So, how do you choose your physiotherapy clinic in seven easy steps?
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.
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.
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?
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.
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.
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?
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
In part 1 of this series, Your Pain Relief Plan Introduction I discussed why we feel pain and introduced the concept that the degree of pain felt could vary widely from one individual to the next due to lifestyle factors and that when long term, typically over 3 months, the brain would lock the pain in. Emotional trauma, even as far back as childhood, had been found to lock in pain for almost a lifetime.
In part 2 of this pain relief series, I will get into more detail about how pain works and discuss the implications of aging and the differences between acute and chronic conditions and the most effective ways of treating these. But first, a quick look at the brain, how it has evolved and how this relates to processing pain.
The oldest part of the brain is the reptilian brain, which deals with basic survival instincts. Next came the mammalian brain, which added the ability to feel emotion. The third part is the human brain, the Cortex, which gives us our human qualities of cognition, sensory perception and spatial reasoning and is in charge of the human decision making process.
How Pain Works
Your nerves transmit pain signals. Inside your nerves, you have sensors for temperature, stress, movement, pressure, immunity molecules and blood flow. Similar to car sensors, any damage or fault to any of these sensors will put a light on your dashboard, to alert you of a problem. The nerve does the same thing by increasing pain.
These pain impulses travel up the spinal cord, to a part of the brain which acts like a router(called the thalamus) and as a simple analogy, this router makes phone calls to other parts of the brain.
Hence our brains decide, like a panel of judges, how much pain is appropriate for us to experience at any one time
The pain experience is complex and involves many areas of the brain:
1. Body sensation and location
2. Movement – muscles may need to brace the area
3. Focus & concentration
4. Fear response
5. Memory area recalling a previous similar experience
6. Motivation - processes pain
7. Stress response - weight, digestion, sleep, temperature
All seven areas interact to decide on the suffering experienced. This may have little to do with the degree of injury and hence makes it clear that a qualified and knowledgeable therapist is needed to properly diagnose and treat the injury.
The Consequences Of Aging
As we age, we need to put more care into our diet, supplementation, exercise, and our workload. It sounds simple, but many of us fail to even acknowledge that as we get older, we have to change the way we use our bodies. As we age, naturally occurring enzymes are fewer, inflammation is greater, and the production of inflexible scar tissue becomes much more extensive. Therefore, long-term solutions for pain relief also need to address our ongoing biochemical changes.
Sleep quality tends to deteriorate and ongoing deprivation can lead to symptoms virtually indistinguishable from widespread pain, fatigue and diffuse tenderness. Early evidence also shows that anxiety, depression and sleep disturbances have been common reactions to the COVID pandemic. Thus the problems faced by Long COVID sufferers are likely to be with us for many years to come.
What is the difference between Acute and Chronic Pain?
Chronic pain, by its nature, may not be resolvable
Chronic pain is long term pain, beyond 3 months, as the brain has hard wired the pain in by that time. Chronic pain can occur because of numerous conditions, such as emotional pain, joint wear and tear (osteoarthritis), spinal disc thinning, bulging or rupture, bone thinning
Suffering is not related to the degree of injury
(osteoporosis), unresolved tendon or ligament damage, to name but a few. Chronic pain, by its nature, may not be resolvable. It may need a lot more treatment than acute pain to bring down to acceptable levels and will benefit greatly from ongoing maintenance or wellness treatment to prevent reoccurrence.
Modern science confirms benefits of a more holistic approach
The latest neuroimaging technology, which can see the electrical activity in the brain in response to different lifestyles, has allowed the world to delve deeper into the understanding of chronic pain. It has been confirmed that pain is modulated by factors such as attention, anticipation, empathy, placebo, meditation, fear, anxiety, posture, emotion and movement. This, in turn, has confirmed the benefits of a more holistic approach to assessment and treatment.
This new insight into chronic pain helps explain why, for example, X-rays showing the degree of osteoarthritis in joints has no correlation to the pain being felt.
To summarise, we have shown how each person's brain can process pain differently, to the extent that one person may feel tremendous pain, when another, with essentially the same condition, might feel little or no pain at all.
The availability of the latest MRI scanning technology has verified that many non-physical factors can impact the way pain is handled in the brain. This in turn supports the benefits of a more holistic approach to assessment and treatment.
Acute problems are usually caused by a recent injury and are best treated promptly, whereas chronic problems are longer-term and tend to be related to the ageing process. Chronic pain in many cases cannot be resolved and lends itself to a longer-term control of symptoms, rather than treatment of root cause as with an acute injury.
In my next blog Your Pain Relief Plan Part 3 I will explain neuropathic pain and the effectiveness of both exercise and drugs and where these may be the wrong solution.
Pain is a very complex problem. It’s also such a common problem that every person on the planet will at some point in their life suffer its consequences, perhaps only a little, but for some unlucky souls, it will be life-changing for the worse.
There are many factors that can affect the severity and longevity of the pain which is suffered. Many of those factors are in our individual control, so the good news is that each of us has the potential to dial in pain relief and reduce the impact of pain on our lives.
In this series of blogs, I will take you on a journey to help you gain a better understanding of pain and its causes so that you will be able to reduce its consequences on your quality of life.
My Qualifications In Pain Relief
For me, the study of the cause and treatment of pain has been a lifelong journey. As a child I witnessed first-hand the suffering caused by long term severe pain when my mother was bedridden for years with back pain. My childhood also came to an abrupt end when I was handed many of the responsibilities and duties my mother could no longer fulfil.
Needless to say, this episode was life-changing for me and it embedded an irreversible need to seek a better understanding of pain and more effective ways to treat those suffering pain. It started a lifelong journey that I am still on to this day. A journey that has taken me to many places around the world and given me the great fortune of working with experts in their fields.
At the outset, I had observed first-hand the inability of our western medical knowledge to effectively deal with severe pain and I thus vowed I would never restrict myself to the boundaries of western medicine alone. Why would I? After all, we all know that the best way to improve is to seek out those who excel. Thus my outlook has always been broad rather than narrow, inclusive rather than exclusive.
As a result of this approach, I will take you to places that perhaps you had not imagined, introducing factors that you would never have considered. I am highly qualified in western medical methods and only too aware of how it has, or in many cases has not improved over the last 40 years in dealing with severe pain. I thus make no apology for introducing ideas and concepts not considered by many of my peers.
However, I would forever regret not communicating my knowledge on pain relief to you and at the same time potentially leaving you to suffer more than needed. Ultimately it is then up to each of you how you choose your own future pain relief journey.
Why do we feel pain?
Pain is a normal human experience and we need it to survive. Pain is nature’s warning system which is designed to protect us. Pain is the symptom and not the cause of a problem.
When someone brings us bad news, we don’t shoot the messenger, do we? No, instead, we listen to what the messenger has to say, and then we go and find the real cause of the problem. It is exactly the same thing when it comes to pain. It is only trying to warn us that there is a problem, and it is up to us to seek out the true reason behind that pain. Where is the pain coming from and why? You can’t put a fire out if you don’t know where the fire is. Pain is no different.
Chronic pain has more to do with sensitive nerves and how your brain processes your lifestyle than the injury itself
Pain signals are sent to the brain for processing through the nervous system. Some nerves send control signals from the brain to the rest of the body. Others send signals from the body to the brain for feedback and processing. Each of us has around 45 miles of nerves connecting all our body parts to the spinal cord, so that provides a lot of opportunities for pain signals to be sent to the brain. The brain has to decide how to express that pain signal and that expression can vary wildly from one individual to the next.
As an example, I have seen patients with bone on bone contact in their knees and yet feel almost no pain, whereas others with far better cartilage cover suffer severely.
Our perception of pain is related to everything we are experiencing in our lives at that time. When we move better, eat better, are happier and less stressed, we minimise the pain we feel.
One secret to conquering pain is to find out what you have too much or too little of. It’s all about balance, and any disruption in the delicate balance of your body can be a strong contender for the root cause of your painful life.
If pain is suffered for too long, typically more than 3 months, the brain can hardwire it in. One reason chronic, or long term, the pain has increased is that there has been too much focus on the localised injury and not enough on the significant contribution made by the nervous system and brain. In so doing, we have allowed the pain to be locked in the brain and no amount of localised treatment of where the pain is perceived to be felt will make any difference. Sadly, it’s not uncommon for perceived pain to be felt when the cause of the pain is in a different part of the body.
An extreme example of locked in pain is when it has been caused by an emotional trauma many years earlier and often from as early as childhood. This trauma has caused a locked-in physical condition which expresses itself as never-ending pain. The trauma and pain are intertwined so tightly that both have to be released at the same time.
I have witnessed first-hand many such situations where the release of a muscle locked in spasm caused an emotional outflow and replay of the emotional trauma which was the root cause of the problem. This emotional venting led to a release from pain suffered sometimes 20, 30, 40 and even 50 years!
To summarise this necessarily brief introduction to why we feel pain, it should be clear that assessing pain is not a simple matter if the intention is to get to the root cause.
In my next blog in this series Your Pain Relief Plan Part 2 I will discuss the consequences of ageing and the differences between acute and chronic pain and why these need very different treatment protocols.
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:
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.
The Physical Assessment
In my three previous blogs on physiotherapy assessment
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.
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.
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
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.
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.