The clocks have gone back and as well as signalling the onset of shorter days, it can also trigger what has affectionately been dubbed the ‘Winter Blues’ – or Seasonal Affective Disorder (SAD).

But what is SAD, how do I know I have it and what can be done to tackle it?

What is SAD?

SAD is often known as ‘Winter depression’ or the ‘Winter blues’ and this mainly due to most sufferers experiencing symptoms during the winter months, although there are some cases where SAD sufferers experience it all year.

Typically, symptoms begin in Autumn as the days begin to get shorter and increase to their most severe point during the Winter months – December to February, often improving as spring begins and fading completely during the Summer months. This can continue in a repetitive fashion year after year.

And, the reason seasonal change has a link to SAD is because one of the main factors behind this condition is thought to be linked to our exposure to natural sunlight.

What are the Symptoms?

As with most conditions, symptoms vary and not everyone will experience the same symptoms, or indeed all of them. However, they can include:

  • A continuous low mood
  • Feeling lethargic, with a lack of energy and desire to perform normal daily tasks
  • Sleep problems – falling asleep during the day, but unable to sleep at night
  • Anxiety, irritability, not wanting to interact with people
  • Depression or feelings of despair, worthlessness or guilt
  • Craving carbohydrates, sweet foods which can then lead to weight gain
  • Loss of libido or interest in physical contact

For some these symptoms, can have a serious effect on their daily lives, leaving them unable to perform even the simplest of tasks.

What is the cause?

While the exact cause of SAD is still not fully understood, it is often linked to the reduction of exposure to sunlight which is why it is more prevalent in the Winter months.

The prominent theory is that the lack of sunlight during this period, may stop a part of the brain called hypothalamus working properly, and which in turn may affect the:

  • production of melatonin– melatonin is a hormone that makes you feel sleepy; In SAD sufferers, the body may produce it in higher than normal levels
  • production of serotonin – serotonin is the hormone that affects your appetite, mood, appetite and sleep patterns – therefore a lack of sunlight may lead to lower levels of serotonin, which has been linked to feelings of depression
  • body’s internal clock (circadian rhythm) – your body uses sunlight as its internal clock, triggering time for various important functions, such as when you wake up. Therefore, lower light levels during the winter may disrupt this and lead to symptoms of SAD

In addition, there is some indication that genes also play a factor in making some people more vulnerable to the symptoms of SAD, as in some cases it has appeared to run in the family.

What can be done to combat SAD?

There are a range of treatments that those suffering with SAD can explore to reduce the symptoms, and help those with severe cases to regain some normality to their daily routines.

These include:

  • lifestyle changes – including increasing the amount of natural sunlight you receive as possible, exercising regularly, eating a better diet and managing your stress levels;
  • light therapy – where a special lamp called a light box is used to simulate exposure to sunlight. There are many different versions available on the market.
  • talking therapies – such as cognitive behavioural therapy (CBT) or counselling
  • medication – if your symptoms do not improve your GP or medical professional may suggest a course of medication, such as an anti-depressant.

If you feel like you are experiencing symptoms of SAD, and wish to discuss with us more detail the ways in which we could help, please get in contact today via email or by telephoning 020 8815 0979.

Teenagers constantly checking their mobile phones, employees hunched over computer screens all day and silver surfers feeling the after-shocks of years spent at a desktop, the sharp discomfort of ‘tech neck’ can strike at any age.  Neck pain associated with badly positioned screens in offices, sedentary lifestyles and looking down – attractively double-chinned – at mobile phones is common in this tech focussed world, and can become uncomfortable.

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. But there are some simple adjustments that could make a difference:

  • Set the computer screen so that’s it at eye level
  • Do some simple neck exercise through the day
  • Make sure that a lunch break gives the neck, as well as the mind, a rest, by getting away from that screen
  • 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.

And if the problem persists?  Occupational therapies like osteopathy can be successful in helping with the symptoms through the use of gentle manipulations, soft tissue massaging, and joint movement.

Robin Kiashek has over 20 years’ experience of Osteopathy and allied therapies and offers safe, gentle and effective treatment for a wide range of patients. There are some fantastic testimonials from people who came to see Robin with upper back and neck pain here.

So, whether you’re a serial surfer, or a deskbound double-chinner, there are things you can do to lessen the discomfort of ‘tech neck’.  And if you’d like to discuss how Osteopathy might help you specifically then please do get in touch with Robin.

Have you noticed how your cat and dog always have a good stretch when they wake from a nap?

Well maybe we should follow suit because when we sleep we lie in the same position for an extended period and this can lead to stiff muscles that become tight through the lack of movement.  So if we were to act like the animals and start the day with a stretch it would really help to:


  • Loosen and realign muscles
  • Iron out any kinks from sleeping in an odd position
  • Signal the brain that it’s time to get up and start using those muscles again
  • Get the circulation going.

And since we start the day all warm after our night under the duvet, the body is already at a temperature ideal for effective stretching.

Stretch it out

Stretching is in fact one of the best ways to keep your muscles healthy, here’s how:

  • Regular stretching strengthens muscles and increases flexibility
  • Increased flexibility in turn benefits joints
  • Both of which will give a better range of motion for day-to-day activities

In fact, stretching daily as a stand-alone activity can boost muscle and joint health, decrease the risk of day-to-day injury by improving flexibility, reduce tension and improve posture.

And while the ‘morning stretch’ so readily employed by our furry friends is a great way to wake up and get going, a more targeted stretching routine for specific parts of the body will have the greatest benefit to you muscle and joints.

Boost your energy

Stretching at work can also help to avoid repetitive strain injuries that are caused by many office-based duties, as well as boost your energy! Simple overhead arm stretches or leg raises under the desk are a great way to start, but don’t be afraid to get up and do a few squats to get your circulation going too.  Here’s my five tips to get a better stretch:


  1. Make sure to stretch evenly on both sides of the body
  2. Hold each stretch for about 30 seconds
  3. Never bounce while you stretch
  4. Focus on the different muscle groups – shoulders, neck, calves, thighs, hips, arms and the lower back.
  5. Breathe! Exhale while going into a stretch and then hold it as you inhale.

And if you are still feeling the strain, and are starting to feel a little stiffness in your neck, arms or lower body then why not consider a course of osteopathy to aid the release of this tension and provide relief from bad posture and tight muscles?

Get in touch to find out more

Hints and tips for achieving a better night’s sleep.  For a happier, healthier you.

Sleep is a hugely popular topic of conversation. And with over 60% of us unhappy with the amount of shuteye we get* it’s not surprising that it’s often the first thing we discuss with our partners in the morning – especially when young children are involved! Read on to find out why sleep is so important, how our bodies can be affected when we don’t get enough and some top tips for getting a blissful night’s rest.

*Dreams UK Sleep Survey 2016

Why is a good night’s sleep so important?

Sleep plays a significant role in brain development and is essential to maintaining cognitive skills such as speech, memory and innovative and flexible thinking. It’s also vital in protecting our physical health.

And whilst most of us know that a lack of sleep often leaves us feeling grumpy and sluggish, how many of us realise the huge impact it can have on other areas of our lives, including our physical and emotional health?

Tell-tale physical signs

The physical impact of not achieving the recommended 7-9 hours of sleep each night can bring a range of issues:

  • Sallow skin;
  • Dark circles under the eyes;
  • A lowered immune system;
  • Increased chances of developing chronic illness such as diabetes and heart disease;
  • Imbalance in the hormones that tell us whether we are hungry or full, which could result in weight gain;
  • Reduced energy levels;
  • Higher insulin levels which could increase the risk of type 2 diabetes;
  • Decreased ability to heal, build muscle mass or repair cells and tissues;
  • Back and neck issues from poor sleep positioning;

Emotionally drained

But the impact of poor sleep isn’t limited to physical issues, it can also have a significant emotional effect:

  • Feeling overwhelmed
  • Irritation, anger or hostility
  • More easily annoyed
  • Fuzzy thinking and difficulty in making decisions
  • A lack of positivity
  • Difficulty concentrating
  • Increased anxiety
  • Forgetfulness

Stress and sleep

Like sleep, or the lack of it, stress is another factor that affects many of us and I’ll be looking at this in more detail in my next newsletter. But increased stress levels can have a significant effect on the quality and quantity of sleep so it’s well worth considering whether you feel anxious and if you can pinpoint stress factors in your life that could be addressed.

What can I do?

So, what can you do to combat the signs of sleep deprivation and reduce the impact it has on your life? Here are some tips for getting that all important 8 hours:

  • Don’t go to bed on a full stomach – avoid heavy or large meals within a few hours of bedtime. They could lead to discomfort and keep you awake;
  • Avoid alcohol before bed – initially it may make you sleepy but can cause wakefulness after a couple of hours and make it difficult to get back off again;
  • Stop the stimulants – caffeine and nicotine are best avoided in the run up to bed time. The effects of caffeine can last for up to 8 hours, so that late afternoon coffee could be causing a problem;
  • Create a calm environment – cool, dark and quiet are the ideal elements to promote a good night’s sleep;
  • Develop a wind down routine – calming activities such as taking a bath, reading a book or performing relaxation techniques could all aid sleep;
  • Timing is key – try to go to bed and get up at the same time every day to re-inforce your body’s sleep/wake cycle;
  • Power down – switch off computers and phones at least an hour before bed;
  • Pillow perfection – make sure your pillow is the correct size and firmness for you. It should fit snuggly into your neck and shoulders so that it fully supports your head;
  • Check that mattress – the recommended lifespan of a mattress is eight years so it might be time for a trip to the shops;
  • It’s all about the base – Your mattress should suit your physical needs, which isn’t necessarily always a hard mattress, as is often the case. In addition, your mattress of choice also needs support. Placing a mattress on slats will not benefit the longevity of it. Consider investing in a divan which is itself sprung and onto which your mattress rests. This combination will be much more beneficial.

But if you are still feeling the effects of lack of sleep and need something extra to help you combat the impact this is having on your life, then why not come and see me?

As an Osteopath and Naturopath (with clinics in North London and Soho, Central London) registered with both The General Osteopathic Council and The British Naturopathic Association, I am committed to helping my patients achieve physical and emotional wellbeing.

I will work with you to address your presenting symptoms and to understand the cause of them. I will also support you to improve your overall health. Plus, there is some encouraging evidence which suggests that acupuncture has a role to play in helping people to deal with longstanding sleep problems and that might be something we could explore.

So why not get in touch today to find out how you can start the journey to a better night’s sleep?

Someone once mentioned to me that “we are the sum total of the decisions we make in life” Did you see Chelsea Cameron on Victoria Derbyshire’s show when she thanked her drug-dependent parents for all the things they DIDN’T do for her as a child and the choices she made subsequently?:

With this in mind, my wife Georgie and I found ourselves last year at a craft exhibition in London. Whilst we were looking for a particular exhibitor, we came across the work of Peter Lanyon who was exhibiting his woodcraft furniture in one of the stalls (

Rewinding the clock nearly 50 years, one of the few subjects I enjoyed at school, apart from Biology, was woodworking but being a boy and it being the 1970s, science was the obvious avenue to pursue.

Magazine rack made at school, circa 1973

Magazine rack made at school, circa 1973


I was taken by Peter’s beautiful handmade Devon furniture, which uses coppiced wood i.e. freshly cut unseasoned Greenwood and traditional woodworking tools. On the spur of the moment, I signed up with my wife to do Peter’s ‘Introduction to Greenwood Furniture Making’ for my 60th birthday present!

Shaping the Ash legs from a split tree trunk

Shaping the Ash legs from a split tree trunk


Whilst this was relatively familiar territory for me, for Georgie it was very much out of her comfort zone. So why mention this in my newsletter to you? The answer I believe is that as we all become older, so we become more set in our ways, both emotionally and physically. For most of my patients and our society generally, lives are largely sedentary and much like me, one gravitates towards what is most comfortable and familiar.

Lanyon 3 Lanyon 4


It is interesting I find how conquering one’s own, seemingly trivial, mental limitations can have profound and far-reaching results in one’s lives. My wife, who is a primary school teacher, had an OFSTED-type class inspection the following week after her return from Peter’s course. She claims that her ‘Outstanding’ OFSTED result was, in part, due to the positive emotional influence she felt having conquered her reservations of her own ability to do woodcraft.

The finished products (Georgie’s table left)

The finished products (Georgie’s table left)


So my message to everyone is: DO SOMETHING DIFFERENT! It needn’t be doing a course – I sometimes ride my motorbike to work a different way …. it’s very small and trivial but it’s just “doing something different”. When was the last time you spontaneously said “hello” to a stranger in an elevator? How often do you stop to say “hello” to someone living rough? And so the list goes on and on. In NLP jargon, it’s called “changing state”.

Almost every one of us knows somebody who suffers from Arthritis, and of the most common statements you’ll have heard those friends or family members make is that their symptoms worsen in the winter. Indeed many people who have the condition go to warmer climates for a holiday at this time of year to lessen the symptoms.

In this article I will take a look at what arthritis is and why winter can make it so painful.

What is Rheumatoid Arthritis?Rheumatoid Arthritis

It’s an autoimmune disease which causes stiffness and pain because of inflammation in the joints. It’s not to be confused with the much more common Osteoarthritis caused by regular wear and tear on the body which is why it troubles people as they get older. Osteoarthritis can cause deformities in the hands as can be evidenced on television in a well-known celebrity baker who is advanced in years.

Doctors usually treat Rheumatoid Arthritis with anti-inflammatories and pain relief medicine however a growing number of people are looking for a natural approach. If you remember a few months back when I circulated ‘The doctor who gave up drugs’ this is an approach I support as a registered naturopath.

Why are the symptoms of Arthritis harder to manage in winter?

According to Robert Jamieson, Professor at the Harvard Medical School and chief psychologist at the Pain Management Centre at Brigham Hospital, it may be a change in barometric pressure which causes the worsening of symptoms rather than cold, rain or snow. He carried out a survey focused on patients with chronic pain which reported “67.9% of the people surveyed responded that they were sure changes in the weather had an effect on their pain. Most of the patients reported that they can feel a change in their pain before rain or cold weather occur.”

His reasoning on it being barometric pressure cause was from a test conducted on a balloon. “When a balloon is inflated, it has the maximum inside and outside pressure. High barometric pressure that pushes against the body from the outside keeps tissues from expanding.” His conclusion was that the falling barometric pressure falls led to tissues expanding in the body and that in turn puts more pressure on nerves that control pain signals. He concluded that “it doesn’t take much expansion or contraction of tissue to affect a pain trigger.”

What if you can’t avoid bad weather?

Living in London makes bad weather pretty unavoidable and not all Arthritis sufferers have the luxury of being retired and able to spend chunks of the winter in sunnier regions. So I would suggest a number of lifestyle changes which could help to lessen your symptoms including:

  • Research naturopathy – we really are what we eat and there’s a connection to many foods and their ability to lessen inflammation. Turmeric contains Curcumin which is very well known for the aforementioned inflammation reduction properties, however if you feel you cannot eat enough curries to contain a beneficial amount there are supplements available in health food shops. Celery is also well known to reduce inflammation and a great way to eat as much as possible is through soup, I have included a recipe from the BBC
  • If you are overweight try to lose a few pounds – the heavier you are, the more pressure you put on joints which in turn causes more pain
  • Try acupuncture – there is increasing evidence that acupuncture can lessen symptoms of arthritic pain. My website has much more information on acupuncture so that would be a good starting point in finding further information.
  • Exercise more – I said above that losing weight would help and regular exercise will aid this. However the more you flex joints the more you’ll keep them flexible so try things that aren’t weight bearing (as running would cause more damage) like swimming or yoga. It’s purely coincidental that my other article this month is on the benefits of yoga to chronic back pain sufferers.

In summary, there is a lot you can do to lessen symptoms. However if the information above seems daunting them feel free to make an appointment with me to discuss manageable changes in your life which can help to lessen the pain – just call 020 8815 0979 or click here to request an appointment.

As a practising osteopath in London I see a number of clients each week that experience back pain, in varying forms and severities. For these clients I am able to provide a comprehensive treatment plan and we work together over a number of sessions to treat the problem. In addition to treatment provided by myself I also look to work with clients on what lifestyle changes can be made and other things that can be introduced to try to prevent problems such as back pain recurring again in the future. I was therefore interested to read about a recent study carried out in the US into yoga and the positive benefits it can have on long-term back pain.

Women practicing yoga in a class

A recent study into yoga and back pain

The study analysed more than 1000 men and women who were experiencing long-term lower back pain. It found that those patients who practised yoga were most likely to improve their mobility and reduce their pain levels. These patients were all taught yoga-like exercises by experienced and qualified professionals.

Lead author Susan Wieland, from the University of Maryland School of Medicine, said: “Our findings suggest that yoga exercise may lead to reducing the symptoms of lower back pain by a small amount, but the results have come from studies with a short follow-up.”

Back pain affects nearly one in 10 people in the UK and becomes more common with age. Very often the cause of long-term back pain is unknown, which can be very frustrating for the sufferer. Perhaps putting down the pain-killers and picking up a yoga mat could help to relieve some of the pain.

Following on from this initial research, the scientists involved in the study are also now calling for longer-term studies to really understand the full benefits for patients.

So what is Yoga?

Yoga, stemming from the Sanskrit work ‘yuj’ to yoke or join, yoga aims to “coordinate the breath, mind and body to encourage balance, both internally and externally,” according to the British Wheel of Yoga. Yoga is a practical philosophy and a system of asanas (postures), promoting physical, mental and spiritual wellbeing. It is an effective antidote to the stresses of modern lifestyle and encourages a fit and supple body. Yoga is a ‘science of the mind’ and philosophical system that originated in India thousands of years ago.

A typical yoga class here in the UK will last between 60-90 minutes and you can find them at leisure centres, gyms and in local halls and community centres. Yoga is very accessible for all body shapes and ages and you really don’t need much equipment (or even shoes!) to give it a go.

Experiencing back pain?

If you are experiencing back pain why not try a yoga class near you, or call The Robin Kiashek Clinics for a consultation on 020 8815 0979.


STOP PRESS:  NHS Research findings 2016 –
9th Perrin Technique Conference for Chronic Fatigue Syndrome.

Perrin Technique LondonThe push for Evidence Based Medicine seems to be a double edged sword – without a double blind trial supporting a claim of efficacy, as required by The Advertising Standards Authority (ASA), one is unable to make claims for a treatment of any condition a patient may be suffering. With costly research, Osteopathy is lagging behind the ‘firepower’ of well-funded pharmaceutical companies.

With this in mind, osteopath Dr Ray Perrin, who was recently awarded the Institute of Osteopathy’s (iO) prestigious research award, has recently completed a unique NHS research project ‘Examining the accuracy of a screening tool for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis’ at The Wrightington Hospital, Wigan.

At the annual Perrin conference on December 4th, the research findings were presented by Lucy Hives, Allied Health Professions Research Unit at the University of Central Lancashire.

The research has proved successful however as with any research there is a period of confidentiality so I cannot dwell on them in detail in this article. The results are being currently submitted to the BMJ (British Medical Journal) for publication, hopefully, next summer. When they are published I will be delighted to share them with you.

Following the presentation, there were lectures from German doctors Dr. Klaus Dorhage , PhD and Dr Andreas Grothusen, PhD (the former also a German Osteopath, the latter a German Chiropractor and both trained in The Perrin Technique) on ‘CFS/ME: A Neuro-Lymphoma-Endocrino-Immunopathy’.

cureYou may remember that I recently wrote about the BBC programme The Doctor Who Gave Up Drugs. Along similar lines I recently attended a workshop based on Cure: A Journey Into the Science of Mind over Body which is a bestselling book by Jo Marchant.

Just some of the questions posed throughout the book include:

  • Are those who turn to alternative medicine deluded, or are they on to something?
  • Can our thoughts, beliefs and emotions influence our physical health?
  • Can we train our brains to heal our bodies?

As an Osteopath who is also a qualified Naturopath who offers, amongst other therapies, Acupuncture and Autogenic Training I truly believe in treating the whole person rather than a symptom or set of symptoms.

The philosophy and direction behind the book made me assess the best way to fulfil my ethos of helping my patients achieve physical and emotional wellbeing.

This book had me gripped from the start when Jo Marchant reviewed the science of what we understood about placebos and how they have the power to make people feel better. She asks if “kissing it better” really works, which most children who have had a bump or graze healed in this way would say it did. She then goes on to ask how and what can be the mechanics of such a thing, perhaps a release of endorphins?

Over the pages she stages a riveting discussion of how language, meaning and culture determine how people experience illness.

I cannot recommend this book enough and if you would like to purchase a copy on Amazon please click here.

So who has been watching on BBC1 a two-part program called The Doctor Who Gave up Drugs?

For those of you who have not watched this program, it is a must watch (only a few days left for episode one!)

A two-part social experiment

doctor_who_gave_up_drugsEpisode one is the first of a two-part social experiment in which Doctor Chris van Tulleken takes over part of a GP surgery and stops patients’ prescription pills. Here is a link to the program, which can be found on BBC iPlayer:

Using exercise to overcome illnesses

In 1995, as part of my 3rd year Osteopathic dissertation, I was very fortunate to meet a charismatic GP by the name of Doctor Hanratty, who worked from East Hailsham in Surrey. Doctor Hanratty had set up an Exercise-on-Prescription program during the preceding years, having sought alternatives to medicating certain patients who suffered from conditions such as hypertension, diabetes and depression:

I approached Doctor Hanratty as I was interested in the possibility of using exercise to help patients overcome illnesses that I thought resulted from lifestyle factors. In particular, I wanted to see if patients suffering from depression can be helped with exercise and with Doctor Hanratty’s help I undertook my dissertation ‘The Effects of Exercise Training on Clinical Depression’, working alongside numerous Surrey GPs who referred patients for my ‘Exercise-on- Prescription’ project.

Weaning off medication

doctor_who_gave_up-drugs2Twenty years later, Doctor Tulleken’s fascinating two-part program illustrates how people suffering with, what he would describe as lifestyle illnesses can gradually begin to be weaned off their medication (with their GPs guidance); these patients suffer from a variety of different conditions including long-term chronic lower back pain, depression and hypertension, to name a few.

Whilst Doctor Tulleken is not against medication, a view shared by myself, he does illustrate how patients can be encouraged over weeks and months to make changes in their lifestyles, enabling them to slowly reduce unnecessary medication and regain control of their lives.

As I mentioned previously, a MUST WATCH program!

Links to both episodes on the BBC iPlayer can be found here:

Episode 1:

Episode 2: