Archive for April 2016

Some Headache Causes and Solutions

There are many people who frequently suffer from headaches, some even on a daily basis. Many feel this is “normal.” In fact, when they visit an Osteopath for the first time for what they believe to be an unrelated issue, they may not even bring it up. They may only discuss it after being asked if they have headaches, as if everyone has headaches.

That’s why it is very important to take a very thorough health and family history when a patient first presents for care at any doctor’s office.

In this process, patients may offer clues to the cause of their headaches. For example, if a patients indicates that she has had headaches as long as she could remember and her family history includes her mother having headaches that were debilitating and an MRI revealed that part of her brain stem extended down into the upper part of the neck, this would prompt an MRI of the patient which could reveal a similar finding. Another example is a patient with headaches that occur one week prior to menstruation. This may lead to the trial of several nutritional vitamin / herbal approaches aimed at reducing fluid retention or build up that frequently occurs pre-menses. Other causes have included traumas from car accidents, slips and falls, and sports injuries. In these cases, the physical examination may lead to a diagnosis of abnormal biomechanics in the cervical spine and Osteopathic treatment addressing these findings may prove very satisfying. Other causes may include stress and/or psychological conditions that required co-management with a mental health practitioner and/or the patient’s primary care physician. The combined efforts of medication and Osteopathic treatments are most satisfying for these patients.

In general, the cause of headaches are usually multi-factorial and therefore, the most effective treatment is a multi-dimensional approach in which osteopathic treatment methods are, in most cases, the most important contribution to the successful management of headaches. Osteopathic treatment approaches include spinal manipulation, mobilisation, muscle release techniques such as trigger point therapy, longitudinal and /or transverse friction massage. Physical therapy modalities including ice/heat, diet and nutritional counselling, and stress management.

Cram Osteopaths




Article provided by Chirotrust

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“My Neck Is Killing Me”

When patients present with neck pain, they always ask, “Where is the pain coming from?” Of course, this can only be answered after a careful history and thorough evaluation is completed by their Osteopath. Let’s take a closer look at what this involves…
The History: This includes a careful description of how the injury occurred, if there was an injury. For example, in a slip and fall injury, it makes a difference if the patient fell forwards, sideways, or backwards and if they landed on their knees, hips, buttocks, back, or if they hit their head on the ground. Also, if there was a dazed feeling or loss of consciousness in the process, your Osteopath would like to know. If there was a head strike, were there any signs of concussion like fatigue, mental “fog,” headache, difficulty communicating, or forming words or sentences? When there is no specific injury, he or she will ask if there were perhaps one or more “mini-” or “micro-” injuries that may have occurred sometime within 2-3 days prior to the onset of the neck pain. The cumulative effect of several small “micro-injuries” can result in a rather significant onset of symptoms several days later. The next batch of information gathered includes factors that increase and decrease the pain, the type of pain quality (sharp, dull, throb, burn, itch, etc.), pain location – “…put your finger on where it hurts and “does it radiate into the arms or legs, severity (pain level 0-10), and timing such as, “it’s worse for the 1st 30 min. in the morning and then loosens up.” Information regarding past history, family history, medical history (surgeries, medications), social history, habits (caffeine, tobacco, alcohol, etc.), and a systems review (heart, lungs, stomach, nervous system, etc.) will also be collected.
The Physical Exam: This includes vital signs (blood pressure, etc), observation – the way the head is positioned (forwards, to the side, rotated, etc.); palpation – touch/feel for muscle spasm, trigger points, spinal vertebra position and motion; range of motion, orthopedic and neurological tests.
The Diagnosis: This is determined after taking all your information and “…putting the puzzle pieces together” to determine what is causing your pain.
The Treatment: Spinal manipulation is performed by applying energy or force to the misaligned or fixed vertebra structures by one of many methods depending on the patient’s size, pain level, tolerance, and so on. Other “manual” treatment approaches include soft tissue therapy such as trigger point therapy, active release, massage, vibration, and others. The use of physical therapy modalities such as ice and heat, depending on your specific situation and needs can also be very helpful. Similarly, exercises to teach you how to hold your proper posture, to improve flexibility or range of motion, and to strengthen the muscles that are weak really help. A workstation/job assessment may also be needed if that appears to be irritating your condition.


Cram Osteopaths




Article Provided by Chiro-trust

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April’s Garden Health Tips

3 tips for groan-free gardening

  1. Avoid repetitive jobs and staying in the same position for too long. Vary what you are doing every ten to twenty minutes and rotate two or three tasks so it all gets done without putting strain on any of your muscles.
  2. Don’t use heavy watering cans if possible. Use a hose or built-in irrigation system to water your plants and grass.  If a watering can is necessary though just fill it half way.  This gives you the added benefit of an extra walk to the tap for a refill.
  3. Build your flowerbeds high and keep them narrow to avoid the need to bend down too low or over too far to maintain them.
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What’s Better for Neck Pain, Medication or Osteopathy?

Although both medication and Osteopathy are utilised by neck pain sufferers, not everyone wants to or can take certain medications due to unwanted side effects. For those who aren’t sure what to do, wouldn’t it be nice if research was available that could answer the question posted above? Let’s take a look!

When people have neck pain, they have options as to where they can go for care. Many seek treatment from their primary care physician (PCP). The PCP’s approach to neck pain management usually results in a prescription that may include an anti-inflammatory drug, a muscle relaxant and/or a pain pill.

Although it’s becoming increasingly common to have a PCP refer a neck pain patient for Osteopathy, this still does not happen for all neck pain patients in spite of strong research supporting the significant benefits of spinal manipulation to treat neck pain. One such study compared spinal manipulation, acupuncture, and anti-inflammatory medication with the objective of assessing the long-term benefits (at one year) of these three approaches in patients with chronic (>13 weeks) neck pain. The study randomly divided 115 patients into one of three groups that were all treated for nine weeks. Comparison at the one-year point showed that ONLY those who received spinal manipulation had maintained long-term benefits based on a review of seven main outcome measures. The study concludes that for patients with chronic neck pain, spinal manipulation was the ONLY treatment that maintained a significant long-term (one-year) benefit after nine weeks of treatment!

In a 2012 study published in medical journal The Annals of Internal Medicine, 272 acute or sub-acute neck pain patients received one of three treatment approaches: medication, exercise with advice from a health care practitioner, or Spinal Manipulation. Participants were treated for twelve weeks, with outcomes assessed at 2, 4, 8, 12, 26, and 52 weeks. The patients in the Spinal Manipulative and exercise groups significantly outperformed the medication group at the 26-week point AND had more than DOUBLE the likelihood of complete neck pain relief. However, at the one-year point, ONLY the Spinal Manipulation group continued to demonstrate long-term benefits! The significant benefits achieved from both exercise and Spinal Manipulation treatments when compared with medication make sense as both address the cause of neck pain as opposed to only masking the symptoms.

With results of these studies showing acute, subacute, as well as chronic neck pain responding BEST to Spinal Manipulation TRY Cram Osteopaths FIRST!

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Fibromyalgia and Sleep

Fibromyalgia (FM) is a condition that has produced more diverse opinions from researchers and physicians than almost any other. This has made finding a healthcare provider who is willing to manage the FM patient very challenging. Similarly, patient perceptions vary widely from those who strive to live a normal life despite their symptoms vs. those who are unable to cope and “give in” to the disorder. FM occurs in about 2% of the population with the majority of sufferers being women. Common symptoms include muscle aches, joint pain, sleep disturbance, and widespread body tender points or areas. The term “fibrositis” was first reported in 1904 to describe patients with these symptoms with many names being used including myositis, myalgia, fibrosis, myofibrositis, psychogenic rheumatism, and more! Not until the mid-1970s did the term “fibromyalgia” become the accepted term, getting rid of the “-itis” suffix which means “inflammation” and adopting the “-algia” suffix, which means condition or pain. In the 1990s, the American College of Rheumatology published distinct criteria for diagnosing FM requiring 11 of 18 tender points to be identified on examination, but this too has been criticized with new recommendations to accept widespread pain, sleep disturbance, and long-term or chronic symptoms as being appropriate to establish the diagnosis. Most recently, a central nervous system (CNS) origin rather than a localized inflammatory condition is now the current accepted area of the body that is the focus of cause and treatment.

The inability to get to deep sleep (which takes 3-4 hours of continuous sleep) has been identified as a major symptom of FM. Similarly, many of the symptoms of poor sleep coincide with the symptoms of FM such as fatigue, poor concentration, irritability, and diffuse pain. While certain medications and herbal remedies have been focused on and discussed, little has been reported on the changes the patient can make to facilitate sleep. The first order of business to help the sleep pattern is to make sure there are no underlying conditions such as sleep apnea or thyroid disease. Second, what is the FM patient’s sleep habit(s) or routine? This includes the time they go to sleep, the time prior to falling asleep once in bed, how many times do they wake up at night and the length of time to fall back asleep, how rested do they feel in the morning, and how long does it take “to wake up” and what has to be done – coffee, meds, etc., to feel “awake.” Third, identify other reasons for waking – pets in bed, a snoring partner, babies/kids or elderly care, and/or working swing or night shifts. The “treatment” of the FM patient for sleep disturbance includes discouraging daytime long naps – short naps are OK limited to 30 minutes max and at least 8 hours before bedtime. Here’s a summary list of recommendations:

1.    Reduce room distractions (no pets, no TV).

2.    Comfortable sleeping temperature and noise level – consider a white noise or “sound machine.”

3.    Establish a bedtime and awakening time based on the number of hours that it “usually” takes for that person to feel “rested.”

4.    Start a “wind-down” 60-90 min. before bedtime – reading, writing – to relax and “let go” of the day’s events.

5.    Avoid stimulating books or movies before bedtime.

6.    Writing down cares or worries of the day in a journal 45-60 minutes before bedtime.

7.    Avoid next day planning during the “wind-down” time period.

8.    Perform deep breathing exercises at bedtime.

9.    Avoid caffeine, nicotine, and alcohol pre-bedtime.

10. Limit exercise after 3 hrs before bedtime.

11. Avoid longer than 30 min. naps less than 8 hrs pre-bed time.

12. Avoid eating 3 hours before bedtime.

13. Avoid clock watching.

14. If unable to fall asleep within 15-20 minutes, get up and engage in relaxation exercise and return to bed when feeling sleepy.

15. Consider a softer mattress (harder is NOT always better).

16. Some sleep centers advocate at least 40 minutes of strong light exposure after rising in the mornings.

Watching Your Back

Cram Osteopaths



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