Germs

Ever wondered why when people are exposed to an illness (let’s say somebody enters the work place with a cough) some people succumb and others do not?

For decades our focus has been on eradiating the germ (or mirco-organism). The term micro-organisms defines organisms that are too small to see with the naked eye e.g. bacteria, fungus, virus, etc. When we take antibiotics we are looking to kill the micro-organism to rid ourselves of the disease.

If this is the case, why then do some people remain unaffected? If it is all about the micro-organism then surely everybody who is exposed will suffer.

It is a valid argument to answer that the non-sufferers are already immune because they may have been exposed to the micro-organism before (learnt immunity). However this argument does not hold true when we consider new micro-organisms. Recent examples would be the bird flu or ebola. Here nobody has learnt immunity as nobody has been exposed to it before. Therefore these outbreaks should be catastrophic affecting hundreds of millions of people. Yet they do not, why?

Lets go back to basics and look at the definition of mirco-organism disease. Wikipedia uses this very clear definition
These small organisms, too small to see without magnification, invade humans, animals, and other living hosts. Their growth and reproduction within their hosts can cause a disease”

We have highlighted the key phrase in the definition here; growth and reproduction. The micro-organisms not only have to invade but reach a critical mass before they can cause disease. Until then we are immune.

Recent studies have shown many healthy non-symptomatic people having the harmful E-coli strain within their gut flora. Yet they remain symptom free.

So what dictates micro-organism growth and reproduction. The answer is favourable conditions. Each micro-organism will need a certain set of conditions to flourish. Our internal environment is composed of sugars, salts, fatty acids, amino acids, coenzymes, hormones, neurotransmitters, white blood cells, waste products and toxins. Therefore alter the internal environment and it can turn the balance of power to another micro-organism.

Diet, lifestyle, exercise, water intake, stress, emotional balance and sleep will affect the composition of our internal environment and thus which micro-organisms flourish.

Diverticulosis

It is a commonly identified problem yet when asked few people understand what is happening inside of us. This article will change that, giving you a clear understanding of the process behind diverticulitis/osis.

In all cases within the body, before you can understand what is wrong you must first understand how things work normally. Diverticulitosis/ilitis is a problem with the intestinal wall. So lets start with the normal structure of a bowel wall.

The bowel is made of primarily two sections, the small and large intestines. The main difference is that the small intestines are a smaller diameter tube. The structure of the walls is essentially the same. The intestines are a long tube made of 4 distinct concentric layers. Layer 1 [the layer in contact with food] is a very thin layer of adsorptive/secretary cells which breakdown and absorb the passing chewed up food. The second layer is a stronger connective tissue layer which carries the blood vessels/lympathic fluid for which the absorbed products are transported away. The third layer is a muscular layer which provides the contractions to mix and move the food along. Covering all of this is a thin cling-film layer [layer 4] which connects the intestines to all the other structures within the local vicinity.

In the case diverticulosis, the muscular layer becomes weak with some small tears forming within them. This creates a gap and because the bowels are continuously churning and moving it can cause the first two layers to push through the gap created in layer 3. Subsequently we get a small pouch forming, termed a diverticula. This pouch sits outside of the normal flow of food moving. However, over time food may collect within the pouch. If the food gets stuck there for a prolonged period of time (lets say greater than 24hrs) then it can start to irritate the lining of the pouch. This causes inflammation and an episode of bloating, cramping pain and altered bowel movements (constipation or diarrhoea). The patient here is termed to have diverticulitis.

If the food stays for a time in which bacteria can multiple to critical level, then we can also have fever, nausea and an increased white blood count, i.e. an infection. The pouches rarely disappear and are there for the rest of the patients live. However, as you can appreciate as long as the food does not get stuck in the pouch the patient will be relatively asymptomatic. The patient is thus termed as having diverticulosis [non-inflamed asymptomatic out-pouches].

The solution to the problem is clearly to avoid getting food stuck in the pouches. Thus eating food that passes through the bowels easily, minimising the straining through the bowels and maintaining the mobility of the intestines is upmost important. Guidance on general foods to eat can easily be found on the internet, specific advise to your system can be gained via a nutritionist and maintaining the mobility of the intestines can be achieved with osteopathic techniques.

Take care and we hope you have gained some useful information from this article.

Pain

Pain is a feeling just like touch. It arises when a certain sensory nerve termed noiceptors (i.e. pain receptors) are activated. In the same way, mechanoceptors (mechanical touch receptors) enable us to feel the pressure of an object on our skin. The pain receptors can be activated in 3 ways:

  1. Compression – when an internal (e.g. a muscle) or external (e.g. a garden slab) object places a mechanical pressure on the pain receptor.
  2. Chemical – the release of specific chemicals within the body. These are commonly associated with inflammation which is created when there is cellular damage.
  3. Ischemic – the reduction in blood flow to the receptor. This affects its overall health and therefore it becomes activated.

Once registered the signal is sent through to our higher centres (our brain) where it is enhanced or diminished. This is determined by our:

  • Emotion at the time,
  • Fears attached to the pain (e.g. if we are fearful that the chest pain is part of a heart attack it will feel more painful than if we know it is just wind!)
  • What is happening around us (e.g. if you sprain your ankle whilst looking after a young child it will be less painful then if you are out with your friends.
  • Past experiences with pain (e.g. rugby players or builders/ farmers can be good at dealing with physical pain because they experience it regularly. However they may respond very differently if they have a problem with their internal organs).

So remember pain is controllable. To keep it to its absolute minimum remain positive, create constructive surroundings and do not fear it but understand it.

Bacteria

A strange relationship exists between us and bacteria. On one hand we are constantly trying to kill them and on the other we can not survive without them.

No matter how much we clean ourselves, we will always have bacteria living on and inside of us. We have a symbiotic relationship with them. This means that we provide a suitable environment for them to live and in return they perform jobs for us. These jobs we can not do ourselves. Thus we can not live without them and they can not live without us.

Yet we are competing all the time for space. Our immune systems (and various other body mechanisms) are in place to keep the bacteria population under control. Failure to do this and the bacteria will run riot, multiple and take over our bodies. This is why, for example we have the urge/desire to wash. Our brains are in tune with our own scent and can identify when we smell and need cleansing. A large proportion of our scent, as you are gathering, is due to the size of the bacteria colony living on our skin.

However, being too clean can also have its problems. We see this amongst those who are classed as obsessive compulsive disorders when they may wash 4-5times a day, brush their teeth multiple times, etc. The consequences is that various bacterial colonies are destroyed and so the jobs they perform go undone. Our bodies then suffer because we can not do them.

Bacteria also keeps our immune system strong. The greater the exposure to bacteria the stronger our immune systems. All systems in our bodies work on a simple principle : the greater the exposure to a stimulus the better we become at adapting to it. Think of throwing a ball, playing a instrument, performing your job, hearing sounds, talking, anything in fact. The greater we do it the better we get. The same applies to our immune system. 100years ago we were exposed to thousands of bacteria daily, 1000yrs ago even more and 100000 yrs ago substantially more as our habits were more rural and technologically free. Our environments today are relatively sterile in comparison. Our exposure to bacteria is relatively low so our immune system gets lazy. Our weakening immune system is one of the many reasons why we are suffering from more coughs, colds and flus? Another of those reasons, is our reliance on medicine. Not only is our exposure to bacteria deceasing (due to the sterile environment) but when are immune systems are engaged (i.e. we have a cough, cold or flu) we provide extra help when it is not needed. Would you want somebody reading the paper out loud to you when you are perfectly capable of reading it yourself?

Now we are not implying that we should all live dirty, wash once a week and eliminate medications. Rather we should strike a balance, excessive cleanliness weakens our bodies as does excessive dirtiness. Giving our immune system a chance to fight the bacteria / virus means it grows stronger and thus reduces the frequency of future illness. Should our bodies struggle then consider sending in the second wave; medicine.

Osteoporosis

Osteoporosis is a disorder that reduces our bone density and strength. It rarely presents with symptoms however makes us prone to fractures in the event of a trauma, e.g. a fall. To appreciate how we can help ourselves combat this disorder, we must first appreciate why / how it occurs.

We humans get everywhere and do many different things in our lifetime. Therefore our bodies must continually adapt to our ever changing tasks. Our bone tissue does this by continually breaking down and rebuilding our bones. At any one time we can be knocking down and rebuilding up to 10% of our bones!

There are two types of cells involved in this process, osteoblasts and osteoclasts. The osteoclasts breakdown bone whilst the osteoblasts rebuild it. When we have osteoporosis there is an imbalance. Either the osteoblasts are lagging behind or the osteoclasts are working too hard. The net result is loss of bone density.

The osteoblasts/clasts respond to various signals for clues on how hard to work. These signals come from a number of sources which are:

  1. The forces passing through our bodies when we perform a physical activity,
  2. Various circulating hormones, particularly those from the adrenal (estrogen / testosterone), thyroid (calcitonin) and the parathyroid (parathyroid hormone) glands.
  3. Foreign substances such as alcohol and some medications (steroids being the most notable).

As we are designed to be more physical when we are younger, the quantity of estrogen / testosterone falls as we age. Unfortunately the drop in estrogen after menopause is significantly greater than the testosterone drop in males. Thus osteoporosis is commonly a female disorder.

The osteoblasts will obviously need the right raw materials to make the new bone. As bone tissue is made from protein fibres encased in calcium/phosphate crystals we need to be consuming and absorbing a range of amino acids, calcium and salts.

Now we have the basic understanding of osteoporosis we can work out how to help our bodies maintain our bones. Performing regular load bearing activity or exercise sends positive signals to our bones, whilst minimising alcohol consumption reduces negative signals. Eating a balanced diet rich in vegetables, diary products, pulse/beans, meats and fish gives osteoblasts the material they need to create new bone. Should we have any medical problems with our adrenal, thyroid and parathyroid glands or our kidneys and digestive systems these need to be investigated and treated accordingly.

Head Shape

We see a lot of babies with this type of condition in our practice. So we thought it would be useful to give parents a simple overview of the subject to help parents who aren’t sure what to do.

There are a number of different types of misshapen heads that are frequently grouped together and referred to as ‘flat head syndrome’. We are going to discuss positional plagiocephaly as this is the most common
and usually preventable. Plagiocepahly is when there is a flattening at the back of one side of the head. With a more marked plagiocephaly there is a flatness present but also the ears may seem misaligned and one side of the forehead may bulge. It is called positional plagicephaly because the position that the baby’s head lays on is a significant factor in the development of this kind of misshapen head.

Things to look out for that may warn you that your baby is more vulnerable to developing this condition:
– Is your baby turning their head to one side more than the other?
– When your baby is lying down, do they looked slightly ‘banana shaped’ to one side?
– Does your baby find it more difficult to breastfeed from one side?
– Does one side of the back of your baby’s head appear flatter?

Advice to help your baby develop a good balanced neck mobility and prevent your baby developing a flat head on one side.

1) Positioning – When your baby falls asleep you could gently turn his or her head to face the other way. In the car seat put a rolled up muslin on the side your baby tends to turn or lean to give support.

2) Bottle feeding – Ensure you are feeding your baby in alternate arms.

3) Breastfeeding – positioning is not such a worry in this case. But if your baby has a tight neck it may be they will have difficulty latching making feeding painful on one side. I would suggest getting your baby checked by a cranial osteopath as releasing the neck may make a big difference.

4) Playing – Encourage your baby to look away from the side they prefer by talking, singing and playing with your baby from the other side.

5) Tummy time – This allows your baby’s head to have a break from having constant pressure on the back of their heads. You can start placing your baby on their tummy from birth. A good time to do this is when they are awake and not too tired or hungry. Little and often is the best way to start.

 

IBS

Irritable Bowel Syndrome (IBS) is a term used to group an array of symptoms such as altered bowel movements, bloating, abdominal cramps, etc. The cause is rarely a single cause but rather an array of different factors e.g. stress, nutritional, lifestyle, mechanical, other health problems, etc. Due to its complexity it can persist for many years with each factor being reinforced. There is no one approach that has the answer, however different approaches (e.g. medicine, osteopathic, nutritional, lifestyle) can help reduce the symptoms.

The digestive system is made up of a group of organs located in abdomen (see diagram). The organs are loosely stuffed into a bag like structure and given some degree of freedom to slide around. This improves their function as well ensures they can absorb the forces generated by our movement. They are supplied by nerves originating from our spine and their blood supply comes from a large blood vessel (the abdominal aorta) which runs centrally at the back of the abdominal space.

For any organ to function properly it needs 3 things;
1) a good blood supply (i.e. its source of nutrients);
2) a good nerve supply so it may do as the brain commands and
3) freedom of movement.

How Structure affects Function
Let us assume you have a stiff or painful spine. The chemical environment generated by stiffness or pain can affect how the nerves function i.e. the quality of their impulses. If this occurs in the location of the organ supplying nerves then the organs will receive a poor quality impulse/command. Organs are like soldiers (they follow orders without question) hence they will do a poor job at digesting food.

Over time this can lead to problems. A stiff spine or a pain related posture may also affect the mobility of the organs, i.e. if your right lower back hurts you may shift your weight to the left which compresses the organs on the left side. Just like your joints or muscles, organs do not like to be still as it affects their function. An immobile organ is far less efficient than a mobile organ and so again we see the digestion process affected.

Managing Arthritis

We are considering how best to manage arthritis. What we have outlined below are our observations from working closely with patients, therefore they may not appear in any research papers!

Although, we cannot prevent arthritis we can take steps to limit its affect on our daily lives. There are a few basic principles we regularly discuss with our patients. These are:

A balanced lifestyle
Keeping a balance in your life can ensure that your joints are not over or underworked. Maintaining strength (e.g. walking) and flexibility (e.g. avoiding static postures for > 45mins) of your joints is key, however recovery tends to be longer in arthritic joints, so rest is equally important.

Avoid repetitive activities
Joints are designed to move and this ensures they function well. However, performing the same type of movement each day results in the same joints and muscles being used. This can ultimately lead to fatigue and irritation of your joints. Therefore, try to alter your activities on a day to day basis.

Realistic aims
We are all made differently and are at different stages of our lives. So be realistic about what you can do in a day and plan breaks in between.

Listen to your body
Pain is our body’s warning signal that is best listened to. Adjusting your surroundings to suit your physical abilities may help reduce the frequency of these pain signals. e.g. if bending is difficult, place regularly used dishes at shoulder height to avoid bending.

Intervention
Manual therapies such as osteopathy or physiotherapy can help keep your joints and muscles healthy by stretching your muscles, articulating your joints and prescribing exercises to help strengthen your muscles. Medication can also help with your pain (consult your GP).

Osteoarthritis

Osteoarthritis is due to wear of the joint surfaces. As we get older your joints start to wear in a similar fashion to parts within a well used machine. There can be factors which accelerate or predispose your parts to wear but ultimately all our joints will show some signs of wear.

So, how does a normal joint progress to an osteoarthritic joint? The points below are listed in chronicological sequence and help explain what happens (step by step) and also how it links to our symptoms we present with:

1) General wear and tear
The surface cartilage starts to show signs of weakening due to lifetime of use

2) Cartilage swelling (symptoms = pain on activity, relieved by rest)
Weight bearing activity causes the weakened cartilage to start swelling.

3) Joint narrowing (symptoms = stiffness and pain)
Swollen, weakened cartilage starts to wear causing the joint space to decrease.

4) Breakdown (symptoms = swelling and clicking)
The continued wearing causes cartilage particles within the joint and an irregular joint surface

5) Compensation (symptoms = enlarged joint)
As the joint becomes painful, we use it differently. This leads to new bone growth on the joint margins

6) Bone Exposure (symptoms = night pain and deep aching)
The cartilage covering is completely worn away, leading to exposed bone.

RA vs OA

The two types of arthritis that are commonly confused are osteoarthritis and rheumatoid arthritis. So what’s the difference?

Osteoarthritis
Osteoarthritis most commonly involves the larger weight bearing joints (such as the spine, hips and knees). It usually presents later in life (over 50 years) and is the result of wear and tear of the joints. This process involves wearing down of the cartilage which sits within the joint space. Osteoarthritis is hence part of our normal aging process, like our grey hair!!

Rheumatoid Arthritis
Rheumatoid arthritis is a process that commonly affects the hands and feet. It usually presents between 30-40 years of age and is the result of our body’s immune system attacking the outer lining of our joints. Rheumatoid arthritis is therefore not part of the normal aging process but rather a disease process.

So to summaries osteoarthritis is a normal ageing process that predominantly affects large weight bearing joints whilst rheumatoid arthritis is a disease process which predominantly affect the hands and feet.

Sciatica

Sciatic is a common problem we see but can be easily misdiagnosed. This article will identify the key symptoms of sciatica and why they occur.

Firstly, why the term sciatica? The answer is simple. Sciatica defines an irritation of the sciatic nerve. The nerve comes from the lower back and runs deep to the buttock muscles, before sheltering under the hamstring muscle as it passes down the back of the thigh. At the back of the knee, it branches into two and runs down the outside and back of the lower leg respectively and ends in the foot (see illustration). It is the largest nerve in the lower extremity and supplies the majority of the structures. To give you a sense of its size, if you imagine the main nerves in the body having a diameter of tree branches then the equivalent diameter of the sciatic nerve would be that of the tree trunk.

So how does the sciatic nerve become irritated? The two most common ways are compression and / or chemical irritation. Compression is simply extra mechanical pressure placed on the nerve by the surrounding structures. Usually surrounding tissues will simply slide past each other during movement. However if a surrounding tissue is tight or damaged it may take up more space (as a result of swelling for example) and thus squeeze the sciatic nerve. Chemical irritation results from the chemicals released during inflammation. One of the roles of these chemicals is to sensitize the local nerves to induce pain. Therefore, if the surrounding tissue is damaged [or indeed the sciatic nerve itself] then the resulting inflammation will chemically irritate the sciatic nerve.

Both of these processes will alter the conduction of the sciatic nerve. When there is a low intensity compression or chemical irritation the sciatic nerve will produce pain along part or the whole of its pathway. As the compression or irritation increases in intensity the functionality of the sciatic nerve will be compromised. This results in pins/needles, numbness or weakness in the muscles along the sciatic nerve pathway.

So therein lies the symptoms of sciatica, back pain with a altered sensation into the buttock, posterior thigh or leg and foot. When the sciatic nerve is weakly compromised it will produce pain in the named distribution, but as the severity increases it will also produce pins/needles, numbness or weakness.