Grief and trauma

I recognise that it’s customary for Osteopaths to blog about the safest way to put up decorations and lift your turkey at this time of year.

But I thought we might take things in a slightly different direction. The festive season can be hard for those who have lost loved ones during the year. Certainly, 2021 has not been the best year for the Kiashek household.  We have sadly attended the funerals of six significant people in our lives since January.

So, I thought it might be useful to reflect upon grief and trauma generally, how they can impact us physically and how we can even be affected by things that happened long before our birth.

Much has been written about how to navigate the emotional side of the festive season if you are grieving.  I can highly recommend this piece from Marie Curie if you are looking for practical guidance. Or check out this wonderful TED Talk by Nora McInerny entitled: We don’t “move on” from grief. We move forward with it.

But grief can also impact our bodies physically and this is something I see often as an Osteopath.   We refer to emotional baggage for a reason.  It’s a catch all expression for how unresolved issues of an emotional nature can weigh us down.  And, just like if you were to carry actual heavy bags for a period of time, this can cause physical symptoms.  Some of the most common include:

Tightened muscles

Aches and pains can be a common physical symptom of grief. This could mean pain or stiffness in the back and/or joints. The pain is down to the surge of stress hormones being released during the grieving process.


Stress, emotional issues and grief can often manifest as tension headaches.  Which can be worrying in themselves. I’ve written before about how Osteopathy can help ease the pain of these headaches

TMJ Disorder

Similar to the tightening of muscles in other parts of the body, Temporomandibular disorder (TMD) is a condition affecting the movement of the jaw. It’s always worth exploring the patient’s lifestyle and any emotional issues as these can frequently be contributing factors.  This is another condition where Osteopathy can help to alleviate the symptoms.

As an Osteopath with 25 years’ experience, I have extensive experience in helping patients with issues like these.  But it’s not just our own emotional baggage that could be affecting us.  Perhaps we need to look even further back?

Family history can be far reaching

I am currently reading a fascinating book called Aftermath: A Granddaughter’s Story of Legacy, Healing & Hope by Allison Nazarian.

Allison grew up very close to her grandmother, who survived Bergen-Belsen, which was one of the Holocaust camps; her mother was born in Bergen-Belsen.  In the book, Allison explores her third-generation experience and looks at how her family’s history empowered and made resilient people like her grandmother, whose life was a triumph until she died in her 90s – but haunted and ultimately destroyed others, like Allison’s mother who took her own life at just 51.

“It made me who I am”

Allison explains: “I was close to my grandparents. They freely and graphically talked of their lives during the Holocaust. I absorbed their experiences. It was all I heard about. I was surrounded by the Holocaust; it was part of every story, every discussion, every day of my life.

“I was told, ‘they could come for us at any time, you have to be ready’. Even now, I have a ‘go bag’ with passports and essentials. There are certain things I have an irrational fear of running out of. It was only at 12 or 13 I realised not everyone’s grandparents were in the Holocaust. It made me who I am.”

Looking after our physical wellbeing

This all particularly resonates with me since my parents were survivors of the Jewish Holocaust. My father’s family were Hungarian Jews and survived Auschwitz. While my Catholic mother suffered the loss of her first husband during the Russian invasion of Hungary at the end of the year. The Holocaust has been a significant trauma which was simply not discussed in our family and which, I believe, impacted the whole family – even those not born at the time  – through emotional difficulties and communication issues.

In my work as an Osteopath, I’m already a great believer in how emotional issues and lifestyle factors can impact on our physical wellbeing.  But it’s fascinating to consider that we may need to examine looking even further into the past for answers to what ails us today.  Perhaps it’s worth looking at how our past, both physically and emotionally, can influence how our genes are expressed in the present day – this is the subject of Epigenetics, a topic I have written about before.

It would be fascinating to hear your thoughts and experiences around this topic so do please get in touch.

And in the meantime, let me revert to type and remind you to bend your knees when you lift that turkey!

Tension-type headaches

Headaches occur in an estimated half of all adults worldwide.   They are the third highest cause of’ time lost to ill health’ around the globe, according to the World Health Organisation (WHO).

It’s believed there are more than 150 different types.  But if the steep rise in Google searches is to be believed then it’s one particular variety that seems to be causing us a problem in 2020 – the tension-type headache (TTH).

What is a tension-type headache?

 This type of headache often begins during the teenage years and affects three women to every two men. The pain can last from 30 minutes to several days or may be continuous.

What causes a tension-type headache?

A TTH is often stress-related or associated with musculoskeletal problems in the neck. But there can be a number of contributing factors, including:

  • Anxiety
  • Emotional stress
  • Depression
  • Poor posture
  • Lack of sleep
  • Physical exhaustion

So, it’s probably not surprising that they are causing us a problem in 2020 given all that’s happened!

How can I ease a tension-type headache?

It’s wise to try avoiding the stressors listed above, learning relaxation techniques like breathing exercises or yoga and perhaps cutting out caffeine.

But, as Osteopath Robin Kiashek knows, trying to stress less is much easier said than done. Robin tells us: “Stress is something many of us feel at some point in our lives and it’s even more evident this year.  But stress isn’t just a mental thing. It can show in the body in a number of ways including shoulder pains and neck aches.  It can also manifest in the diaphragm, through the neck, into the temporomandibular joint and up into the skull.”

How would Osteopathy help relieve TTH?

Osteopathy can help address the underlying factors of TTHs. That’s because Osteopaths can examine the collective elements that could be contributing to the pain.

Robin Kiashek added: “I believe that physical and mental wellbeing are inextricably linked.  I work with my patients to get a full understanding of what’s going on in their life.  Then I can better understand how that might impact them physically and also rule out underlying pathology which may require referral for more specialised assessment.”

In practical terms, Osteopaths may use a variety of techniques, all of which could help ease headaches:

  • Gentle structural osteopathic techniques, including manipulation
  • Gentle soft tissue massage
  • Lymphatic drainage techniques
  • Trigger point therapy
  • Western Acupuncture
  • Tailored exercise and stretching programmes to include in your daily routine
  • Low Level Laser Therapy,

Robin added: “In many cases, gentle massage techniques to loosen any tight muscles and manipulation techniques can be used on the joints of the neck, thorax and back.  This can relieve the build-up of muscular tension that may lead to headaches”

Patient testimonials

Over the past 20 years, Robin has seen a huge number of patients for headaches.

One patient said: “I had been suffering from headaches since childhood. Over the years, these had become more frequent and debilitating to the point where it was most unusual for me to have a day free of headache.

“I was recommended to see Robin. Robin set about releasing the tension in my upper back and neck though a series of manipulations and cranial massage. He also gave me some shoulder and neck exercises to do at home.

“I still attend regular treatments with Robin and my headache frequency continues to subside. Robin’s approach has without question improved not only the quality of my life but also that of my family, who now have less frequently to endure a bear (literally) with a sore head.”

If you are suffering from TTH or any other type of headache please do get in touch. Robin would be happy to conduct a call under no obligation.


There’s an increasing amount of anecdotal evidence from people suffering from Long Covid.  This is where symptoms remain for much longer than the suggested two week period and are often accompanied by issues outside the officially recognised cough, fever and loss of taste or smell.  These most commonly include debilitating fatigue, breathlessness, muscle aches and joint pain.  Also, ‘brain fog,’ memory loss, lack of concentration, and depression. Very similar to the symptoms of Chronic Fatigue Syndrome (CFS).

What is Chronic Fatigue Syndrome?

The main symptom of Chronic Fatigue Syndrome (CFS) is feeling extremely tired and generally unwell.  But this tricky condition can also deliver a range of additional nasties.  The severity of which can vary from day to day, or even within a day.  These include:

  • muscle and/or joint pain
  • headaches
  • sleep issues
  • brain fog – problems thinking, remembering or concentrating
  • a sore throat or sore glands that are not swollen.
  • flu-like symptoms.
  • feeling dizzy or sick.
  • fast or irregular heartbeats (heart palpitations)

Over the past few weeks, Osteopath Robin Kiashek has seen an increase in the number of patients presenting with these types of symptom.

Robin said: “Several of the patients I’ve seen with CFS symptoms know they have had COVID.  But, of course, we will never know how many people have already had it but were asymptomatic.”

What can be done to ease the symptoms of CFS?

Robin has been a licensed practitioner in The Perrin Technique™ for CFS/ME and Fibromyalgia for over 10 years.

This is a manual method that aids the diagnosis and possible treatment of Chronic Fatigue Syndrome/ME.  It was developed by Osteopath and neuroscientist Dr Raymond Perrin DO PhD in 1989.

What is the Perrin Technique™?

The Perrin Technique™ is based on Dr Perrin’s theory that different stress factors whether physical, allergies, emotional or infections lead to an overstrain of the sympathetic nervous system.

Further investigation has led to a probable cause of this nervous system overload being a build-up of toxins in the fluid around the brain and the spinal cord.

Some of the poisons caused by infection or inflammation in the head or spine flow through channels from the brain into the lymph ducts of the head face and neck.

The toxins are also meant to drain down the spinal cord and out into the lymph ducts lying along the spine. In a CFS/ME sufferer there is a back flow of these normal drainage points which leads to further toxicity and dysfunction of the central nervous system. This leads to the many symptoms we see in CFS/ME.

Research over past 30 years has validated Dr Perrin’s theories read more about them here.

The Perrin Technique and Long COVID

Dr Perrin and his colleagues from the University of Manchester have written to a number of medical publications to highlight the potential for a post-viral syndrome to manifest following COVID-19 infection.  A similar situation was previously reported following Severe Acute Respiratory Syndrome (SARS) infection, also a coronavirus.

Back in the clinic

Whilst this may sound like yet another blow from the hammer that is proving to be 2020, there is light at the end of the tunnel.

Robin said: “Working with the symptoms of CFS is never straightforward and patients often end up at my door after suffering for months (if not years).

“They have frequently been subjected to a barrage of medical tests and received lots of negative results.  So, they are also feeling understandably anxious about what’s could be ailing them.

“The good news for people struggling with Long COVID symptoms is that they are fairly recent and are therefore likely to respond more quickly to treatment.  But it can still be a long haul.”

Patient X has been seeing Robin intermittently since the end of April, shortly after they started to feel unwell.

Patient X explains: “In April, I was feeling the post-viral effects of likely Covid-19 and felt I had nowhere to turn to for support from a health and well-being perspective. My GP practice still remains phone consultations-only and I was frustrated that my health wasn’t improving. I had crippling fatigue, strange neurological symptoms, insomnia, dizziness and many other symptoms following the acute viral phase.

“Luckily, I did some research and learned that the Perrin Technique might be beneficial.

“I started regular sessions with Robin and was grateful for the holistic advice. He confirmed that I had post viral fatigue which mirrors chronic fatigue syndrome and I started my Perrin Techniquesessions weekly.

“I am not 100% yet back to normal, but I feel it’s been a beneficial journey so far. I also feel empowered that I have a way of helping my recovery beyond resting and healthy eating.”

There are two Robin Kiashek Osteopath Clinics  – in Central London (on Regent Street) and in East Finchley.

If you’re suffering with any of the symptoms listed above, then why not request an appointment or call on 020 8815 0979?

What can we do to lessen the impact of working from home

Remote working or working from home (WFH) has been on the rise for the past last few years.

And since lockdown there’s been a huge spike in the number of people swapping their perfectly set up office desks to makeshift work spaces desks in their living rooms, kitchens or even bedrooms.

According to the latest statistics released by the UK’s Office for National Statistics in April, 49.2% of adults in employment were working from home as a direct result of the social distancing measures introduced in response to the Covid-19 pandemic.

Whilst restrictions around social distancing might be easing, there’s still a huge number of people who either work remotely permanently or for the majority of the working week.

But what physical implications and emotional does WFH create?

Repetitive Strain Injury (RSI)

Whether it’s your wrists, hands, forearms, elbows, neck or shoulders – RSI has a lot to answer for. RSI is a general term use to describe muscle, nerve and tendon pain caused by repetitive movement and overuse. It can strike anyone who performs a repetitive or high intensity action for long periods without rest. It’s also exacerbated by poor posture or activities involving working in an awkward position. Like typing on a computer or using your smartphone excessively.
Symptoms of RSI include burning, aching, or shooting pain. But you might also experience stiffness, throbbing, tingling or numbness, cramp or chronically cold hands, particularly in your fingertips.

Headaches and migraines

Bad posture, increased screen time and changes in our daily routine can all trigger tension headaches. The main feature of a migraine is a headache. But other symptoms include disturbed vision, sensitivity to light, sound and smells, feeling sick and vomiting. They can last anywhere between four to 72 hours.

Neck problems

Neck pain associated with badly positioned screens and looking down – attractively double-chinned – at mobile phones is increasingly common in this tech focussed world, and even more of an issue with so many of us now working from home.
According to The Institute of Osteopathy, tight neck and upper back muscles, stiff joints, and trapped nerves are common effects of spending too long being hunched over screens, and if left untreated, can cause splintering pains through the shoulders and hands.

Emotional implications

One of my patients told me recently that she’s always referred to her husband as her nearest and dearest. But now she just calls him her nearest! And I think that many of us can probably empathise with that feeling!
Lockdown and the ongoing working from home has put many of us in much closer proximity with family than we’re used to. And that requires emotional adjustment. Plus, there can be employment and financial worries to take into account. And stress and anxiety can bring a host of physical symptoms.

What can we do to lessen the impact of working from home?

There are a variety of ways that you can lessen the impact of working from home on your physical and emotional wellbeing.

These include:
• Set the computer screen so that’s it at eye level
• Keep your feet flat on the floor and try not to cross your legs.
• Consider a wrist rest to keep your wrists straight and at the same level as your keyboard.
• Use a headset if you use the phone a lot, rather than clamping the phone between your ear and shoulder.
• Do some simple neck exercise through the day
• Drink plenty of water through the day – the discs between the vertebrae in the spine consist mainly of water so keeping hydrated will ensure they stay healthy.
• Try to take regular breaks – these are good for body and mind. Small and frequent rests are preferable to one long one

Learn about our Home Office Ergonomics service, a service designed to improve your home working arrangements


As we head into Migraine Awareness Week (3rd to 8th September), here are a few facts about this disabling condition that might surprise you:

  • Migraine is the world’s third most common illness, suffered by one in seven people across the globe and eight million people here in the UK;
  • Migraines affect twice as many women as men and can also strike at young children;
  • Most sufferers have an average of 13 attacks a year, lasting between four hours and three days;
  • The World Health Organisation (WHO) categorises chronic migraines as more disabling than blindness, paraplegia, angina or rheumatoid arthritis;
  • The illness costs the UK around £2.25 billion per annum, taking into account the cost of medication and the 25 million days of sick leave!

(Sources: Migraine Trust/ Migraine Action)

 What is migraine?

Migraine is, therefore, an absolute headache in every sense of the word. But more than that, it’s actually a complex neurological condition that can affect the whole body. Usually (but not always) there’s a painful headache preceded or accompanied by disturbed vision or aura. This can present with, for example, flashing lights, blind spots, zig zag patterns, pins and needles, numb limbs, confusion and difficulty in speaking. Not all sufferers experience aura, and other common symptoms include dizziness, nausea, vomiting, sensitivity to light, sound and smells. Attacks can vary in frequency and severity with an often enormous impact on someone’s work, family and social lives.

There is no known cause or, sadly, any cures currently on the horizon. What we do know is that most sufferers have a genetic predisposition and that their migraines can be triggered by one or more factors – stress, alcohol intake, the environment, hormones (women) and lack of food or sleep. It’s no longer helpful just to blame chocolate, cheese and red wine, and the best way of pinpointing your particular triggers is to keep a daily ‘migraine diary’.

Professor Peter Goadsby, Professor of Neurology, King’s College London, describes migraine as “an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger”.  (Source: Migraine Trust).

Best treatments for migraine

Most treatments focus on controlling the pain, severity and frequency of attacks via the use of medication.

Having said that, complementary therapies such as Western medical acupuncture – piercing the body with fine, sterile needles at certain points to regulate pain – has had some success in reducing the need for medication and the frequency of attacks..1 This approach has been endorsed by The National Institute for Health and Care Excellence (NICE), particularly for patients who do not respond to certain medications.

Osteopathy is also popular because it helps relieve symptoms whilst understanding and addressing the underlying, sometimes multifactorial, factors involved. The treatment utilises a variety of osteopathic techniques.

Kind words from migraine sufferers

I’ve seen many patients struggling with migraines.  One said:

“I had been suffering from headaches since childhood. Over the years, these had become more frequent and debilitating to the point where it was most unusual for me to have a day free of headache. Headaches became migraines and I felt ‘better’ when the migraines had retreated to the state of ‘mere’ headaches.

I was recommended to Robin who set about releasing the tension in my upper back and neck through a series of manipulations and cranial massage. He also gave me some shoulder and neck exercises to do at home. I was asked to keep a ‘headache diary’ showing severity and frequency in order to plot any improvements.

After around 5 or 6 sessions the headaches became less severe and didn’t turn so readily into migraines. About 8 weeks into treatment I had a major headache which, when it subsided, disappeared completely. Thereafter I began to get not only headache-free days, but headache-free weeks. The cycle had been broken.”

So if you’re suffering from migraines why not book an appointment with me to see what can be done to alleviate the symptoms and cause of your migraines.


1 Migraine Trust/Vickers A. et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial BMJ 2004;328;744-9.

Most of us have experienced headaches at some point in our lives.  They can be painful, debilitating, annoying and worrying.  But they also come in many forms.  So, what are the causes and how can we relieve the symptoms?

Headaches are not always as straightforward as you may think, in fact there are over 150 different types – each with its own list of causes and symptoms.  So, how can you possibly know how to deal with yours?


What type of headache do I have?

It would be impossible to list all 150 here, but to get you started with identifying the type of headache you may be experiencing, here are some of the most common:

Tension headaches: Most common among adults and teens. A tension headache causes mild to moderate pain and can come and go over time, usually with no other symptoms.

Migraine: A migraine is usually accompanied by intense headaches, often described as a throbbing pain which can last from 4 hours to 3 days, and usually occur between 1-4 times per month. Alongside the headache, sufferers can experience other symptoms such as:

  • sensitivity to light, noise or smell
  • nausea and vomiting
  • loss of appetite
  • visual disturbance prior to onset of headache

Cluster headaches: these are 3-4 times more likely to affect men than women, can feel like an intense burning pain behind or around the eye or on one side of the head.  Whilst it is the least common type of headache, it can be the most intense and severe.  Cluster headaches leave sufferers unable to follow their usual daily routine.  They cannot lie down or keep still and attacks are often accompanied by eye redness and copious watering and a very runny nose.

So called because they tend to occur in groups, cluster headaches come in many forms:

  • Clusters of headaches 1-3 times per day
  • A prolonged period of headaches lasting 2 weeks to 3 months
  • Headache attacks lasting 15 minutes to 3 hours
  • No headaches at all for months or years, but then they return later.

Sinus headaches:  Sufferers feel a deep constant pain in cheekbones, head and nose. This type of headache can be associated with a cold or other seasonal medical complaint, such as hay-fever.

Hormone headaches: Women often experience headaches when changes in their hormone levels occur, usually during periods, pregnancy or menopause.


What causes headaches?

Headaches can incredibly debilitating, so what causes the pain?

Headaches come from a mix of signals sent between the brain and nearby nerves.  These nerves, blood vessels and head muscles switch on and thus send signals to the brain to tell it, it is in pain. Unfortunately, there has been no clear factor to determine why these signals turn on in the first place.

Headaches can be triggered by a variety of things:

  • An illness – such as a cold, fever or virus;
  • A condition such as sinusitis, an ear or throat infection;
  • An injury such as a blow to the head;
  • Emotional stress or depression;
  • A change in sleep patterns;
  • Skipping meals;
  • Taking too much medication;
  • Too much physical activity;
  • Changes in the environment around you – i.e. second-hand smoke, strong smells, noise, lighting and changes in weather;
  • Hereditary – migraines especially, tends to be passed down through generations;
  • In rare cases, TIAs (Transient Ischaemic Attack) etc. which would need a referral to either a GP or A&E.


What can I do to ease my headache or symptoms?

In addition to preventative measures such as avoiding the stressors listed above or perhaps eliminating caffeine, many people turn to over the counter medication, relaxation techniques, having a lie down or taking a relaxing bath.

But what other approaches are there that could help relieve your symptoms?

The short answer is Osteopathy – which offers the possibility of relieving the symptoms whilst understanding and addressing the underlying, sometimes multifactorial, factors

A combination of manual therapies such as osteopathy and tailored exercise programmes to suit you as an individual, could lead to long-term control of some types of headaches.

Recent research has shown that manual manipulation treatments such as those performed by an Osteopath, were as effective as prescribed drugs for providing relief from short term chronic headaches, but with fewer side effects than medication.


What will an Osteopath do?

Initially, a detailed case history and clinical examination of the patient will be done to eliminate underlying pathology, which may require referral for more specialist assessment.

Osteopaths may use a variety of techniques, all of which could help ease headaches. These could include:

  • Gentle structural osteopathic techniques, including manipulation
  • Gentle soft tissue massage
  • Lymphatic drainage techniques
  • Trigger point therapy
  • Western Acupuncture
  • Tailored exercise and stretching programmes to include in your daily routine
  • Low Level Laser Therapy, when appropriate.

If you would like to discuss headaches which you might be experiencing, Robin would be happy to talk to you with no further obligation.

In the meantime, click here to read testimonials from some of my clients who have found our techniques helpful in easing their symptoms.

There are a number of questions I am frequently asked when I tell people I am an Osteopath. These generally go along the lines of “what do you actually do”, “how are you different from a Chiropractor” or “what can you treat?” Conversationally these questions are easier to answer, however this printed article has a finite word count. So in this instance I will direct you to my website where not only these questions, but a multitude of others, are answered.

So why do people most commonly need an Osteopath?

london osteopath w1 n2 n10For me, within a clinical setting, I like to use the analogy of ‘The Dripping Tap Syndrome’. People will often have a small twinge or niggle of pain (a dripping tap over a glass scenario) which progressively starts to irritate that little bit more frequently (the glass starts to fill up). This can be over a period of weeks, months or even years. The analogical drip ultimately starts happening more often until eventually the final drop causes the glass to overflow and the patient experiences a significant increase in pain (commonly known as ‘acute’ pain). This ‘final drop’ can be an everyday event – maybe a sneeze, bending forward, a certain slight move etc

People come to me when the glass has overflowed. And my job is not only to turn it off, but to then understand why the tap was dripping in the first place. And the underlying reasons can sometimes be multifactorial – both on a physical level and sometimes emotional

How Can an Osteopath Help?

Assuming that someone has an issue which I can help, be that chronic or acute pain, sciatica, workplace injuries, sporting injuries or migraine, there is a very common set of three questions people ask me:

  1. What’s happening? (which is often a subtext for is it something more serious which I may not survive)
  2. How long will it take to fix?
  3. Will it come back?

A Holistic Approach to Health

Physiotherapist massaging patientUltimately I take a holistic approach to any health issue and, to go back to the analogy, find out why that dripping tap first occurred. As somebody who has undertaken extensive training from Osteopathy and Naturopathy, Post graduate studies in NeuroLinguistic Programming (NLP)/Life Coaching, Western Acupuncture, The Perrin Technique for Chronic Fatigue Syndrome and Low Level Laser Therapy.

Stopping the drip is normally the relatively straightforward part of what I do. When it comes to preventing it from recurring this is where I need to understand the individual patient’s causative factors and working alongside them, help reduce the probability of a re-occurrence.

We both want the same goal, the patient to be happy and pain free. And by working together that is a more likely outcome.

To find out more about working with me in North or Central London please call 020 8815 0979. Alternatively you can request an appointment directly through our website here: