Latest news from the Brighton Spinal Group
09.12.2011
Acupuncture has modest benefit in whiplash
In one of the first trials to look specifically at the effect of acupuncture in whiplash patients, the technique produced only modest benefits on pain, Australian researchers report. A comparison of real and sham electro-acupuncture in 124 patients at a Sydney clinic found that the active intervention resulted in improvements in pain scores at both three and six months, but the effects were unlikely to be clinically important, according to researchers from the Rehabilitation Studies Unit at the Sydney Medical School. Writing in Spine (36:1659), they say patients with chronic or subacute whiplash-associated disorders were randomly allocated to 12 sessions of real or simulated electroacupuncture for six weeks, but active acupuncture had no effect on disability or health-related quality of life. “The therapeutic effect in both groups ... could be explained by the strong expectations from both the participants and the investigator that acupuncture treatment would produce improvement in pain,” they say. “Nevertheless, its effect on pain even after six months shows that acupuncture could be an important treatment in chronic [whiplash] for which there are very few effective treatments."
04.10.2011
Poor sitting posture and a heavy schoolbag as contributors to musculoskeletal pain in children
Objectives: The purpose of this study was to evaluate a multidisciplinary, interventional, ergonomic education program designed to reduce the risk of musculoskeletal problems by reducing schoolbag weight and correcting poor sitting posture. Methods: Data were collected twice before and twice following intervention using the Standardized Nordic Body Map Questionnaire, a rapid upper limb assessment for posture evaluation, and schoolbag weight measurement in children aged 8 and 11 years attending two schools within the central region of Malaysia. Results: Students who received the ergonomic intervention reported significant improvements in their sitting posture in a classroom environment and reduction of schoolbag weight as compared with the controls. Conclusion: A single-session, early intervention, group ergonomics education program for children aged 8 and 11 years is appropriate and effective, and should be considered as a strategy to reduce musculoskeletal pain among schoolchildren in this age group. Keywords: ergonomic, education, intervention, assessment, musculoskeletal pain, school children, awareness Comments: all children complaining of back pain in class should have their posture assessed. Authors: Syazwan AI, Mohamad Azhar MN, Anita AR, Azizan HS, Shaharuddin MS, Muhamad Hanafiah J, Muhaimin AA, Nizar AM, Mohd Rafee B, Mohd Ibthisham A, Kasani A Published Date September 2011 Volume 2011:4 Pages 287 - 296
03.10.2011
Hear about the latest research on back pain - free public seminar on Wed 26th October 7pm - All Welcome, bring a friend if you like.
"Advances in the treatment of ongoing back pain." will be presented by Dr Victor Wilk, Musculoskeletal Physician & Bruce Gilmore, Physiotherapist on Wednesday 26th October 2010 at the Deck Bar , 212 Bay Street, Brighton, 3186 ( opposite the pilates studio ) . Nibbles will be provided from 6.45pm, ( drinks at bar prices ) Seminar commencing at 7pm. RSVP please to : " healthpromotion@brightonspinal.com.au " If you require further information, please contact Angie at Brighton Spinal Group ph. 9596 7211.
01.10.2011
Leading physiotherapist calls for new approach to the management of chronic low back pain
Low back pain is the second greatest cause of disability in Australia and the USA. Despite the large increase in health resources spent on low back pain, the disability relating to them continues to increase. Treatment of lower back pain in the past has focused on the use of single modality physical therapies, however, there is growing evidence that therapy needs to be multimodal. Recent research on non-specific chronic low back pain suggests that pain is due to a complex combination of: 1 Physical behavioural factors, such as incorrect movement or posture 2 Lifestyle factors, including sleep disorders, activity and sedentary levels, and life stress 3 Neuro-physiological factors, such as altered pain threshold and pain processing linked to nervous system changes 4 Psychosocial factors, such as negative beliefs, reduced stress tolerance, fear, anxiety, depression 5 Genetic factors which potentially influence the above factors The above factors are often interlinked and can create a vicious cycle of pain and disability. There is increasing evidence that treatment of back pain needs to be focused in a person-centred manner. This allows the practitioner to classify and identify drivers of pain to facilitate targeted management. There is emerging evidence that by focusing on these cognitive, lifestyle and movement behaviours, the treatment is more effective than the traditional approaches in clinical practice. These interventions place a strong emphasis on the therapeutic relationship, goal setting and behavioural changes, rather than just treating signs and symptoms of back pain. Physiotherapy can embrace and deliver a new integrated behavioural approach to clinical management of non specific chronic low back pain, by moving beyond the old belief systems as how to understand and interpret pain. These new innovative approaches to management of low back pain will also provide the framework for the management of other chronic pain disorders. Excerpts from article by Peter O’Sullivan Specialist Musculoskeletal Physiotherapist
11.04.2011
Low back spinal surgery not helpful in returning patients to work
A new study published in the Journal Spine revealed that Fusioni surgery for chronic lower back pain was not effective in helping injured workers back to work. Two years after fusion surgery, only 26% (n = 188) of fusion cases had returned to work, while 67% (n = 483) of nonsurgical controls had returned to work (P ≤ 0.001) within 2 years from the date of injury. The reoperation rate was 27% (n = 194) for surgical patients. Of the lumbar fusion subjects, 36% (n = 264) had complications. This latest research confirms that in cases of severe back pain, surgery is often not as effective as active rehabilitation. Exercise programs are still the mainstay of therapy for managing chronic back pain. At Brighton Spinal Group we have a dedicated onsite gymnasium to help strengthen the spine and facilitate return to work. Ref:http://journals.lww.com/spinejournal/Abstract/2011/02150/Long_term_Outcomes_of_Lumbar_Fusion_Among_Workers_.9.aspx )
20.07.2010
What is the difference between Physiotherapy & Osteopathy?
When it comes to problems that respond to manual therapy, there is little to suggest that one profession is more effective than another. In fact, the limited studies that have been carried out seem to indicate just the opposite – the result of treatment depends more on individual technical skills and experience than the particular discipline a practitioner belongs to. Like painting, dance or music, manual therapy is very much a skill. Among manual practitioners, regardless of their profession, some show real aptitude for the job and achieve better results than others. At Brighton Spinal Group you can rest easy, we have the most experienced and able manual practitioners in Melbourne. A physiotherapist has completed a four year degree and treats problems in four broad areas: 1) Chest problems (pre and post chest surgery, emphysema, asthma). 2) Neurological conditions (strokes). 3) Major orthopaedics (broken bones and joint replacements). 4) Minor orthopaedics (strains, aches and pains). The first three groups mostly receive physiotherapy in hospital; manual therapy plays a small part in their recovery. The fourth group, minor orthopaedic conditions are commonly treated in private practice and respond well to manual therapy. A musculoskeletal physiotherapist has completed a twelve month post graduate diploma in manual therapy. Mobilisation techniques (small rhythmic oscillations) are central to a musculoskeletal physiotherapist’s treatment methods and preferred to manipulation (joint cracking). They are seen as a safe and effective way of treating joints, whereas manipulation is more difficult, takes longer to learn and incurs a slight risk. A physiotherapist also uses electrotherapy (ultrasound or interferential therapy), heat packs, supportive braces and exercises, and has close relations with the medical profession. You could consult a physiotherapist for rehabilitation after a fracture or cerebral stroke as well as everyday aches and pains. An osteopath has completed a five year double degree and specialises in the management of conditions that respond to manual therapy (strains, aches and pains). A long appointment (about 30 minutes) with gentle treatment and few visits (average 4-6) are the hallmarks of osteopathy. A typical treatment may begin with massage focused to areas of painful muscle tension. Soft tissue massage is an important element of an osteopathic approach. Then movements (articulation, mobilization and stretching) will relax and free up the deeper soft tissues (ligament, disc and deep muscles). Finally, gentle manipulation (joint cracking) can loosen the most inaccessible tissues and release stuck joints. The graded sequence of steps is comfortable, relaxing and highly therapeutic. The therapy improves blood flow and chemical exchange, which promotes the physiology of healing and pain resolution. You could consult an osteopath for a musculoskeletal problem that is long standing, keeps recurring or has ‘done the rounds’ with other therapies.
17.06.2010
I have a bad back, who should I see?
Our practitioners are highly qualified and specialise in spinal and joint conditions. All of our practitioners at Brighton Spinal Group have a similar focus, most using manipulation and manual therapy. If you have a chronic or complex condition, or have seen various practitioners with little or no relief, it may be best for you to see our musculoskeletal physicians. For further details visit our muscuoloskeletal page. If you are unsure who to see please contact our patient liason officer, Angie by phoning 9596 7211 or email healthpromotion@brightonspinal.com.au
01.05.2010
Benefits of prolotherapy- a personal account
"I have personal experience of the reigning paradigm when at the age of 15 (48 years ago) a right "throwers elbow" developed during my training with the javelin in the Decathlon. I was given one of the first corticosteroid injections for an athletic injury by an orthopedic surgeon specialising in sports medicine. This injection was followed several weeks later by an unexplained painless effusion (swelling) in the right elbow joint which settled within weeks, leaving me with a mild flexion contracture. The injection made no difference to my symptoms and I never made it in the Decathlon, also because I simply wasn't good enough. However my partner Maria was a champion NZ high school middle distance runner with justified olympic aspirations in the late 70's. She developed bilateral peripatellar (knee cap) pain and was treated with RICE, NSAIDS, corticosteroid injections and finally disabling surgery in 1980, putting a definitive end to her running career. It was the beginning of 25 years of pain, swelling and increasing disability in both knees in addition to moderate severe osteo-arthritis changes in the undersurface of the patella. She needed walking poles just to walk down to the beach here, a distance of just 100 meters. It was'n until I started treating her with prolotherapy things changed. Last year she ran in the NZ masters Track and Field championships in the 800 meters and got a silver in her age group against strong opposition. Her knees will never be normal, but they are painfree and functional." Dr John Lyftogt (Sports Medicine, NZ) For further information regarding prolotherapy at Brighton Spinal Group, click on information / topics of interest. Prolotherapy is performed by our musculoskeletal physician, Dr Victor Wilk.
01.09.2009
Brighton Spinal Group E-Newsletter
Brighton Spinal Group has a monthly e-newsletter. To join our mailing list, please visit the home page of the website and fill in your details. Receive up to date information and research regarding back pain, spinal and joint care, as well as latest news in regards to our team.
08.04.2009
Dr Wilk appears on Channel 10 News
Dr Victor Wilk, Musculoskeletal Physician presented the results of a nationwide survey on back pain to the Australian Pain Society meeting in Sydney on 8th April 2009. The survey found 8 out of 10 people suffered back pain in the last 6 months and that about 40% saw their GP first for advice. Current guidelines recommend to try and stay active and as first line therapy to take paracetamol at regular doses of two 500mg tablets 4 times a day until the pain eases. We should be more careful when taking non steroidal anti-inflammatory drugs (ibufrofen, naproxen, diclofenac, aspirin etc) as these may potentially aggravate other problems such as stomach ulcers, heart and kidney problems.
24.11.2008
Dr Victor Wilk featured on 3AW- Back Pain
Dr Victor Wilk musculoskeletal physician featured on Talking Medicine with Dr Sally Cockburn ( Dr Feelgood) on 3AW on Sunday night 23rd Nov 2008. “ Victor explains about some of the myths about low back pain and about what you can do to about it. Musculoskeletal Medicine deals with the non- surgical treatment of problems related to the muscles, bone and joints. A comprehensive assessment leads to an individual program that may include a combination of therapies including exercises, drug therapies, manual treatment and X-ray guided spinal injections. If you have a chronic problem – maybe an assessment with one of our musculoskeletal physicians is worth considering
17.10.2008
96% of back pain referred to orthopaedic surgeons don't need surgery
Low back pain and sciatica will be come under the microscope at a Melbourne conference involving four Australasian medical organisations specialising in the treatment of these conditions. The Australasian Musculoskeletal Medicine Conference will be held at The Sebel, Albert Park 17-19 October. According to conference organiser, Dr Victor Wilk, Melbourne musculoskeletal physician, 96% of back pain partients who are referred to orthopaedic surgeons do not require surgery. “Low back pain costs Australians more than $1 billion in medical bills and more than $8 billion in indirect costs. We believe it could be treated better than it is at present.” He said the conference will discuss assessment and treatment of back pain according to evidence-based guidelines. We need to educate doctors and other allied health practitioners about reducing their reliance on expensive and potentially harmful X-ray investigations which often don't find the source of the pain. “We would also like to see a reduction in the current overloads experienced by hospital orthopaedic outpatient departments as more GPs become confident in assessing and treating back pain. “Most episodes of back pain are not suited to surgery. Most can be dealt with using conservative measures. Of course, one needs skills to be able to sort out those needing surgical attention and those who do not. Dr Brian McGuirk Musculoskeletal Physician will present a study showing that 82% of patients referred to surgeons in Newcastle NSW, for treatment of back pain didn’t need to see the surgeon at all. And of the 18% seen – less than one quarter required surgery." Dr Wilk and his organisation, the Australasian Faculty of Musculoskeletal Medicine, along with the Australian Association of Musculoskeltal Medicne, the Australian College of Physical Medicine, and the New Zealand Association of Musculoskeletal Medicine, will bring together a number of experts in the fields of surgery, radiology, psychology and rehabilitation. Professor Nikolai Bogduk and Dr Brian McGuirk are keynote speakers. Both have already published landmark work on treatment of acute low back pain, and their work forms the basis of the guidelines used in Australia. “Our aim is to get all GPs skilled in this area of medicine so that we can stem the flood of disability due to back pain. The doctors who practise in this area full-time use a variety of techniques, ranging from manual (hands-on) treatments, psychological and behavioural therapy and exercises, to X-ray guided injections into structures of the spine. The conference will combine scientific meetings with practical workshops.
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