology is thus continuously evolving.
The equipment we use in house allows us to vary the settings to help you in the best way possible. It is understood that the use of different frequencies can stimulate the release of natural opioid pain killers in the body and that by using dual frequencies, both the intensity and longevity of the pain control can be varied.
A benefit of using needles with this type of electrical signal is that the pain relief can be applied at deep levels, within the muscles that are causing the pain.
Western Acupuncture
Western acupuncture as taught today is a small subset of Chinese acupuncture, combining needling to local areas of pain or spasm, ‘Ah Shi’ points, sometimes called trigger points, plus some use of Chinese points, but without reference to Chinese theory.
Needles are used in the same way as Chinese medicine and the types of needle are the same. The focus in western acupuncture is to link the treatment to western medical principles, which requires ‘evidence based’ justification. This is discussed below in the Acupuncture in the NHS section.
Chinese Medicine is a complete standalone medical system and is totally different to western medicine. By teaching and using Chinese acupuncture points, western acupuncture in effect has a foot in both camps.
Intra Muscular Stimulation – GunnIMS
The majority of acupuncture needling is performed at relatively shallow depths in the body. As explained above, the needles are inserted and left static until removed.
GunnIMS is completely different.
Professor Chan Gunn, a medically qualified Doctor, discovered GunnIMS by accident while carrying out tests in a laboratory in Vancouver, Canada. He found that patients were in pain, quite often long term, or chronic, pain, because of muscles being in spasm. In addition these muscles were not responding properly to the signals from the brain to expand and contract. He found that by inserting needles into these non-responding muscles, those same muscles could be made to release and start behaving normally. To effectively release a muscle he found that multiple insertions were needed, using the needle more as a microsurgical tool rather than a simple insertion device.
Eventually GunnIMS evolved to using an external device, called a plunger, which allowed the therapist to rapidly and easily retarget the needle to achieve the required result.
GunnIMS is fundamentally different to acupuncture
The results in treating muscle pain are far superior. It utilises western anatomical knowledge and makes no reference to Chinese Medicine. It generally requires much deeper needling and directly targets and micro surgically treats muscles in spasm. The training is thus totally different and only those practitioners trained through the Institute for the Study and Treatment of Pain (ISTOP), based in Vancouver, are qualified to provide GunnIMS. Nicky Snazell is one of only 3 practitioners in the UK to have reached the highest level of training and was awarded the first honorary membership of ISTOP in the world for her dedication to the use of GunnIMS.
Nothing Is Wrong
A major strength of GunnIMS is that it is unsurpassed in diagnosing and treating muscle spasm. Both MRI and X-ray cannot ‘see’ muscle spasm, it is totally invisible to these scans. Thus many patients who may have been in long term pain and given a scan, only to be told ‘nothing is wrong’ will now understand why.
Dry Needling
Dry needling refers to the use of a non-hypodermic needle. Acupuncture needles are solid, they cannot inject a drug. Thus they provide a dry and not wet treatment.
Hypodermic needles, which are used to inject drugs, are relatively much thicker and more painful to insert. This is perhaps why so many of us grow up with needle phobias.
It may at first seem that both acupuncture and dry needling are the same. After all they are both dry techniques. But there the similarities end. Whereas acupuncture is a traditional method developed thousands of years ago, dry needling is relatively new, only having been adopted in the last few decades.
Dry needling is primarily used to treat tight muscles, or trigger points, to ease muscular pain. In some cases the needles are inserted and left for a number of minutes. In some cases the needles are moved up and down to increase the effect.
The term Dry Needling is tending to replace GunnIMS as the teaching of dry needling is much more widespread. In many cases there is an overlap with GunnIMS. However, GunnIMS specifies that only Medical Doctors and Physiotherapists (in countries with the highest standards) are qualified to be trained, it also requires intensive training and passing exams. Dry needling courses can be attended by less qualified therapists and can involve little more than a weekends training.
Does Needling Hurt?
Our skin has a lot of nerves to sense touch, hot and cold, pressure and pain. However, once a needle has gone beyond the immediate outer layer, there are very few pain sensors.
A skilled practitioner understands this and will penetrate the skin very quickly, so that you would feel nothing more than a small prick. (no pun intended)
TCM will aim to penetrate to the layer of fascia where the patient gets a very definite sensation which is almost totally painless. Thus the majority of TCM and those western practitioners who use TCM points, will be almost totally painless.
The next level of needling is dry needling into tight muscles, or trigger points. This can cause pain, usually only slight and short lived.
Again, an experienced practitioner can use skills and technology to largely alleviate the pain response. Firstly, by using a therapeutic laser, which will generally penetrate up to 30mm into the body and greatly help to relax muscle spasm. In fact ‘Laser puncture’ refers to the use of a laser over TCM points, and can be helpful in treating patients without needles.
The second and more powerful technique to minimise a pain response is by first acupuncturing specific points which are known to minimise pain signals reaching the brain and others that will put the patient into a relaxed meditative state. This is no different to the same procedures used in China and now used in the USA for pain control in surgery.
A healthy, normal muscle has very limited ability to even realise a needle has penetrated it and in this situation a patient is unlikely to be aware at all. At times muscles will go into severe spasm and fail to respond to normal expand and contract commands from the brain. A very common example is low back pain and sciatica.
If you feel that acupuncture or GunnIMS could help you then please call us on 01889 881488 to book now.
Our staff capabilities are at the highest standard available in the UK.
Availability Of Treatment Has Never Been More Important
With the daily media bombardment about COVID, it is no wonder that fear is generally growing. Fear of the social impact of another lockdown, fear of the uncertainty of our livelihoods and even fear of our very existence. Staffordshire has announced that it will go to Tier 2 at midnight on Friday and this will inevitably raise the fear factor higher.
Mental health has taken a back step with this pandemic and never before in my working life has there been so much anxiety, loneliness and grief hidden away in society.
Your pain, whether physical, mental or both, isn’t going to disappear and many of you are going to need a lot of help in the coming months. Increasingly, we are being asked to help guide people through these difficult times both mentally and spiritually, the latter problems only serving to multiply the actual physical pain.
We Are Staying Open
We know that stress lowers our immunity and raises our sensitivity to pain. Gold standard trials have also proven a relationship between lifestyle stressors and white cell count. What this means is that stress, if left untreated, will slow down your ability to heal, plus worsen your response to pain, inflammation and disease. Yet psychosocial pain is, I believe, wrongly still an afterthought in western medicine, even though more often than not, it holds the key to hidden trauma and deep emotional stress.
At this clinic, we have long recognised the importance of looking at the whole person, rather than just the location of pain. That’s why, even though I am highly qualified in western medical techniques, I have written 5 books on a more holistic approach. In my first book, The 4 Keys To Health, I introduced a simple traffic light scoring system which encompassed the psychosocial factors that affect our health and which can cause so much of our pain.
Our goal is thus to help people in all aspects of their health and never before in my lifetime has there been such an urgent need for this approach. Beyond treating your pain, we wish to get you to as close optimum health as possible to help protect your immune system.
That’s why at the clinic we love to build a relationship with our clients to prescribe a tailor-made treatment plan, working out the best way to help with the mind set and adding in massage, and technology such as laser, shockwave, deep oscillation, acupuncture and IMS dry needling.
Keeping Abreast Of Research
We are constantly monitoring recent research to find new techniques to help. As an example, a recent Harvard trial successfully used electroacupuncture to improve survivability in COVID infected mice. This is highly relevant research, as in some cases it has been shown that it is the human bodies over response to COVID infection which has caused excessive inflammation [cytokine storm], leading in some cases to death. The research findings are significant. Electroacupuncture treatment before the cytokine storm increased survivability by a factor of four, from 20% to 80%. When applied after the cytokine storm, survivability increased by three-fold, from 20% to 60%. Both are huge benefits and it emphasises the benefit of preventative treatment.
As a result of our integrative approach to treatment, combining orthodox western medicine with alternative, we routinely carry out electroacupuncture here.
For those of you who need our help, we are open and will continue to be open unless forced to close by government ruling.
None of us know how long this pandemic is going to last, but the expectation is that it’s going to be a long time. If the availability of treatment is shut off there is going to be a drastic rise in pain and suffering. We have already seen this in the lockdown with patients begging us to see them. That’s why I believe it is so important that we stay open in the coming months.
Our patients are so grateful that we are here now to help them with their pain, pain they suffered for months without any help during lockdown. They have bombarded us with thanks. We will continue to stay open and help you unless and until the government dictates otherwise. Sadly, the chances are there will be few, if any, alternatives for you.
Control Your Stress Now And Improve Your Resistance To Disease
While the government is correct to react to rises in cases, we each need to keep in perspective what the tier trigger points represent, so that we can keep better control of our stress. Tier 2 is triggered at 100 per 100,000 population. Put another way, on average you would need to get close to 1000 people before you are likely to be near a COVID positive risk. How likely, if you are careful, are you to interface closely with 1000 people, especially in these troubled times? Maintain social distancing and always wear a mask to reduce your chances of infection further.
What does this tell us? Mix only with people you are reasonably sure act sensibly and act sensibly yourself. Nothing is guaranteed in life, but by acting sensibly and taking all possible precautions, you can use your own positive response to improve your health.
What We are Doing About COVID-19 At Nicky Snazell Clinic
COVID-19 has had a dramatic affect on all our lives and not surprisingly at Nicky Snazell Clinic as well. Our foremost concern is the safety of patients and staff and we strive to stay fully up to date with the almost daily changes and wherever possible keep ahead of the curve. More on that later.
Screening
Even if you are an existing patient, but definitely if you are a new patient, we will take you through a screening process to make sure it is safe and justified for you to come in for treatment. There will be quite a few questions, and we ask you to bear with us on this as it’s all in our best interests. For sure, the questions asked will constantly change in line with latest guidelines. Where the risk is deemed higher, then a more detailed assessment will be needed with a physiotherapist, before treatment can be authorised.
Please note that in cases where you may need to be accompanied, then that person also has to pass screening to be allowed on site.
Changes At The Clinic
All of our 13,000 plus patients will know that our aim has always been to create a welcoming, peaceful and relaxing environment from the moment you walk in the door. Well that of course, to an extent, went out the door when we adjusted rapidly to the pandemic. Our waiting room has been effectively closed and patients are now asked to wait in their cars until their allotted start time. At that point they should come in alone with a face mask on, use the readily available hand sanitiser and their therapist, wearing full PPE, will take them to the treatment room.
At the end of the appointment the therapist will, if necessary, book a follow-on appointment and we then ask that you go to reception, where we have installed protective screens, to pay in advance for the next appointment. To speed this process, we now only take payment by card and by touch whenever possible. Where a payment requires a pin, the terminal is sanitised after use.
We then ask that you leave the clinic immediately as we want to minimise time that patients are in the clinic. Please don’t think we are being rude if we don’t chat as we used to. We are minimising your time on site. We have also staggered the start times between therapists, to avoid multiple patients being on site outside of a treatment room at the same time.
Cleaning
All rooms are sanitised between treatments and thus treatment times will be slightly shorter. In addition, we use a spray which lasts up to 5 hours on surfaces and this is used on all common touch points every 3 hours. Thus, for example, when you open the door to come in, you can be sure that the handle and surrounding woodwork will have been sprayed and is as safe as is practical.
We understand of course that some patients will need to use the toilet and we request that if needed, you first advise us so that we can sanitise after each use. Note, however, that the toilet is also thoroughly sanitised every 3 hours with our 5 hour effective spray. Please try to avoid the need to use our facilities wherever possible.
Your Part
We require that you use a face mask which covers your mouth and nose at all times while inside the clinic. All of the available scientific information supports the need to wear masks inside a building. It is important for each of us to realise that wearing a mask helps protect those around us from us. By not wearing a mask properly, this would be putting our staff at additional risk and this is not acceptable.
Patients at times have found difficulty in wearing a mask, but we politely request that you must do so for the short time on site. Bear in mind that our staff are in full PPE all day to protect you.
Patients who do not comply with this request may be refused further treatment.
We also need your help in running to time. It is vital that you have vacated the treatment room on time, leaving sufficient time for the room to be sanitised. Any overrun will mean that patients will be held in the waiting room and this is not acceptable.
Payment In Advance
We have changed our payment procedure, as we now ask for payment in full at time of booking and in 99.9% of cases this has been fully understood and accepted. On one or two occasions, however, patients have misunderstood our reasoning for this. We have made this change by necessity, as many patients leave the building immediately after their treatment and it would be totally unworkable for us to have to continuously call patients to take payment. We had to come up with a single system for all, so this change is not a reflection on any one patient.
Staying Ahead Of The Curve
Part of our role is to stay up to speed with the ongoing changes caused by our government updates, but in addition, we, and in fact all of us, can choose to operate more safely if we wish. An example would be that last night Scotland announced that most COVID-19 infections were caused by meeting people from outside our household within our homes and thus banned this. In England a more relaxed position has been taken. It is, however, up to us to decide which position is more in our best interest. If we at the clinic feel it worthwhile to use more strict guidelines to help protect all, then we reserve the right to do so.
Having lived in the USA twice, I personally check in on their news channels and in particular I look for information from Dr Anthony Fauci, who is the USA’s leading disease expert, having been advisor to the last six Presidents. He talks more openly and simply than we tend to get in the UK. He is also completely apolitical and is only interested in scientific proof. There is also a wealth of real world, scientifically based information put out by Dr Sanjay Gupta.
Yesterday Dr Gupta interviewed Dr Fauci and for those who want a better insight and understanding of where we are right now, then I recommend you watch the interview on YouTube.
For those who don’t have time to watch this, here are some snippets:
- Dr Fauci is optimistic that a vaccine may be ready for approval by November or December, based on the limited results available in the small-scale phase one and two trials. But, and this is a big but, the all important large scale phase 3 trials are double blind, placebo controlled trials and so even he has no idea what the current results are. In fact, nobody does, except one or two statisticians who see unblinded results. In simple terms, a double blind trial means that only the statisticians know who is getting the placebo and who is getting the vaccine being tested, not even the manufacturers, as the trial is conducted by an independent group. This is the gold standard for scientific testing and is not something that can be politically manipulated.
- The best advice is that we must all wear face masks if social distancing can’t be maintained.
- What we didn’t know a few months ago was that 40% to 45% of COVID positive people were asymptomatic, nor were we aware that a substantial proportion of the infections were coming from those who were without symptoms. That makes it overwhelmingly important to wear a mask.
- There is a suggestion that some of the virus droplets in the air may be light enough to hang around and circulate, thus acting as an aerosol. The facts are we don’t know yet, but in many respects, it doesn’t matter. It just emphasises the advice given: wear a mask, keep your distance, avoid crowds, wash hands regularly, ventilate rooms.
- Yes, the elderly are more at risk, but people with underlying conditions, at any age, are at risk.
The overwhelming issue is that we all need to get on with our lives while we minimise our risk during this pandemic. We believe we are taking every possible step to minimise that risk and that we have created a far safer environment than most.
Take care, be safe, think of others
Major National Shift of Opinion On Treating Chronic Pain
Some of you may remember the time when there was a national outcry about the so-called ‘post code lottery’ with the treatment on offer from the NHS varying dependent on where you lived.
Subsequently a new organisation, NICE (National Institute for Health and Care Excellence) was setup to take responsibility for authorising which treatments should be made available in the NHS. Those treatments approved were then to be made available by the NHS equally to everybody and thus put an end to the so-called post code lottery.
NICE thus has essentially total control of what the NHS can and cannot offer. Their published guidelines are broadcast by the press, radio and TV and as such the general public are influenced by the NICE recommendations. This in turn has an indirect impact on private healthcare providers, as the public perception on what is good, bad and ugly will align with what they see and read in the media.
Acupuncture In The NHS
Over recent years acupuncture acceptance in the NHS has generally been in decline, with some regions considering it quackery, using the NICE guidelines as support, while others still considered it a valuable treatment. Some of our own therapists who worked part time with us, and full time at the NHS, reported being banned from using acupuncture in the NHS and they came to us to retain their skills in what they considered a beneficial treatment.
Back Pain and Acupuncture
For a number of years NICE considered acupuncture as a Gold standard treatment for back pain. Then this decision was reversed, and acupuncture was considered as ineffective in treating back pain and this situation has persisted until recently. This was equivalent to swinging from the top end of a scale to the bottom.
New NICE Guidelines
On 3rd August 2020, NICE published a draft clinical guideline
“commonly used drugs for chronic primary pain have little or no evidence that they work and should not be prescribed. Instead it recommended that people with chronic pain should be offered supervised exercise programmes, some types of psychological therapy, or acupuncture”
Now this situation is nothing new. It has been known for years that the prescription of some drugs, such as opiates, are ineffective with chronic pain and yet have been overprescribed to the extent that it has caused an opiate dependency crisis. In the USA, the majority of drug addicts have been created by prescription drugs. Think about that for a minute. Ok, it is not so bad here in the UK, but the issues are the same.
Until the COVID pandemic hit us worldwide, the opiate crisis was very high profile and during that time Nicky was asked by 30 radio stations across the USA to speak and advise on other methods for treating chronic pain. In this she talked about the evidence of the inappropriateness of certain drugs on chronic pain and at the same time talked of the benefits and success she had seen when using acupuncture and even more so with dry needling. With over 13,000 patients and 30 years of treating, she had had a massive opportunity to see the evidence of the benefits of needling. So much so that we have quietly ignored NICE guidelines at her clinic.
NICE To Know We Were Right
So now NICE has done it’s second U turn and acupuncture is recommended again for chronic pain, something we have persisted with throughout our existence. Of course, it’s far too early to know what impact this will have on the NHS. While we would like it to be lifted out of the quackery branding, this will take quite some time, no doubt. That, however, is not our concern.
What Does It Mean For You?
For those who have been to our clinic for treatment, some travelling hundreds of miles or more, you will have most likely experienced our acupuncture skills. Some of you will have experienced and gained the benefits of dry needling.
For sure, the media is going to be talking about the benefits of treating chronic pain with acupuncture. That in turn is going to increase the demand for this type of treatment and raise the confidence level in the general public that this type of treatment can help them. This in itself is of tremendous importance as a positive mindset is so important to outcome.
Better yet, we can offer more effective treatments for chronic pain and at the very highest level available in the world.
Nicky Snazell is trained to the highest level in GunnIMS and worked directly with Professor Gunn, the forefather of todays dry needling. She has taught IMS internationally and is teaching her skills to the team at our clinic.
We have also recently added Jon Hobbs to our team. Jon is Chairman of the UK’s Acupuncture Association of Chartered Physiotherapists (AACP), the body responsible for setting the standards of acupuncture training for all physiotherapists in the UK, whether private or in the NHS. Jon is also one of the worlds’ leading acupuncture trainers and is passing his knowledge to our team during in house training.
The benefit to you is that you can be sure that our clinic has skills and knowledge which is at the very highest level in the UK. And now we have national support ………. again.
If you, or someone you know, is suffering chronic pain, then please contact us. We can help.
Great event management can help your health and here's how
At Nicky Snazell Clinic Stafford, we find ourselves treating events staff, exhibitors and conference managers for stress-related issues such as back pain, neck pain, and general niggles, most of which are the result of stress caused by their jobs.
If you are involved with running an event or exhibition, it can be a high-stress situation, one which despite your best efforts is controlled by others. - That is where well-executed event management can help.
So, what should you do?
Firstly, you should carefully select your exhibition partner, someone like Exhibition Designer, custom exhibitions & live events specialists. They take your brief and run it, taking the hassle out of your event management. Event companies like this look after the managed delivery, reducing the stress involved with stand creation. This type of company also understands the best ways to provide breakout areas where event staff and visitors can sit and discuss business in comfortable surroundings.
Secondly, follow Nicky's advice allow yourself to relax emotionally, draw on your spiritual self through the mind and body meditation- It will relieve your anxiousness and negative energy. This kind of self-awareness will make a difference to your output at the event and your health and wellbeing.
Stress and negative energy are dangerous because they affect our bodies physically, upset digestion, which restricts nutrient absorption making us tired, and lethargic and can cause mood swings - all this volatility is not good for our performance.
Headaches, neck stiffness, backache, lots of common issues can be stopped sooner with knowledge and advice. We try to provide this at Nicky Snazell's Pain Relief Clinic because it modifies the causal behaviours that keep a niggle from going away. The mindset of event staff is paramount to stopping this impending stress developing into ongoing issues.
Summary
Think about what you are doing, give yourself time, work with a right exhibition company, remember your mental wellbeing and make time to relax. Stay well hydrated and smile.
We hope that you enjoyed this article and we look forward to hearing how it helped you. Thank you and bye for now.
Author, teacher and Harley Street Physiotherapist Nicky Snazell on AACP training.
Over the years, Nicky has developed her own approach and has written five books on this. Central is the use of acupuncture and IMS and in Nicky’s opinion ‘the needle is an essential diagnostic tool’.
The clinic sends the team on AACP foundation and training days, which they find very beneficial. All four of the established physiotherapy team are AACP members and a new member is about to begin her AACP foundation course. Nicky encourages her staff to maintain AACP membership, as she “feels so much support from an organisation that has my back and that of my colleagues”. Nicky also encourages her team to gain valuable CPD via attendance of the AACP conference and courses, which are guaranteed to include evidence-based medical acupuncture.
Nicky still treats patients four or five days a week, using her own approach, which includes skills learnt with the AACP. She is also writing her sixth book specifically for therapists and is offering in-house advanced needling skills internships.
She can sometimes be found offering guest lectures at AACP events.
The Practical Application of Nicky Snazell’s Advanced Needling Skills
Nicky Snazell is one of the worlds leading GunnIMS dry needling practitioners, having reached the highest training level and awarded a fellowship of ISTOP. She has treated thousands of patients over nearly 30 years, taught IMS and presented on pain and health internationally, and written 5 books on pain and health. Nicky is a recognised authority who attracts patients from all corners of the globe.
This internship will take you from previous theory and practical courses in which you were taught WHERE to put needles, to the essential and more important step of WHY and HOW.
Internships will involve one on one with Nicky Snazell, observing while she treats complex neuro-musculoskeletal cases.
She will elaborate on:
- How you diagnose with a needle
- The difference between Eastern-based acupuncture and GunnIMS dry needling
- Physiological theories and anatomical placement of needles
- Provide an initial understanding of the WHY of treating and HOW to mix with Eastern practice.
Nicky will also provide an understanding of how her 4 Keys approach gives a baseline to both assessing the patients healing time, plus the overall health of their immune system. This will guide the most appropriate type and intensity of treatment. In other words, the dosage.
Previous experience required:
- Foundation BMAS or AACP course
- Minimum of 3 years acupuncture practice
- Chartered Physiotherapist or
- Medic with post-graduate training in MSK and acupuncture
Internship days will start at 9:30 am and finish at 3:30 pm, with a 30-minute lunch break (please bring your own lunch), and will be held at Nicky Snazell’s Clinic near Stafford.
Internship cost £250 per day
For more information, please call Nicky Snazell’s Wellness & Physiotherapy Clinic on 01889 881488.
The clinic is in central England and has rapid access to most of the country, with an excellent motorway network nearby. Stafford is only 1hr 15min by train from London.
Spinal Disk Bulge Physiotherapy For A Spinal Disc Rupture
Can a disc slip? The simple answer is no. It’s a layman’s term that is unfortunately very misleading to the general public.“My disc has slipped out, can you put it back in” is not an uncommon conversation opener on the telephone. Of course, it’s quite difficult then to get the caller to understand that this can’t actually happen, which is why Spinal Disk Bulge Physiotherapy is key to recovery.
Let’s look at the spine’s anatomy and in particular the role of the disc.
The spine is made up of 7 cervical (neck) bones called vertebrae, 12 thoracics (middle) vertebrae and 5 lumbar (lower) vertebrae. The top 2 vertebrae in the neck are a little bit different, so putting those to one side, between each pair of the remaining vertebrae there is a disc, the purpose of which is to provide shock absorption and allow movement. The disc itself is attached strongly to the vertebrae and cannot slip out.
A disc is made up of a tough fibrous structure on the outside, layered in exactly the same way we make cross-ply tyres. On the inside, there is a soft, crab paste-like moist material. As we age this tends to dry out. There are also endplates in contact with the vertebrae. The spinal disc is 70% to 90% water, so making sure you are well hydrated is very important to disc health.
There are two major types of damage to these discs. The first is when the disc is overloaded sufficiently to cause a protrusion, or bulge in the outer wall, as in the diagram above. This is similar to what you see on the side of a car tyre when it has hit a curb. Sometimes this is referred to as a slipped disc. It’s not possible to just push the bulge back in, but specific exercises can help to relocate this and over time the disc may heal itself.
The second and more serious damage is when the overload has been sufficient to rupture the outer fibrous structure and force the inner material to squeeze out. This is called a herniated or ruptured disc.
What Are The Implications Of A Disc Bulge Or Herniated Disc?
A disc bulge will cause pain if it is central and compresses the central spinal column, or if it bulges to one side into the exiting nerves. In either case, if the compression is significant enough, it will cause pain and/or numbness and weakness and possibly loss of control in the limbs.
If the disc bulge is central it could cause problems down both sides of the body. If the bulge is on one side, it will only cause problems on that side.
If the disc has been ruptured or herniated, the same problems with compression of the central spinal column and exiting nerves can occur. In addition, if chemicals from the inside of the disc come into contact with the nerves, it can cause severe pain even without any compression of the nerves. In such cases, a course of anti-inflammatories will most likely be prescribed.
Can Spinal Disk Bulge Physiotherapy Treat A Disc Bulge or Herniated Disc?
In many cases, a bulging disc and a herniated disc will over time heal themselves. The time required may depend on the severity of the problem and may take from weeks to months to resolve. Physiotherapy treatment can help reduce the pain much more quickly. The key is to get an accurate diagnosis through a physiotherapy assessment, possibly needing an X-ray or MRI. Treatment can include specific exercises to help reduce the disk bulge, Gunn IMS dry needling, electroacupuncture, laser, shockwave, core stability rehab and postural rehab. In severe cases, surgery may be needed.
If you have suffered a recent back injury or had a long-term problem then it’s advisable to get your condition assessed and treated. We have extensive skills in treating spinal pain and clients travel from all over the UK and abroad to seek our help.
Call 01889 881488 now.