So, how do you choose your physiotherapy clinic in seven easy steps?
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Physiotherapy skills and qualifications
The most important question - is the physiotherapist appropriately qualified and is there any evidence of ongoing learning and development? Although principals remain consistent, the skills and style of approach can be different as can the aftercare. Please make sure you get reassurances of qualifications and can see ongoing development of therapists.
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Clinic Location
If you need physiotherapy, it is important to consider a local physiotherapist or one that is convenient to you. At Nicky Snazell Clinic we do provide specialist physiotherapy to clients from all over the world who come to Nicky for healing, but in general, we would recommend that you consider a therapist who is within a commutable distance of your work or home location. A commutable distance is 40-60mins for the right care, Nicky Snazell Pain Relief Clinic service; Stafford, Lichfield, Cannock, Rugeley & Stone.
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Style of approach
Like people, physiotherapists are all different. While we hope that they all subscribe to the highest possible standards and approaches, it is important that you make sure that from the initial consultation you feel connected with your therapist and their unique style of approach.
Consider the following:
- Have your questions been answered?
- Did you feel a connection with the therapist?
- Are you clear on the next steps?
- Did the therapist explain costs?
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Getting to the root cause
Spending time to find the root cause of pain is more important than the treatment itself. We find some clients have pain that is the result of unresolved childhood issues, bereavement and work-stress for example. Without spending the time to really understand your unique situation, often it can be like treating the surface of the problem and not the long-term view of the issue.
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Ongoing Physiotherapy care
Once your initial condition and pain are 'fixed', ongoing care is essential. As they say, prevention is better than cure, so periodic check-ups and follow-ups will help ensure that you are maintaining your health. We quite often treat sports injuries and also recommend massage for clients which can relax and rejuvenate you avoiding the aggravation of the problem area.
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Other services
Sometimes you may receive physiotherapy which can show that you would benefit from other services such as electro-acupuncture, the aforementioned massage. Does your therapist offer other services to support your wellbeing?
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Customer service
A good physiotherapy clinic has a team who can facilitate customer support and great customer service, like helping you to book your appointments, reminders and periodic communication in the form of useful insights, tips and observations to help.
If you are looking for a Physiotherapist why not give our team a call: 01889 881 488
This is the fifth part in a series of blogs looking at the process of a physiotherapy assessment and treatment plan. If you have missed the 4 earlier blogs, then here are the links:
A Different Perspective On Your Physiotherapy Assessment
The Subjective Physiotherapy Assessment
The Subjective Physiotherapy Assessment – Part 2
Your prescription is the final part of the physiotherapy assessment process. After we've got a connection. We have learned who your authentic self is. We’ve gone through the four keys analysis, to assess your immune system and general health. We have worked out what’s going on with you in terms of food, movement, stress, lifestyle and the way that you use your mind. And we’ve looked and listened to your physical being, all the sensations that are going on your physical being. How sensitive you are. How much warmth, your circulation. The hesitancy when we move part of the body, the link with your eyes and your brain. The tone in that part of the body. And we've worked out what's going on, at that moment, to the best of our knowledge.
Only then do we decide on a tailor-made prescription for you, which can be a combination of many things. These may need to be in my clinic, or there may be a lot of things you can do at home as you don't really need us to be there for you, apart from just encouraging you along the way. It may also involve physical treatments, via just laying on hands, massage, that connection, dry needling, acupuncture, shockwave, manipulation, exercise advice. You name it, there's a myriad of physical hands-on treatments that we do.
We will write a prescription that's tailor-made just for you. It will be based on that moment in time, your immune system, your mind, your lifestyle and your available time. It will then progress to help your body get to the best you can be for your age, with whatever problem that you have. That is what tailor-made means. It means being listened to. And it means prescribing that medicine, be it in terms of a pharmaceutical drug, be it in terms of herbal medicine, be in terms in what we do, which is physically treating you and listening to you and looking at you holistically.
That's what we do.
If you are in pain right now and you feel confident we can help, then why not call. Erica, Jean and Charlotte will be happy to help.
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
The Physical Assessment
In my three previous blogs on physiotherapy assessment
A Different Perspective On Your Physiotherapy Assessment
The Subjective Physiotherapy Assessment
The Subjective Physiotherapy Assessment - Part 2
I discussed concepts and steps which for most will not have been considered and most will have assumed that the physical assessment was the first step.
That is the mistake that so many make, missing out on the vital steps of creating the right environment to build connection and trust and gaining a deeper understanding of your important beliefs. Make that mistake and you are destined to gain so much less.
So the physical part of the assessment. What do we do? Well, in a private room we may ask you to take off some of your clothes, so you might want to be wearing clothes you're comfortable in and can take off quickly. If you're too shy to take off your clothes, just say it, it's not a problem.
Many of the assessments we make at my clinic are not common in the UK or anywhere else in the world. I am fortunate to have studied and qualified at the highest level in specific pain relief techniques and as a result I have learnt and ingrained advanced assessment techniques in myself and the rest of my team.
Then we'll be looking structurally at your skin. What does it look like? How healthy it is? What are the hairs like? Are there hairs missing? Does that mean the nerves are not working properly in that area? What's the temperature of the skin? Is it sweaty? Is it dry? How does the limb move? Does it move normally? If not, it will tell us is it’s likely to be arthritis in the joint that's blocking it. Or is it likely to be a tendon? Or a muscle or ligament? Or is it the nerves? Are they transmitting messages normally?
Or is it the brain? Has your brain created the pain felt in the body, possibly locked in from an emotional trauma many years earlier, even back to when you were a child? Chronic pain is created in many parts of the brain (evident in scans). Mindmapping physiotherapy techniques help to unwire the pain felt in the body.
So we're assessing the physical aspect. And that tells us so much about where we believe the problem is, or which systems are mostly causing the problem. Is it mostly the muscles? Is it mostly the nerves innovating the muscles? Is a blood flow problem? Is it something to do with what you are eating or if you don't move enough you are too weak. Or are you so stressed up, that you’re just pumping out inflammation into the area and you’re getting a more aggressive form of arthritis. And you don't need to. By looking at and at the same time feeling the response of your body, we learn a lot. If we hold a patient's hand that's sore, your eyes tend to move very differently than if you hold part of the body that isn't. Also there's a feeling about the hand, there's a hesitancy and there's a sort of a difference in the tone or strength.
There is so much in our senses, that we pick up on when we're assessing physically. Clearly this can only be done physically, face to face. Most of the above would be totally impossible to achieve by virtual means.
In my next blog Your Physiotherapy Prescription I’ll take you through how we develop a Physiotherapy treatment prescription, or plan, which takes you through the steps needed to achieve a successful outcome and let you get on with your life.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
Ok, you are in pain, you have tried the obvious remedies, like pain killers and anti-inflammatories or a bit of exercise, but they didn’t fix the problem. You don’t want to be on drugs for too long, so you are thinking about getting to see a physiotherapist to assess you properly and find out what the problem really is and how best to fix it.
This presents you with a number of problems, such as where is the best physiotherapy clinic to go to and is it experienced with helping your type of problem. If you have friends or family who can provide help, based on their own experiences, then great. If not, the next best thing is to look at Google reviews and /or ask on social media. If you want some help on how to choose a clinic and what you need to ask, then click on this link How to Choose A Physiotherapy Clinic
You may have assumed that a physical assessment will be the first step.
That is the mistake that so many make, missing out the vital steps of creating the right environment to build connection and trust, and gaining a deeper understanding of your important beliefs. Make that mistake and you are destined to gain so much less.
Many of the assessment skills we use at my clinic are not common in the UK or anywhere else in the world. I am fortunate to have studied and qualified at the highest level in specific pain relief techniques and as a result, I have learnt and ingrained advanced assessment techniques in myself and the rest of my team.
Thus today, I want to approach this from a different angle, one you might not have thought of as being important, but trust me, it’s vital to a successful outcome. It’s the environment of the assessment room, and that means not only your room but the physiotherapists as well when the assessment is being done virtually.
You see, we all have an inherent ability to recognise if there is a true focus on the problem and that you are being listened to. If the environment is full of distractions or interruptions, then your physiotherapist’s thoughts will be disrupted and you will sense it. Your physiotherapist needs to be in the present moment, focussed and not allowing other thoughts to clutter up their head.
That’s my number one piece of advice.
Clearly, the environment is much better when you are face to face with the physiotherapist who is assessing you. There’s much less probability of distraction and that vital bond of trust is so much easier to build.
If your physiotherapist practices mindfulness techniques, they will induce a mental state capable of focussed attention on you. Your healing will commence as soon as you sense the caring intention.
I’m going to continue this explanation of how to achieve a successful assessment in more blogs. If you want me to keep with me on this journey, look out for my next instalment ‘The Subjective Physiotherapy Assessment’, which continues to look at this topic from a new perspective.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
In my two previous blogs A Different Perspective On Your Physiotherapy Assessment and The Subjective Physiotherapy Assessment, I discussed the importance of getting that connection and really listening to get the patients story. Why are you here, what are your beliefs about treatment?
Now it’s time to go further, honing it down with specific questions about the problem.
Let’s use an example to help illustrate. Someone comes to me and they've had chronic pain in their foot for a very long time. I would be asking questions about the possibility of arthritis. Questions regarding the nervous system. Looking at the way that the body moves. Seeing if the pain is transmitting down from the spinal cord, because it could be a problem in the spine itself and not the foot at all. Having a look at the function of the foot, seeing if biomechanically the patient is walking in a strange way, and is that is making it worse?
How does it feel? How does the tissue feel? Is there any swelling? Are there problems with circulation? Is the sensation there? Are the nerves working properly? Is there an amplification of pain so that when I touch, the tissue is overly sensitive? What are the clues as to what's going on?
This is a very important start to this part of the assessment, which leads to the physical assessment.
To recap, the first part is establishing the connection and the story, the background, the beliefs, the values. The next part is to do with the Four Keys, to do with your immune system and your general health.
The next part is to hone it down into the particular problem today and how it's starting to manifest itself physically.
The final step is to go into the physical, which we can't do remotely by zoom. The physiotherapist has to get hands-on and assess physically, face to face.
In my next blog The Physical Assessment I will delve into the actual hands-on physical assessment. Many of you may have thought that this would be the first step in an assessment and that is the mistake that so many make, missing out on the vital steps of building connection and trust and gaining a deeper understanding of the all-important beliefs of the client. Make that mistake and you are destined to gain so much less.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
I get asked a lot of questions about physiotherapy assessment. What do we do at my clinic? How do I assess? How do I teach assessing?
In my previous blog A Different Perspective On Your Physiotherapy Assessment, I mentioned that the first and most important thing is to have a safe, quiet environment that builds a connection and trust. If you don't feel that with your physiotherapist, you're not going to want to proceed to any kind of medicine or treatment and your outcome won't be as successful. There won't be that connection.
To recap, the most important thing for the patient is that the physiotherapist has created a sacred space, a quiet office, where the phones are switched off, the computer is not a distraction, and you eyeball each other to get that connection. And then your physiotherapist listens to your story. And how you describe what's going on with you. And then, in that moment of connection, your physiotherapist can get glimpses of the real authentic self behind the story, who you really are.
Once your physiotherapist glimpses the story of the problem, he or she can start to elicit some background which is past medical history. So we'll ask questions like the health of your family to see if there are relevant genetic links. We may also explore your beliefs and values and more about your family so we'll know how difficult it is for you to attend and for you to have the necessary treatment. We may touch on your past experiences of treatment because if you've been scared or let down previously, you're going to have very different expectations. We need to address that head-on.
And then, of course, my favourite four keys questions (see my first book ‘The Four Keys To Health’ available on Amazon), which looks into your mindset, lifestyle, fitness and what you eat. All these help us assess how well your immune system is working, and your general health, which helps refine our treatment prescription.
That, in a nutshell, is the first part of the physiotherapy assessment.
In my next blog ‘The Subjective Physiotherapy Assessment – Part 2’ I will continue on this journey of helping you understand how to really get the most out of this process.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
Call 01889 881488 Now
p.s. Don’t try to book online at this time as that is only suitable for existing clients already being treated for an existing problem.
How can I relieve neck pain? The first thing to understand is how this happened, neck pain can be caused by other conditions such as muscle weakness in the shoulders, perhaps lifestyles such as workplace seating or even sports. Take a moment to consider what could be causing yours. While doing this, think about the type of pain you have. Is it a strain or a trapped nerve?
What does a trapped nerve in neck feel like?
A trapped never typically feels more painful in certain positions, and the pain again can be shooting, described as electric or pulsing. A trapped nerve can throb and jolt when you are moving. A strain usually feels more like a burn or a tear; these sensations can be confusing, so please do not worry if you struggle to distinguish between the two - Our team can help you understand this better and decide the best ways to help you.
How long does neck strain take to heal?
A strain can take between 24-hours and a week to recover. If you are concerned Nicky Snazell can help you with pain relief, it is still worth considering what caused this. The underlying source is always the best way to provide you with long-term pain relief, and maintenance can reduce reoccurrence.
What is the fastest way to fix a stiff neck?
If you are not ready to consider treatment, we recommend gentle stretches and a gentle massage in-between cooling and warming treatments like an ice-pack and a hot water bottle/wheat/rice bag. Be careful when doing this yourself. If you are unsure how to manage this effectively, contact us.
Which massage is best for neck pain?
This depends on how you got the neck pain; if it was doing sports, then as you might expect, sports massage could be the proper treatment. Typically, massage is the right treatment for neck pain; manipulating the soft tissue can relax the problem and promote blood flow and healing.
Where can you go for help with neck pain?
Nicky Snazell pain relief clinic in Stafford can help with neck pain. Please view this page for more information on neck pain, or contact us. Our experienced team of physiotherapists will help you navigate your pain and provide the most effective advice to help you long term.
Like a traditional massage, sports massage more intensely manipulates the soft tissues and tendons. In addition, the masseuse uses more strength to purge the muscles, which helps to loosen and condition the essential structural integrity. As a result, you are less likely to become injured during sports or physical activity.
Sports massage also helps to promote blood flow, which can aid healing and recovery after intensive exercise, which is why you will often find sports massage administered before and after races at running clubs.
What are the common areas for sports massage?
- Typical sports massages include legs used by runners, athletes, hockey, cricket, and rugby players.
- As well as the common sports previously mentioned, Netball and Tennis are also popular with shoulder and lower back sports massage therapies.
- The lower back is also a widespread complaint from horse riders, and we have seen jockeys from all over the world.
What is a sports massage therapist?
A sports massage therapist administers the massage, 'a masseuse', and is often referred to as a therapist as this serves a purpose and not just for pleasure. Sports massage has more medical benefits than other massages which are for relaxation and wellbeing.
What is a sports massage like?
A sports massage is slightly more aggressive than a typical massage, so it can be somewhat uncomfortable initially; however, your therapist will discuss this with you throughout so that it is tolerable. The fact it is more aggressive should not put you off because the effectiveness of the sports massage is driven by the pressure placed on the soft tissues.
There are many reasons that sports massage is so good for you and keeps you injury-free. This article covers some of the reasons sports massage is good for you.
What is sports massage good for?
- It is good for legs, shoulders, lower back, knees, calves, and neck.
- It is good for keeping your joints stable and loose, reducing the risk of sports injuries.
- It is ideal for those who are physically active, runners and hikers.
- It is good for people who have previous injuries to stave off issues resurfacing.
How can Nicky Snazell Pain Relief Clinic help?
Pain relief clinic is here to help; you will see one of our very experienced team. From there, we will discuss your specific needs and then complete your wellness programme. Nicky and the Pain Relief Clinic look forward to welcoming you aboard. If you are a first-time client, then please use the contact form; if you are an existing patient, you can use the online booking form.
Physiotherapy Treatment For Vertigo Caused By BPPV
Vertigo is a problem that affects around half the population at some point in their lives and is more common as we get older. Fortunately, the symptoms usually only last for a few seconds to a minute or so, but the symptoms are very unpleasant including:
• Nausea and vomiting
• Dizziness
• Fainting
• A sense of rotating
• Inability to stand or walk
What Causes Vertigo
It is widely accepted as the most common cause of vertigo is BPPV (Benign Paroxysmal Positional Vertigo) and this is linked to the 3 semi-circular canals in the inner ear. The role of these canals is to sense the position of the head in the 3 axes of up /down, right / left, forward/ backwards. If any incorrect signals occur, the brain doesn’t know where your head is and gets confused.
Faulty signals are caused by very small chalk crystals becoming loose and getting into the semi-circular canals. These loose crystals then move in the canals, stimulating faulty signals.
The types of movement which most frequently initiate a vertigo attack are rolling over in bed, getting out of bed, sitting up after lying flat or looking up or down.
Vertigo Treatment
Left untreated, vertigo will usually resolve itself but may take several months. Fortunately, treatment is fairly simple and painless and typically no more than 3 specialised Physiotherapy treatments are needed over a couple of weeks.
David Paling, a senior physiotherapist and our clinical lead can diagnose and treat BPPV.
If you or someone you know is suffering from vertigo, then physiotherapy treatment with us should seriously be considered.
Call the clinic now on 01889 881488 and ask for an assessment with David.
Most people have heard of acupuncture and understandably assume that if a treatment involves a needle, it must be acupuncture. This is akin to saying that everybody who uses a knife must be a surgeon. Our task here is thus to look in depth at all the ways that needles are used, so that you better understand what the differences are and thus eliminate the confusion surrounding this type of treatment. By doing so, it will also hopefully help you gain confidence to try this form of treatment in the future and help you seek out the best type of practitioner for your problem.
History
Historically, the use of the needle for treatment started in the east, most probably in China, many thousands of years ago. Thus, there have been thousands of years to refine and improve the understanding of acupuncture in Chinese Medicine, the latter being a complete medical system which looks at the whole body. It regards illness as the body being out of balance and thus seeks to identify why it is out of balance and then treats to redress this.
What Is Acupuncture?
Today’s acupuncture uses very thin needles, much thinner than a hypodermic needle. These are inserted in the body at prescribed Chinese points which have a known therapeutic effect, or directly into an area of muscle spasm or pain. The needles are generally inserted and then left for anything up to 30 minutes.
Electro-Acupuncture
Electro-acupuncture was originally developed for use as analgesia in surgery. However, the benefits of electro–acupuncture were soon recognised for the control and treatment of pain. Research is still ongoing to better understand the best settings to use and the technology is thus continuously evolving.
The equipment we use in house allows us to vary the settings to help you in the best way possible. It is understood that the use of different frequencies can stimulate the release of natural opioid pain killers in the body and that by using dual frequencies, both the intensity and longevity of the pain control can be varied.
A benefit of using needles with this type of electrical signal is that the pain relief can be applied at deep levels, within the muscles that are causing the pain.
Western Acupuncture
Western acupuncture as taught today is a small subset of Chinese acupuncture, combining needling to local areas of pain or spasm, ‘Ah Shi’ points, sometimes called trigger points, plus some use of Chinese points, but without reference to Chinese theory.
Needles are used in the same way as Chinese medicine and the types of needle are the same. The focus in western acupuncture is to link the treatment to western medical principles, which requires ‘evidence based’ justification. This is discussed below in the Acupuncture in the NHS section.
Chinese Medicine is a complete standalone medical system and is totally different to western medicine. By teaching and using Chinese acupuncture points, western acupuncture in effect has a foot in both camps.
Intra Muscular Stimulation – GunnIMS
The majority of acupuncture needling is performed at relatively shallow depths in the body. As explained above, the needles are inserted and left static until removed.
GunnIMS is completely different.
Professor Chan Gunn, a medically qualified Doctor, discovered GunnIMS by accident while carrying out tests in a laboratory in Vancouver, Canada. He found that patients were in pain, quite often long term, or chronic, pain, because of muscles being in spasm. In addition these muscles were not responding properly to the signals from the brain to expand and contract. He found that by inserting needles into these non-responding muscles, those same muscles could be made to release and start behaving normally. To effectively release a muscle he found that multiple insertions were needed, using the needle more as a microsurgical tool rather than a simple insertion device.
Eventually GunnIMS evolved to using an external device, called a plunger, which allowed the therapist to rapidly and easily retarget the needle to achieve the required result.
GunnIMS is fundamentally different to acupuncture
The results in treating muscle pain are far superior. It utilises western anatomical knowledge and makes no reference to Chinese Medicine. It generally requires much deeper needling and directly targets and micro surgically treats muscles in spasm. The training is thus totally different and only those practitioners trained through the Institute for the Study and Treatment of Pain (ISTOP), based in Vancouver, are qualified to provide GunnIMS. Nicky Snazell is one of only 3 practitioners in the UK to have reached the highest level of training and was awarded the first honorary membership of ISTOP in the world for her dedication to the use of GunnIMS.
Nothing Is Wrong
A major strength of GunnIMS is that it is unsurpassed in diagnosing and treating muscle spasm. Both MRI and X-ray cannot ‘see’ muscle spasm, it is totally invisible to these scans. Thus many patients who may have been in long term pain and given a scan, only to be told ‘nothing is wrong’ will now understand why.
Dry Needling
Dry needling refers to the use of a non-hypodermic needle. Acupuncture needles are solid, they cannot inject a drug. Thus they provide a dry and not wet treatment.
Hypodermic needles, which are used to inject drugs, are relatively much thicker and more painful to insert. This is perhaps why so many of us grow up with needle phobias.
It may at first seem that both acupuncture and dry needling are the same. After all they are both dry techniques. But there the similarities end. Whereas acupuncture is a traditional method developed thousands of years ago, dry needling is relatively new, only having been adopted in the last few decades.
Dry needling is primarily used to treat tight muscles, or trigger points, to ease muscular pain. In some cases the needles are inserted and left for a number of minutes. In some cases the needles are moved up and down to increase the effect.
The term Dry Needling is tending to replace GunnIMS as the teaching of dry needling is much more widespread. In many cases there is an overlap with GunnIMS. However, GunnIMS specifies that only Medical Doctors and Physiotherapists (in countries with the highest standards) are qualified to be trained, it also requires intensive training and passing exams. Dry needling courses can be attended by less qualified therapists and can involve little more than a weekends training.
Does Needling Hurt?
Our skin has a lot of nerves to sense touch, hot and cold, pressure and pain. However, once a needle has gone beyond the immediate outer layer, there are very few pain sensors.
A skilled practitioner understands this and will penetrate the skin very quickly, so that you would feel nothing more than a small prick. (no pun intended)
TCM will aim to penetrate to the layer of fascia where the patient gets a very definite sensation which is almost totally painless. Thus the majority of TCM and those western practitioners who use TCM points, will be almost totally painless.
The next level of needling is dry needling into tight muscles, or trigger points. This can cause pain, usually only slight and short lived.
Again, an experienced practitioner can use skills and technology to largely alleviate the pain response. Firstly, by using a therapeutic laser, which will generally penetrate up to 30mm into the body and greatly help to relax muscle spasm. In fact ‘Laser puncture’ refers to the use of a laser over TCM points, and can be helpful in treating patients without needles.
The second and more powerful technique to minimise a pain response is by first acupuncturing specific points which are known to minimise pain signals reaching the brain and others that will put the patient into a relaxed meditative state. This is no different to the same procedures used in China and now used in the USA for pain control in surgery.
A healthy, normal muscle has very limited ability to even realise a needle has penetrated it and in this situation a patient is unlikely to be aware at all. At times muscles will go into severe spasm and fail to respond to normal expand and contract commands from the brain. A very common example is low back pain and sciatica.
If you feel that acupuncture or GunnIMS could help you then please call us on 01889 881488 to book now.
Our staff capabilities are at the highest standard available in the UK.