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ACEUPDATE
Vol 3 QIssue 13 Q July 2011
Where parallel lines meet
Welcome to the latest edition
of Ace Update. Since last I
wrote there has been a
significant addition to the
clinic. Kingston Chiropractic Plus
(KCP), which was previously on Surbiton Hill, has taken a
room, bringing with them a very large patient list and
three reception staff. For those of you who have already
phoned or visited the clinic since June 20th, you will have
noticed the difference. The ladies answering the phone are
Sue, Danuta or Rose and Joanna, Stuart’s daughter, is still
working on Fridays and Saturdays. So when you phone
please book your appointment through them, there is no
need to speak to the practitioners in order to do that.
the history and philosophy of the profession. There are
some differences between the two professions in the
way that we work but ultimately we are in the business
of pain relief and management. So if you have an urgent
requirement for treatment and either Kathy or I are
unavailable we will offer you the opportunity to see
one of the chiropractors and we are happy for you to
if you are as well.
Oliver
In addition to Neil and Zane, we also have Gary with us
now. He is a sports therapist who worked at KCP and he is
with us now on Thursdays between 12noon and 4pm. He
offers sports injury management and massage and gives
us an extra day to offer this service to all patients. So again,
if treatment is urgently required and Sophie or Carlie-Ann
are not available or are full we will offer you the chance to
see Gary if you are happy to see him.
KCP is run by Mr Neil Reilly who has been a chiropractor
for 24 years, and he has an associate, Zane Hall, a South
African, who has been with the clinic since 2004. Now,
I am sure some of you are wondering how we can have
‘the rivals’ working at the same place. Well, from our
perspective there is the simple economic reason that
they are using a room five and a half days a week and
paying us for that usage.
So, big changes, but we hope that the nature of the clinic
will not change. It is busier and a bit more business-like
(from our perspective) but we will ensure that the
atmosphere of the place remains relaxed and friendly.
So, as and when you come in and are greeted by a new
face from behind the reception desk, give them a smile,
(they will smile back!) and if you do have any comments
please pass them on.
But actually there is no reason why we should not work in
the same premises particularly since we are both
established clinics with our own patient lists, individual
reputations and are self-sufficient enough not to have the
the anxiety of treading on each other’s toes. KCP will soon
have their own telephone line installed so when you
phone you may still get the answer-phone or you may be
asked to wait a little while if the receptionists are on the
other line. In either case please be patient and we will talk
to you as soon as we can.
Stop Press:
For the past 3 years we have charged the same price
for Osteopathy and we feel it is now necessary to raise
them. Therefore, from this September Osteopathy
charges will be:
£40 – for a new consultation
£33 – for a return treatment
£45 – for my 1hour ‘osteopathic massages’
In this issue
We have a couple of articles from KCP: Neil is writing
about the history of his clinic and Zane is writing about
02 Magnesium. Could you be deficient?: Stuart McLean
03 Dealing with Chronic Pain: Sophie Capito
04 All in a line: Neil Reilly
05 What is Chiropractic?: Zane Hall
06 Get fit, live longer: Oliver O’Callaghan-Brown
07 Acupuncture can reduce period pain: Victoria Busk
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Magnesium
Could you be
deficient?
by Stuart McLean
I am writing about this vital mineral due the large number
of patients that, on testing, have shown deficiencies.
Testing can be done either though a blood test or hair
mineral analysis through Biolab laboratories. Another good
indicator of possible deficiency can be seen by analyzing a
7 day food and drink diary. Nationally women tend to have
lower intakes. According to the National Diet and Nutrition
Survey 2003 only 77% of women aged 19 – 34 reached the
recommended intake of 270mg/day. An even more
worrying statistic is that 20 % of women don’t even reach
the lower reference intake of 150mg/day.
However a sensible serving would be around 20g, providing
118 mg. The advantage of pumpkin seeds is that they are
easy to snack on. Wherever you are, at any time of day, you
can pop a few pumpkin seeds in your mouth and get
roughly a milligram of magnesium per seed. They are also
rich in other essential nutrients such as zinc and selenium
and others.
The body needs magnesium in order to perform over
three hundred different biochemical reactions.
Magnesium helps sustain normal nerve and muscle
function. It is also responsible for helping to keep blood
sugar levels regulated, promoting healthy blood pressure.
Magnesium is also involved in protein synthesis as well as
energy metabolism.
Chocolate
Most of us love to eat chocolate – so here’s an excuse, sort
of. The estimates of magnesium in chocolate range 100mg
to over 500mg per 100g. Milk chocolate or other highly
diluted chocolates are well below even the 100 mg figure,
and not worth considering for their magnesium value. The
thing to remember is that raw cocoa beans would be your
absolute best source for magnesium, though they are
certainly not to everyone’s taste, and not all that easy to
find. A 10g square of 70-85% cocoa solids will provide about
23mg of magnesium.
The first symptoms of magnesium deficiency can be
subtle. Most magnesium is stored in the tissues, so leg
cramps, foot pain or muscle ‘twitches’ are usually the first
signs. Numerous clinical studies support that Insomnia,
PMS, chronic fatigue, migraine headaches are also very
common magnesium deficiency symptoms.
Leafy greens
All leafy green vegetables are rich in magnesium.
50g of raw spinach about 5 leaves provides 40mg of
magnesium while 100g of cooked cabbage provides 24mg
and just 5 brussel sprouts provides 20mg. So don’t forget
the greens.
So how can we ensure adequate intake of this vital
mineral?
Fish
Many patients try hard to eat fish, objecting mainly to the
taste. However Halibut is a fish renowned for its lack of taste
needing to be spiced up. But it is very rich in magnesium, a
100g portion provides 107mg of the stuff; a good reason to
eat fish.
Best Sources of Magnesium:
Oats
Start the day with breakfast, oats and wheat bran are
excellent sources of magnesium. Although cooking reduces
its level it is still a good source. 40g oats cooked with water
provides 11mg of magnesium. If you add an additional 5g
of wheat bran, you add another 31mg of magnesium.
In conclusion, eat a varied diet containing nuts, seeds,
whole grains, vegetables and fish to maintain healthy
levels of this mineral and thereby ensuring good health
and vitality.
Pumpkin seeds
Pumpkin seeds are in a category of their own so far as
magnesium rich foods go, at 592 mg per 100 g serving.
Ace Osteopaths ™ Complementary Health Centre ™ Update ™ Volume 3 ™ Issue 2 ™ May 2008
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Dealing with Chronic Pain
Chronic pain refers to pain that continues or persists over an
extended period of time. This could be from an injury,
accident or even after surgery. Pain itself is difficult to define
as everyone feels pain differently. The definition of pain
devised by the International Association for the Study of Pain
(IASP) is “pain is an unpleasant sensory and emotional
experience associated with actual or potential tissue damage,
or described in terms of such damage”. This is a widely used
and accepted definition of both short-term acute pain and
chronic pain.
By Sophie Capito
Exercise produces endorphins which are brain chemicals that
help improve mood but can also block pain signals. Exercise
also strengthens muscles, helping to prevent re-injury and
further pain. Walking may be all the exercise that is necessary
it will depend on each person’s circumstances. If you’re
unsure what exercise is best for you seek advice.
Reducing stress levels is very important. Stress and tension
increase sensitivity to pain. Sometimes stressful situations
cannot be avoided in life so another way to help deal with
this would be to learn some relaxation or meditation
techniques. Improving your diet can help with pain as can
reducing the consumption of alcohol or stopping smoking.
A well balanced diet will help prevent weight gain and
improve sleep.
Acute pain is the body’s warning system that protects itself
from further injury. Chronic pain is when there are changes in
the nervous system and brain so that the pain system no
longer functions as a warning system. It fails to “switch off”
sending information to the brain via the nerves that tells us
how much pain and where it is coming from but also sending
information to the emotional areas of the brain.
Last but not least, keep a journal of your pain. Out of 10 (10
being the worst) make a note of what level you are at when
you wake up, before you go to bed, after taking any pain
relief or after receiving any treatment. Though you’ll be asked
verbally by your doctor or practitioner how you are feeling
people tend to use the same words to describe how they are
feeling, when in reality they may well be improving. Putting
your pain level down in writing helps the brain to “see” the
improvement that you may not even be aware of yourself.
You should be able to see more clearly what treatment,
exercise or pain relief works best for you and also how you
can become worse if you do the wrong things or have too
much stress. Try it for 2 weeks to see if you can break your
pain pattern!
Most pain eases in a normal healing time so chronic pain is
defined by the IASP as “pain which has persisted beyond the
normal tissue healing time”. There is no formally accepted
time frame for this but one can assume most chronic pain is
that which persists for more than 3 months.
There are numerous articles on chronic pain so there is no
point in my going over all that is out there. My intent here is
to give you some hints that are most recently accepted as
ways to help deal with chronic pain. The main aim is to alter
the brain’s reaction to pain, to de-sensitise it, thus giving
some relief.
Massage is widely accepted now as a way to relieve pain and
tension. The effects may only be temporary but it allows the
brain to “remember” what it feels like to be pain free. It is
especially effective for back, neck and shoulder pain.
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All in a line
By Neil Reilly, Principal, Kingston Chiropractic Plus
Being something of a fanatic about correct alignment
it has become apparent to me that I have even managed
to maintain this in the location of my 4 practice premises.
In March 1990 I started my first practice at 18 Ewell Road,
Surbiton, where I had a single room and I lived upstairs.
Many patients will remember the ginger cat that we had
at the time who liked to climb into any cars parked on the
front and go to sleep. On many occasions he had to be
retrieved from distant jaunts when he was discovered by
an unsuspecting patient.
In June 1990 the Medical Research Council published it’s
findings comparing Chiropractic treatment for lower back
pain and Physiotherapy. These were very favourable to
chiropractic and it must have been a slow news day because
the story made the front page of several daily papers and it
was also the lead item on the BBC news.
The practice quadrupled over night.
In October 1993 the practice moved to 1 Surbiton
Crescent where Mark Kennedy and Pernille Larsen
joined us. In 1996 the chiropractor on the Hook Road,
Jasper Dokkedal, died and we were asked to amalgamate
his practice. In 1999 the Chiropractic Act was passed and
it became illegal to call yourself a Chiropractor without being
registered with the General Chiropractic Council. Chiropractic
had become legitimate.
In 2003 the practice moved to 29a Surbiton Hill Road where
Zane Hall joined. Zane brought expertise both in Chiropractic
manipulative therapy and prescriptive rehabilitation exercise
to the practice which has since proved to be the future of
spinal care. Reflecting on 24 years of practice there are a
couple of things that really strike me. First the change in
relationship between Chiropractors and GPs has been
dramatic. In the 1980s if I got a referral from a GP I would call
my friends and brag about it- now it is a daily occurrence.
Second, the emphasis has shifted from lower back disorders
to neck related disorders. I am sure that this is related to the
increasing use of computers over the 20+ years and the
ergonomic battlefield that we are now exposed to.
In June 2011 the practice moved in with Kathy and Oliver
O’Callaghan-Brown at Ace. The future looks exciting with
Osteopaths ad Chiropractors working together for the first
time to bring the best approach for all patients old and new.
Those of you who know the geography of Surbiton will have
realised that all 4 practices have been in a line from 304 Ewell
Road for about 2 miles towards Kingston. I have been
accused of taking this business of alignment too far.
Ace Osteopaths ™ Complementary Health Centre ™ Update ™ Volume 3 ™ Issue 2 ™ May 2008
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What is Chiropractic and what
do we know about its history?
By Zane Hall, Associate Chiropractor, Kingston Chiropractic Plus
I have been a chiropractor since 2002 and practising in
the UK since 2004. I have been asked to pontificate on
the subjects outlined in the title. He also said it was ok for
me to get on my soap box now and then, so here goes.
regarding a range of other, related conditions. As with
most official statements they try to be everything to
everybody. In this case I think the extracts above will
satisfy most people.
Officially the General Chiropractic Council defines
chiropractic as concerned with the framework of bones
and muscles that support the body (the musculoskeletal
system (MS system)). Some problems of the MS system can
be caused by accidents, stress, lack of exercise, poor
posture, illness and everyday wear and tear. These problems
may cause pressure on the nerves in the body. Depending
on your condition the chiropractor may manipulate parts
of your spine or joints and give you advice on exercise,
self-help, diet and lifestyle. Some chiropractors also offer
rehab programmes.
The history of chiropractic is a more problematic topic.
Basically in about 1880, a gentleman who might have been
hard of hearing was cleaning the consulting rooms of a
‘magnetic healer’ who noticed somehow that he’ had a
bone out of place’ in his neck. Incredibly he ‘relocated’ the
bone and the gentleman could hear again. The healer
theorised that the displaced bone had altered the nerve
flow and as such was the origin of the disease.
Soap Box time! Various chiropractic organisations have
alternatively been trying to deify these ordinary people
into quasi-religious totems or drag the profession out of
the mis-information and mysticism of the time. To put it
into perspective, ‘modern medicine’ at the time was not
aware of bacteria and as a result tens of thousands of
people dies after ‘procedures’ just for the want of clean
hands! I feel that this is a dis-service to the patient and the
profession - and its practitioners – need to apply the latest
understanding of disease/pain/inflammation to better
serve our patients! If anyone is particularly interested in the
history of chiropractic, do an internet search for DD Palmer
and proceed from there. I think we will all be better
served by forgetting about the various idealised
stories from the past and applying ourselves to
diagnosing our patients accurately, improving
their knowledge of their ailment, providing
effective treatment solutions and empowering
them with strategies to maintain their health.
To do this we need to actively seek new
knowledge and should let the past stay in
the past.
Manipulation involves precise handling and movements
of joints or parts of the spine, sometimes moving them
further apart than they would normally go. Similarly, the
British Chiropractic Association states that Chiropractic
is a primary health-care profession that specialises in the
diagnosis, treatment and overall management of conditions
that are due to problems with the joints, ligaments, tendons
and nerves, especially related to the spine. Chiropractic
treatment mainly involves safe, often gentle, specific spinal
manipulation to free joints in the spine or other areas
of the body that are not moving properly.
Apart from manipulation chiropractors may
use a variety of techniques including ice,
heat, ultrasound, exercise and acupuncture
as well as advice about posture and lifestyle.
Although chiropractors are best known for
treating back and neck pain, which they do
very well, patients also consult chiropractors
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GET FIT, LIVE LONGER
Exercise is the vaccine to chronic disease
by Oliver O’Callaghan-Brown
This is a pet topic of mine and it is also a regular theme is
the British Journal of Sports Medicine. The following train
of thought featured in the May edition.
sedentary lifestyle is a bigger risk factor for mortality than
mild to moderate levels of hypertension. Since few doctors
would give up measuring blood pressure as a vital sign why
would they choose to ignore measuring activity levels?
There is a chronic issue in the public domain or obesity
and inactivity that is leading a lot of people towards the
premature onset of chronic diseases and death at a younger
age. Medicine has moved on so much that people who died
of heart attacks in the 70s would now be saved and would
live for many more years. However this does add a significant
burden to the NHS and leads to a service that struggles from
the very numbers that require its help. But there is now
significant evidence that shows a direct relationship between
physical activity and health – those who maintain an active
and fit way of life live longer healthier lives and will require
less medication and NHS treatment as they enter old age.
Those who are unfit and sedentary very predictably develop
chronic diseases like heart disease and diabetes. This
association between activity level and health status exists
irrespective of gender, ethnicity or age. All benefit from
exercise, all suffer from inactivity.
One could argue that asking patients about their activity
levels does not ensure that they make changes but
explaining the benefits allows them to make an informed
decision and at minimum everyone should be informed of
the benefits. If adults are not doing 150mins/week and
children are not doing 420mins/week then they should be
flagged as being at risk and advised of the importance of
being more active. They are more likely to take up exercise if
it is connected to a disease they are currently dealing with or
that they are at risk of. It should be the doctor’s responsibility
to make connections with the fitness industry, to identify
those fitness professionals who can help although ideally this
should be done centrally. Surely this would be more
beneficial to patients than having to refer to a medical or
surgical specialist?
To be honest the reluctance of the medical profession and the
lack of impetus from above results in people like Robert Salis,
the author of the piece in the BJSM and me standing on a soap
box and encouraging the patients to mobilize their doctors.
But if enough of you are aware of the benefits of exercise and
pester your doctor for more exercise prescription the more
likely this will sink in and force the hand of the medical
profession to get off their own backsides and think about the
health of their patients, not just their disease.
Exercise is medicine that every patient needs to take. Its
clinical benefits should not be denied to anyone especially
those with chronic diseases like hypertension, heart disease
and diabetes to name but three. Also anyone who is at risk
from these should consider exercise as a ‘vaccine’ that greatly
lowers the risk of illness and certainly extends life. It is readily
available to everyone and thus the exercise habits of every
patient that should be assessed at every visit to the doctor;
there is no excuse not to.
(Acknowledgements to Robert Salis Br J Sports Med May 2011 Vol 45 No 6.)
But the medical fraternity seems to want to resist this,
prefering to continue to provide more time-consuming,
uncomfortable and even more dangerous therapy. Would
you readily take insulin shots, have chemotherapy or
undergo surgery by choice if there was a less risky solution? I
am sure the answer to that is no and yet everyday many
thousands of people do just that because they believe that it
will help and the system is set up to administer these
treatments. If a similar system was in place to administer
exercise prescription surely patients would be more likely to
consider that treatment option.
An essential first step is for doctors to establish the exercise
habits of their patients, treating the question and answer as a
vital sign since there is no better indicator of a person’s health
and likely longevity than the min/week of activity they
engage in. It makes more sense to stop taking blood pressure
at every visit than to ignore exercise habits because a
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Acupuncture can reduce period
pain (dysmenorrhoea)
By Victoria Busk
A review by Australian authors has concluded that current
evidence suggests the use of acupuncture to reduce
menstrual pain. The authors looked at ten trials reporting
on 944 participants. The results were positive, showing that
there was an improvement in pain relief from acupuncture
compared with a placebo control or with Chinese herbs. In
two trials acupuncture reduced menstrual symptoms (such
as nausea and back pain) compared with medication, in one
trial acupuncture reduced menstrual symptoms compared
to Chinese herbs, and in one trial acupuncture improved
quality of life compared with usual care.
Interestingly acupressure fared well with improvement from
pain relief compared with a placebo and in a second trial
acupressure reduced menstrual symptoms compared with a
placebo control group.
This is good news for anyone suffering with this debilitating
condition. Dysmenorrhoea, indicating pain before, after or
during menstruation, can affect woman at any time during
their menstruating years. According to Chinese medicine,
the aetiology of period pain can be due to emotional strain
such as anger, frustration and resentment, excessive
exposure to cold and dampness, overwork or chronic illness
and excessive sexual activity and childbirth.
Acupuncture treatments focus on the patient as each
individual is unique and the treatment is tailored to the
particular condition and circumstances. A thorough
consultation is taken as well as taking the pulse and looking
at the tongue that are important indications as to what is
happening within the body.
If this is something that you suffer with and would like to
find out more information please get in touch.
Acupuncture for primary dysmenorrhoea. Cochrane Database Syst Rev.
2011 Jan 19;1:CD007854
Ace Osteopaths ™ Complementary Health Centre ™ Update ™ Volume 3 ™ Issue 2 ™ May 2008
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