MAY
17th
Information for Bupa Members "Resent changes to our arrangement with BUPA Healthcare" This clinic has been part of the BUPA Physiotherapy Network since 2009 following their “blind tender” process. As part of this process we are required to re-negotiate our contract every 2 years.

Our current contract came to an end on 17th May 2017 and we have been in negotiations with them since this time. BUPA continue to bully their providers into accepting lower fees and creating more hoops for them to climb through.

We have decided that BUPA no longer satisfy our terms of business and we are not renewing our arrangements with them.

We are able to complete any treatment for BUPA patients until 14th July 2017 providing that treatment has been authorised prior to 18th May 2017.

We can still provide BUPA patients with our expert services but unfortunately we will not be able to submit your account to BUPA for direct settlement.
If you need to reclaim the costs of your physiotherapy treatment through BUPA you will need to discuss this issue with them. They will also be able to direct you to anyone remaining on their provider list.

We would like to thank all our loyal BUPA Members who have used our services over the years and would be very pleased to help you in the future should you make alternative arrangements.

We apologise for any inconvenience caused.
NOV
1st
Fee Revision for 2017 "Please be informed that as of 1/01/2017 our fees will increase slightly. They are detailed here. " 1.11.16

REVISION OF FEES AS OF 1st January 2017


Standard Charges

Initial Assessment & Treatment - £40
On-going Treatment Session - £35

Accounts

Initial Assessment & Treatment - £45
On-going Treatment Session - £38


Additional Charges

Ostenil Injections - £140 (+ Appointment Fee)

Steroid Injections - £15 (+ Appointment Fee)


Joint Aspirations - £45


Letters to Doctors - £15


Strapping - £10


Medical Reports - £100


Iain Briggs
Chartered Physiotherapist
MAR
15th
Steroid Injections - are they for you? "Steroid injections are a useful addition to more traditional physiotherapy modalities. We have been using them safely as part of our treatments since 2003. " Steroid injections are a useful addition to more traditional physiotherapy modalities. They are used to help reduce inflammation in soft tissue such as the synovial lining of a joint or a tendon attachment such as a tennis elbow. Steroids are not aliens to the body. You make your own steroid to help with inflammation and tissue repair but not in a suitable quantity.

Steroid injections can be administered into an inflamed joint (intra-articular injection) or into inflamed tissue near to a joint like a ligament attachment or tendon sheath (peri-articular injection). The steroid injection will reduce inflammation, swelling and pain within the area and thereby help reduce the healing time.

The steroids we use are Hydrocortisone, Kenalog and Depo-medrone. We also use a local anaesthetic (Lidocaine or Bupivacaine) to produce a suitable numbing down of the area being injected.

The steroid is delivered in a slow release form. Once it has been injected it starts working almost immediately but it usually takes up to 48 hours before there is a significant improvement in your symptoms. The improvement usually continues for up to about 14 days though patients often report a further gain over the following 4/52.

The commonest injections we carry out are to and around the shoulder area. These include tendon injections to the rotator cuff, intra-articular injection for frozen shoulders and arthritic pain and to the shoulder bursa for impingement problems.

Tennis and golfers elbow are another group of conditions that respond well to
peri-articular injections after a course of deep frictional massage and stretching.

De Quervains teno-synovitis of the thumb and trigger finger both respond well to local infiltration of the tendon sheath, as does the joint at the base of the thumb and the dorsal ganglions around the wrist.

The various bursa around the hip joints can often be settled down with a course of electrotherapy and selective soft tissue stretching along with an appropriately timed steroid injection.

We have also been having good results around the knee with joint and bursa aspiration followed by a suitably placed steroid injection.

Steroid injections are a useful adjunct to deep ultrasound and soft tissue stretching for plantar faciitis and chronic ligament strains around the ankle.

In the vast majority of cases one injection is all that is needed to relieve symptoms, however, a second and occasional a third injection is sometimes required.

There are far fewer side effects from the correct use of injected steroids as opposed to when using oral anti-inflammatory medication. Here at the clinic we are always very careful to select the lowest dose possible to produce a suitable improvement.

We liaise closely with your own doctor as to the suitability of injection therapy in the management of any musculo-skeletal disorder. If you have any concerns with having an injection as part of your treatment, Iain would be very happy to discuss these with you.

Some of the more common side effects include:-

Anaphylaxis is an allergic response to the injection. Although extremely rare it is potentially serious. Injections are only carried out at our York Bridge Site where we have a full medical team trained in its management and we carry the full range of anti-anaphylactic drugs.

Infection can complicate an injection procedure. Injections are carried out using a non- touch aseptic technique. The steroid injection may lower the auto-immune response locally allowing an infection already present in the body to attack the weakened area. For this reason we do not carry out injections on patients who are feeling unwell or just getting over an infection i.e. chest infection or urinary tract infection. For your safety we may choose to re-schedule a planned injection appointment.

There can be a slight increase in symptoms for first 24 hours. This is known as post injection flare.

Steroid injections can cause a temporary upset to the normal diabetic control and it is always a good idea to be vigilant of this if your diabetic control is unstable. There have also been cases of temporary increase of blood pressure.

Steroids can interfere slightly with the normal hormonal levels in the body. This can manifest in facial flushing often experienced the following morning. It is rare for this to last more than a few hours. Minor disturbances of the menstrual cycle in females are less common and will self-correct by the end of the next full cycle.

Steroid injections can cause slight alterations in the sub-cutaneous skin pigmentation and also atrophy in the subcutaneous fat layer. Very few injections are administered so close to the skin layer that this is likely to be a problem.

Remember that to date we have carried out over 1000 successful injections since 2003 with no complications. You could be our next success ?!
MAR
25th
Anyone for Pilates? "Pilates can be a useful adjunct to a succsessful physiotherapy rehabilitation program - who can it help?" Anyone for Pilates?

What is Pilates?

The Pilates method of training is based on the original works of German born Joseph Pilates who designed a series of exercises that used both physical and mental techniques to condition the body.

His method of exercise was devised for actors, dancers and athletes. In the 1920’s he used his studio in New York to run exercise programmes to help build strength, improve posture and increase flexibility.

In recent years Pilates has gone from being virtually unknown to becoming popular in studios, health clubs and private classes.

What is Modern Pilates?

Modern Pilates brings his work into the 2st Century by using all the latest research and knowledge we have about safe and effective exercise.

Developed by physiotherapists and fitness experts, Modern Pilates classes aim to re-balance the body by improving posture, muscle tone, flexibility and core stability.

The slow and controlled approach to exercise that Modern Pilates adopts can also help to relieve stress and tension, help with back problems, assist in injury rehabilitation and improve body awareness.

Who is Modern Pilates suitable for?

Modern Pilates is suitable for all ages and abilities and is particularly recommended for the
following :-

Back and neck problems
Poor abdominal tone
Recovery from musculo-skeletal injury
Osteoporosis
Pelvic floor problems
Stress
Poor posture
ME (myalgic encephalisis)
MS (multiple sclerosis)
Following childbirth
Modern Pilates classes are ideal for the first time exerciser, clients returning to exercise after injury or childbirth and for those who live a busy and stressful lifestyle.

Where can I find out more about Pilates?

We would recommend you discuss your Pilates requirements with Janet Butler who is an Advanced Pilates Instructor, having completed an extensive training taught by physiotherapists.

We have worked closely with Janet since 1993 firstly as a fitness instructor and more recently as an Advanced Pilates Instructor. We have found Pilates to be of great benefit to all our patients particularly those recovering from neck and back pain helping them to regains their optimum flexibility and postural control.

Janet has suffered from back pain herself following years of teaching high impact exercise and knows firsthand of the considerable benefit of the Modern Pilates method of exercise.

Modern Pilates – Educating Minds to Strengthen Bodies

Why not give Janet a call on 01524 833154 or 07968 372 039
or check out her website

www.janetbutlerpilates.co.uk
JUL
22nd
Whiplash "One in 200 of us will suffer a whiplash type injury at some time in our lives. They are not normally serious and most people who suffer from a whiplash injury go on to make a full recovery." A whiplash is a soft tissue injury often arising from minor trauma. It most commonly affects the neck though can also affect the thoracic and lumbar spine. Although it can cause considerable pain and discomfort it is rarely serious and most people make a full recovery in 6 – 12 weeks.

Whiplash can be caused by a road traffic accident (RTA) or sustained whilst participating in a variety of sports. It is commonly caused when the neck is jolted suddenly from behind and then recoils in a forward direction. This is the typical onset in a car accident where there is a rear end shunt. It may also happen in the opposite direction if you are unlucky enough to run into the vehicle in front.

With our roads getting busier ever day more and more of us are involved in road traffic accidents. It is estimated that 1 in 200 will suffer from whiplash at some time in our lives. If you follow a few simple guidelines in the early stages following a whiplash type injury you can really take control of your symptoms and help yourself to a speedy recovery.

A whiplash is rarely serious, however, there a few occasions when you should be checked over by your GP or nearest Accident and Emergency Unit. If you are experiencing any of the following symptoms or have been in a major accident we would advise you make an appointment to see your GP before seeking the help of a Chartered Physiotherapist. These include:- have severe neck pain, loss of consciousness, have a severe headache, disturbed vision, drowsiness, confusion, nausea, vomiting, balance problems or pain with numbness or pins and needles in your arms.

It is normal to feel under some stress and anxiety following a whiplash injury but remember that being in pain does not mean that you have a major problem. It is important to stay as active as possible and carry on with every day normal life. Try and stay at work and carry on with hobbies. Let your employer know that you have had an accident and they will be more understanding and may be able to offer a lighter work load for a few weeks.

To help you carry on normally it is important to control the pain adequately. This can be done with the help of some over the counter pain killers. We do not recommend the use of anti-inflammatories in these early weeks as they have been shown to slow the healing process even though they do help control pain. Pain can be felt almost immediately after a whiplash injury, however, it is quite common for it to come on more slowly over the first 48 hours. This is as the inflammation builds up. This is nothing to worry about and is part of the normal cascading inflammatory process that is in fact essential to normal healing
If your pain is not controlled we would recommend seeing your GP who would be able to prescribe a stronger combination of drugs as appropriate.

Please remember that by controlling your pain effectively it will help you remain active and stop your joints from stiffening up. Hot or cold packs are also very useful in helping to control your pain and we would recommend trying either to see which helps you the most.

If your pain is not settling and you neck remains stiff after a week following the above advice we would recommend having an assessment with a Chartered Physiotherapist who is specialised and experienced in treating whiplash disorder. They will carry out a thorough examination of your injury and give you education and advice specific to your problem.

Physiotherapists will also use a variety of other treatments to help control your pain and to get you moving again. Massage may be used to reduce tension and pain around your neck muscles. Electrotherapy or acupuncture may be used to help reduce your pain. Joint mobilisation and manipulation have been shown to be particularly helpful when used soon after the whiplash injury to restore normal movement.

Please remember that if you have been involved in an accident and have sustained a whiplash injury you can speed up your recovery by following a few simple rules.

It is usual to experience some pain and discomfort after your injury but this does not normally mean you have sustained a serious injury.

Get your pain under control with some over the counter analgesia. Use hot packs or wheat bags as well.

Take care of your neck posture and keep your neck moving by gently turning it to one side a few times then to the other.

If your pain is not lessening and your movements remain restricted after 7-10 days consider having a thorough assessment by one of our team and let us help speed up your recovery.

Please remember be positive and stay active.
Chartered Society of Physiotherapy Manipulation Association of Chartered Physiotherapists Physio First Association of Chartered Physiotherapists in Orthopaedic Medicine Society of Orthopaedic Medicine Acupuncture Association of Chartered Physiotherapists