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Sciatica (or in layman’s terminology lumbago) is a common nerve pain, which is a symptom of an underlying condition that affects the back, hips and legs. It is characterised by a pain accompanied sometimes by pins & needles and/or numbness and/or weakness in the legs. Sometimes the pain affects both legs, and though it most commonly runs down the back of the legs, it can manifest at the front or side too. The cause of the symptoms is irritation or compression of the sciatic nerve.

What is the sciatic nerve?

The sciatic nerve is the longest nerve in the human body, beginning at lower spinal region, running through the buttocks and extends right down the length of the leg to the feet. The symptoms (pain/pins & needles/numbness/weakness) can be felt either locally in the lower back or anywhere along the course of the sciatic nerve (as far as the feet). Other areas, including the genital region, can also be affected.

How do you get sciatica?

In most cases sciatica is caused by an irritation or compression of the sciatic nerve, commonly a bulging disc in the lower (Lumbar) spine. Discs are very special shock-absorbing, cushioning tissue structures, which sit between the vertebrae (the bones that make up the spinal column). Structurally, discs can the thought of as having an inner soft core (nucleous pulposus) surrounded by tough circular outer fibres (nucleous fibrosus), the outer fibres holding in place the softer inner core. Typically, over a period of time, the outer surrounding fibres develop micro tears due to, for example, poor posture or overloading over a long period of time (see the June blog article ‘The Dripping Tap Syndrome’). Bearing in mind the lower spinal discs absorb most of the upper body weight, these micro fissures in the outer fibres begin to allow the inner soft core to bulge outwards through the tougher outer fibres, resulting in a ‘disc bulge’, which in turn can begin to impinge on the surrounding tissues, including the sciatic nerve (this scenario is commonly eroneously called a ‘trapped nerve’).

How is sciatica treated?

sciaticaHere at the Robin Kiashek Clinics we promote prevention, and have plenty of advice on keeping your spine healthy and pain-free (see our recent article ’10 Tips for Maintaining a Healthy Spine’). However, if you are either experiencing symptoms, no matter how mild, or would like an assessment, an initial consultation should be considered. Robin will take a full case history followed by a clinical examination, which will provide you with a ‘working diagnosis’ of your situation.

You will get a care plan for your treatment, which may include a couple of follow up appointments, and you will get plenty of guidance on understanding pain, and will be given a strategy to move your recovery forward, including advice on exercise.

For more information on sciatica or to book an appointment with Robin, please call 020 8815 0979.

Western Medical Acupuncture is just one technique used by London Osteopath Robin Kiashek.

In this short video, Robin explains what this type of acupuncture is.

For more information on acupuncture please click here.

Here at Robin Kiashek Clinics we have been looking after patients with back pain and structural spinal problems for over twenty years. In some cases, pain is related to the way we are built but in others pain is present because of a recent or historical injury. Any pain is a signal that the body is out of balance and needs assistance in getting back to normal.

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At the Robin Kiashek Clinics, as well as treating acute pain when it occurs, we also aim to prevent problems in our patients before they take hold, so here is a list of 10 tips on how to look after your spine to ward off potentially debilitating problems.

Tip 1 – Rest Your Spine

We mean it! If you have suffered an injury or you are in acute pain, after seeing a specialist, ensure you thoroughly rest your spine. If there is swelling & inflammation, it will need time to go down and the tissue needs rest to recover.

Tip 2 – Wear Supportive Footwear

This might not be immediately obvious, or what you want to hear if you are a lover of high heels, but the plain truth is your footwear determines your posture. Your musculoskeletal structure is one system. Where one part is impacted it is felt elsewhere.

Tip 3 – Quit Smoking

This is not a big headline but it really should be. Nicotine and the general dehydration that goes along with smoking can adversely affect your spine. Also, in the same way that smoking affects blood vessels and circulation, it affects the vascular structures in your disks and joints. Many smokers suffer from lower back pain. It is no coincidence but backed up by research.

Tip 4 – Get a Massage

getty_rf_photo_of_hands_on_backMassage is good for so many aspects of your health. Primarily it helps increase endorphins – your body’s natural painkillers – that provide relief to sufferers of chronic pain. It helps stimulate your circulation, bringing a good blood supply to the affected area, and it improves your lymphatic drainage system helping your body combat disease.

Tip 5 – Limit Sitting Time

This is rather hard if you have a desk job, but you can combat stiffness and aches by regularly getting up from your desk and having a walk around, ensuring you get outside for part of your lunch break. Some people swear by standing desks. If at home, using advert breaks to get up and potter about for 5 minutes, or setting a simple kitchen timer for 45mins to remind you to move, could help you. Any movement and activity is good.

Tip 6 – Have an Ergonomic Workspace

Taking a little time in planning where and how to position your seat, your keyboard and screen or other things on your desk or workspace, can really save your back from straining and twisting. If you spend a lot of time shackled to a phone, for instance, it makes sense to give some thought to positioning essential tools or supplies.

Tip 7 – Practice Good Posture

Whether standing or sitting, try and be aware of your spine’s position. Stand with feet a comfortable width apart and try to hold your tummy in, elongating your spine if you can. When sitting, try to sit up, and if necessary, use a lower back support to help the natural curve in your back to stay in position. Knees bent at right angles and feet flat on the floor should also help steady your posture and support your spine. It’s surprising how we forget such a simple thing!

Tip 8 – Get Comfortable in Bed

Sleep will elude you if you are not comfortable in bed at night. Ask yourself if you need any extra support (maybe a cushion under your knees or between our knees if you sleep on your side) to take the pressure off your hips or lower back? Are you getting enough support from your pillow or mattress? Even things as basic as temperature and atmosphere can affect your sleep and whether you feel pain or not.

Tip 9 – Hydration, Nutrition and Weight

Drinking plenty of water is essential, whether you have a health complaint or not. Eating right also makes the difference in the speed at which you can bounce back from pain and injury. Particularly for people with any joint or muscle pain, sufficient hydration helps lubricate the joints and eating regular, well balanced meals means good lubrication of joints and disks, and nutrition reaching the parts of the body that are struggling. Excess weight puts unnecessary pressure on already beleaguered bones and joints, and can delay recovery or prolong pain. Consider seeing a dietician if you struggle with nutrition or controlling your weight.

Tip 10 – Stay Active and Exercise Your Core

As long as you aren’t in severe pain and have the green light to walk or exercise, try to do as much as you can manage, especially if your specialist has given you particular exercises to practice. If you are able to go to classes at the gym or are fortunate enough to have a personal trainer, depending on your level of fitness, you can hone in on core strength exercises to strengthen the muscles of your abdomen and back, and also your legs. This will support your spine and take the pressure off your lower back. Ensure your instructor is qualified to help you and always make them aware of your condition.

Be it a herniated disk or muscle strain, only a thorough examination by an experienced specialist can reveal the kind of pain it is, and consequently, how to treat it. At The Robin Kiashek Clinics we can offer the very best care and all that Robin’s vast experience can offer. Requesting a consultation is easy – click here to enter your details.

Low Level Laser Therapy (LLLT) is a technique used by London Osteopath Robin Kiashek.

In this short video, Robin explains what low level laser therapy is and what it can be used to treat.

For more information on Low Level Laser Therapy (LLLT) please click here.

We are delighted to introduce The Alexander Technique to The Robin Kiashek Clinics. Our STAT qualified Alexander Technique teacher Adrian Farrel explains further the therapy further.

The Alexander Technique is fundamentally different to other therapies in that it’s not strictly speaking a therapy at all. It’s therapeutic benefits are well documented but what sets it apart is that it’s truly educational. It essentially shows you how to stop hurting yourself with unconscious patterns of movement, and muscular and mental tension. You can think of it as a self care skill that puts you in the driving seat to actively take responsibility for your own health and well being, as well as improving your performance in sporting activities or playing a musical instrument.

The Alexander Technique is a practical form of embodied mindfulness, and this is something else that sets it apart from most other therapies. At it’s core is the idea that the body and mind aren’t simply connected (leaving them as separate entities still), but are part of a functional and indivisible whole, a psychophysical unity. As such it’s not just useful for dealing with physical pain but also how you react (and over-react!) to situations mentally, helping you to reduce your stress levels whilst maintaining your poise and improving posture.

The majority of musculoskeletal issues are down to the way we use ourselves. In fact, 100% of Repetitive Strain Injuries, almost by definition, are self inflicted injuries. It’s not so much what you do, but how you do it, the quality you bring to the repetitive movement. And acclaimed spinal neurosurgeon Jack Stern MD thinks that 97% of all back pain sufferers can benefit from the Alexander Technique, helping them to change the way they use themselves. He recommends it for his own patients and uses it personally for himself to help with the rigours of having to bend over while performing long hours of surgery.

There are no formal exercises, although it’s common to encourage a lying down “exercise” called Constructive Rest. It’s an exploration of how you respond to movement and situations, and how to become aware of habituated tension and prevent it. It allows you to become more you, without the unnecessary habits that get picked up along the way, allowing you to move more freely and economically. A skill for self development that can be applied to any activity whether that’s sitting at your computer, running, gardening or picking up your kids and pushing the buggy.

The Alexander Technique has been clinically proven for back pain with NHS funded gold standard randomised trials with the results published in the British Medical Journal, and is recommended by backcare.org.uk.

Many multinational companies have also turned to it for help including Chanel, the BBC, Google, HM Treasury and the Cabinet office in Whitehall. In fact, Victorinox, the makers of Swiss Army Knives, managed to reduce absenteeism by 42% by employing Alexander teachers to help their staff. And over twenty NHS trusts and hospitals have also brought the benefits of the Alexander Technique to their own staff.

The Alexander Technique has become very popular in the world of performing arts over the years with devotees such as Madonna, Paul McCartney, Sting, Keanu Reeves, Hugh Jackman, Victoria Beckham, Leonardo DiCaprio, Richard Gere, Dame Judi Dench, Pierce Brosnan and Hilary Swank for example. But it’s so much more than a celebrity best kept secret, it is genuinely something for everyone, whatever your background.

If you are interested to learn more and want to speak to Adrian about The Alexander Technique then please contact him on 07808 612510 or email info@alexander-technique.london

At The Robin Kiashek Clinics, we believe in a holistic approach to your general health. Therefore, as well as assisting patients with conditions that are currently causing them pain, we also look to encourage and promote other preventative techniques and practices such as meditation and mindfulness. After reading about some exciting new research in this field, we thought we would share some of the findings with you.

The benefits of regular meditation

We have long known of the benefits to body and mind from regular meditation and focused relaxation, but the evidence has often been dismissed as anecdotal. Now, across the world, we are seeing more and more studies into what happens to us physically when we engage in this kind of mindfulness activity regularly.

What is mindfulness and meditation?

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Before we discuss this latest research, let’s briefly touch on what meditation and mindfulness is. Meditation has been traditionally associated with the Buddhist faith and is considered to be a state of contemplation or prayer. Nowadays it is considered to be the practice of sitting quietly with one’s thoughts or focusing on breathing. The idea is to keep your mind in the present moment, calmly clear your mind of any particular thoughts, whilst in a lying or seated position, and becoming aware of the energy coursing through the body in order to relax.

Mindfulness is similar, in that it is a the practice of remaining present and becoming conscious of your thoughts, how they spring up, what they are telling you about your situation and learning how to observe those thoughts with a view to overcoming any negativity. It can also be practiced whilst going about daily tasks, by way of stepping back and being more aware of how we are feeling or acting.

Recent studies of brain activity

A very recent study used MRI (magnetic resonance imaging) scanning to prove conclusively that meditation can affect grey matter positively, causing it to undergo large, observable changes.

The work has been carried out in the Massachusetts General Hospital (MGH). The project’s director, Sara Lazar, has concluded that during an average daily 27-minute meditation, the very structure of the brain alters. These changes lead to prolonged positive and relaxed feelings, and if sustained over a period of 8 weeks, result in significant changes and improvements in emotional life, as well as in the body.

In previous studies by Lazar’s team, the area of the brain that relates to attention and emotional integration, the cerebral cortex, has been shown to thicken in regular practitioners of meditation, more so than in subjects who had no previous experience in such activities.

Changes in our ‘dinosaur brain’

What is more, in the amygdala, the part of the brain often referred to as the ‘dinosaur brain’, responsible for regulating anxiety and stress reactions, there is a decrease in density of grey matter, meaning that the body is less likely to respond in a stressed way when faced with displeasing or adverse situations.

None of this brain activity was observed in the group of subjects who did not engage in mindfulness practice during the period of the study. No growth boosts in the brain were found. This showed without doubt that changes in the brain were not part-and-parcel of time simply passing, but that consistently engaging in mindfulness drastically changes grey matter.

The brain can be changed

Now we know more about the brain’s incredible plasticity, and we also have more confidence in encouraging human beings to be pro-active in their own brains’ re-structuring. It is now a certainty that the brain can be assisted into a state that leads to enhanced health and improvement in emotions and relationships, as well as increasing our ability to cope with stress.

Meditation to cope with stress

So, in light of the research above, might you consider introducing a regular mindfulness or meditation practice into your daily routine? Just 30 minutes per day, either first thing in the morning or last thing at night can help to make fundamental changes that will help the brain to cope with negative emotions such as stress or anxiety. These types of negative emotions may end up leading to more serious mental or even physical complaints (many of which we can help to treat in clinic), so it is wise to have a strategy to combat them.

Wellness and The Robin Kiashek Clinics

Wellness is at the heart of scientific endeavour, and here at Robin Kiashek Clinics we use the latest studies in diverse fields to keep our services on the cutting edge. To find out more about what we offer and our holistic approach to your health, please call us on: 0208 815 0979.

 

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 www.robinkiashek.co.uk 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: https://www.robinkiashek.co.uk//request-an-appointment/

In clinic I seem to be asked more frequently than before about Plantar fasciitis, and anecdotally I have heard people speaking about the number of friends/colleagues of theirs who suffer from it.

What is Plantar Fasciitis?

AdobeStock_54976863 [Converted]It is actually a very common reason a person will suffer from pain in their heel and is caused by an inflamed or swollen plantar fascia (which is the fascia connecting your heel bone to your toes and supports your foot arch). This condition can cause immense pain when you stand-up or put pressure on it which is caused by a build-up of calcification at the point where the fascia meets the heel bone.

What Triggers Plantar Fasciitis?

Just some of the triggers for Plantar fasciitis include:

  • Excessive running or walking on hard surfaces
  • High arches
  • Wearing ill-fitting shoes
  • Having either high arches or being flat-footed
  • Carrying extra weight

Most people find that the symptoms and pain are most prevalent when they stand up after sitting for a long time or when the first get out of bed in the morning. Many of my patients would say their symptoms get less painful throughout the day however this isn’t exclusively the case and some patients say that the sharp stabbing pain and stiffness ease but their foot actually takes on more of a dull ache as the day goes on.

Prevention of Plantar Fasciitis

So, you may ask me, how can it be prevented?

  • Make sure if you’re a jogger/runner that you have well-fitting shoes, I’d recommend going to a specialist running shoe shop
  • If, on the opposite end of the spectrum, you have a sedentary lifestyle and don’t get much exercise start trying to get even twenty to thirty minutes per day of exercise, starting with walking or something gentle
  • If you are overweight try slowly and steadily lose some weight
  • If you’re on your feet all day or have a job which requires you to stand make sure to wear suitable insoles or stand on a soft mat

Of course, even the best laid plans don’t always lead to a condition free life. You may do all you can to prevent Plantar fasciitis yet still end up in pain. If you come to see me at the clinic I will:

  • Take a detailed case history, including Lifestyle factors which may have caused the problem Assess both feet, passively and actively (note the way you walk/heel strike)
  • Assess the ‘Closed Chain’ biomechanically – the pelvis, leg and foot
  • If confirmed as Plantar Fasciitis, Low Level Laser Therapy (https://www.robinkiashek.co.uk//low-level-laser-therapy-lllt/) will be used to the plantar fascia
  • If relevant, a combination of Osteopathy and Western Acupuncture used to address any related biomechanical underlying issues to the Pelvis and leg
  • Give the patient Lifestyle advice to aid speed of recovery and future possible relapses

For further information on Plantar Fasciitis or to book a consultation with me in either the North London or Central London (Regent Street) clinic, please call (020) 8815 097 or click here to request an appointment.

exercise on prescriptionI am a keen advocate of the benefits of exercise as part of the journey to health restoration. I therefore wholeheartedly back the government scheme that means NHS patients will be prescribed exercise as part of ongoing treatment for certain conditions.

The workouts are set for patients who suffer from obesity, heart disease, stress, diabetes, osteoporosis and back pain. It has also been created for pensioners who have suffered accidents or falls.
In a bid to make the country healthier and to cut hospital waiting lists, the schemes are making aerobics, yoga, weight training and swimming either free or discounted for up to ten weeks at a time.

For many of the patients who visit my clinics, this kind of help and support is extremely welcomed. The sheer fact that exercise is now classed as a treatment plan and not just an advisory action will almost certainly change its level of importance in patients’ minds. If a doctor prescribes a patient antibiotics, then they will take the prescribed course – the same commitment is now likely to start evolving for exercise.

Department of Health guidance has been provided to doctors which highlights precisely what can be described for certain patients. Insurance cover and legal responsibilities (for patients who attend the gym under prescription) have also been addressed. Exercise specialists published by Fitness Industry Association will take legal responsibility while patients are exercising under these prescription workouts.

I know that all biological systems work in conjunction with one another and I am positive that a national increase in exercise will result in fewer people needing medical treatment for illness or disease. It will also go a long way towards placing a higher value on regular physical exercise, the importance of maintaining good health and working on the notion of prevention rather than cure.

I have always been interested in the power of exercise. In 1995, I researched the “exercise on prescription” model with 60 GPs and wrote a dissertation entitled “The effects of exercise on clinical depression”. The “exercise on prescription” model being trialled then enabled GPs and allied healthcare professionals to refer patients with conditions such as hypertension, diabetes and depression, for a monitored exercise regimen instead of prescribing medication.

Just like I believe our biological systems do not work in isolation, neither does treatment. By looking at both the cause and treatment of conditions in more entirety, perhaps we can start to get the whole country healthier.

low level laser therapyLow Level Laser Therapy (LLLT) is a treatment that can speed up certain healing processes by using specific wavelengths of light to interact with tissue. It has been effective in treating a variety of chronic and acute conditions in order to enhance functionality and to reduce pain, swelling and spasms. Some conditions that respond particularly well to LLLT include:

  • Sports Injuries
  • Plantar Fasciitis (Heel Pain)
  • Epicondylitis (Tennis Elbow)
  • Achilles Tendonitis
  • Acute & Chronic Back Pain
  • Adhesive Capsulitis (Frozen Shoulder)
  • Rheumatoid & Osteo-Arthritis
  • Chronic Oedema (Swelling & Fluid Retention)
  • Fracture Healing
  • Headaches & Migraines (including TMJ Dysfunction)

I advise my patients that LLLT can stimulate certain cell types including muscle, ligament, cartilage and nerves; therefore a thorough evaluation of each patient’s case should be conducted to assess the correct form of treatment.

Interesting Note: The light used in LLLT has the ability to penetrate 2 to 5 centimetres below the skin!

So what happens during LLLT treatment?

During treatment, the laser (which is about the size of a torch) is placed directly over the injured area for about 30 seconds to several minutes (the exact time depends on the size of the area being treated and the severity of the injury). As a painless and extremely safe process, the light passes through the layers of skin and interacts with the light sensitive areas of the mitochondrial and fibroblast cells. Once the cells have absorbed this light energy, a series of events initiate, which create a healing process to the injured or damaged tissue. The desired result is a reduced level of pain, swelling and inflammation and an accelerated healing process.

Depending on your type of condition and its severity, you may be offered LLLT on a weekly or twice-weekly basis where the frequency of your treatment will decrease as your condition improves.

Find out more about: Low Level Laser Therapy.