Negative beliefs about low back pain (LBP) are common. Fifty percent of the general population believe pain in the back means that the back is damaged. Around ninety percent believe that ignoring pain can damage the back; and seventy believe there is ongoing weakness in the back following an episode of LBP.

It follows then, that the experience of LBP can feel threatening and scary for many people. If the spine is the central structure of the body, protecting the precious spinal cord, what happens when the spine is ‘damaged’, ‘weak’ or ‘worn’? Could it mean ending up in a wheelchair?

Contrary to popular beliefs, the spine is a strong structure and serious underlying structural causes of LBP are rare. The association between common MRI findings such as disc degeneration and disc bulges and LBP disability is weak. In contrast, what people believe and do about their LBP has a strong influence on how long the pain will last and how disabled they will be by it.

Speak to us to help relieve your fears surrounding your lower back pain

Continue reading “Pain at the back of the knee?” →

Is it worth stretching  the plantar facia?

Plantar fasciitis is a painful condition that affects runners, those who stand on their feet all day and a host of other recreational sports enthusiasts. The characteristic feature is the excruciating morning pain that sufferers need to put themselves through in the first few steps getting out of bed. How can we manage this problem?

Descriptions on the cause of plantar fasciitis varies based on what you read and who you listen to. Some say it is a traction issue of the plantar fascia attachment onto the heel bone . They claim the evidence for this are the ‘bony spurs’ seen on xray of the feet of sufferers of plantar fasciitis.

Others claim that it is inflammation on the bone attachment caused by overstretch and overuse of the plantar fascia. Finally, others argue the point that degeneration develops in the  attachment due to a bone compression zone (similar to how many tendinopathies develop) and over time pain develops in a similar way to how pain develops in chronic tendon problems.

Many forms of treatment have been proposed over the years such as stretching, rolling the plantar fascia over a roller, stretching and massaging the plantar fascia over a frozen water bottle , steroid injections, wearing of night socks (someone from Germany invented this), orthotics and a host of other conventional physiotherapy based interventions and non-conventional interventions.

For starters, it can be argued that over stretch is the cause of the problem to begin with. Over-pronation of the foot has often been implicated in plantar fascia problems. As the arch flattens the plantar fascia takes up a tensile force and needs to support the bones of the medial longitudinal arch. If the foot flattens over and over again, the poor plantar fascia needs to support the flattening arch. If over-stretch is the potential cause then why keep stretching it?

However, some studies have even suggested that the plantar fascia cannot even stretch. In a study by Chaudhry et al (2008), it was shown in a mathematical model that to even produce a 1% compression and shear force on the plantar fascia takes enormous forces that cannot be produced by normal means.

It almost suggests that if you attached a plantar fascia to a chain, you could pull a 1 tonne truck and it still would not stretch. So how is a night sock or roller going to be able to produce any change in length at all?
What stretching and foam rolling the plantar fascia does is either reduces pain locally as the fascia sufferer does not feel as much pain, or it changes the intrinsic foot muscles so that they provide extra support to the medial longitudinal arch.

Therefore in essence should we stretch the plantar fascia? Answer …It may help, or it may not, as long as there is no harm in trying it.

To book in to chat to us about your foot problem we have a Podiatrist and an Osteopath based at Rothery Health plus a private GP and a team of sports therapists

Even though sitting for long periods might have negative effects on our overall health, it does not appear to be a major cause of getting low back pain (LBP). Nevertheless, sitting for prolonged periods is a common aggravating factor for people with LBP, and as such methods to reduce sitting discomfort are often sought. One of the ways people do this is investing (often large sums of money) in a new chair.

Many investigations  have looked at the role of several different chair designs in the management of LBP. We have previously shown that sitting on dynamic (wobbly) chairs and stools does not prevent or reduce LBP.

The use of a backrest, or a sloping seat (like a kneeler chair), have also been looked at to see if they have an effect of LBP. Overall, while using a backrest appears to help reduce back muscle tension to some extent, there is no clear evidence that using a backrest affects the development of LBP. The use of a sloping chair did not help reduce LBP (in fact, if anything they were slightly provocative on average).

We believe there are two possible reasons why reviews of chair design generally suggest that changing chair design does not have a meaningful positive effect on LBP.

1. LBP, like most chronic painful conditions, involves much more than physical factors like the way we sit, bend and lift. We know that treatment approaches which adopt a pretty narrow “physical” approach to chronic painful conditions such as LBP have limited effectiveness. Therefore, it is hardly surprising that changing a single thing in a persons life (e.g. the chair) without addressing any other potentially relevant factors (e.g. their job satisfaction, their activity levels, their sleep, their thoughts, fears and mood) are ineffective.

2. The studies offer the same chair to all subjects, rather than trying to match the right chair for the right person. For example, we have previously shown that changing chair design might help some people with LBP sit more comfortably, yet similar changes in chair design might make other people with LBP more uncomfortable.

In conclusion, LBP is usually not just about the chair (or indeed any other uni-dimensional factor). If interested in examining whether a change in chair design is worth considering, as one part of an overall treatment plan, then try to make sure the proposed changes reflect the individual presentation

1/Cover your head, fingers, and toes.
Blood flow stays concentrated in our core, making our limbs more susceptible to the cold. In addition to wearing gloves, consider roomier shoes to accommodate thermal or wool socks. A large percentage of body heat is also lost through the head, so wearing a hat is a must.

2/For extra protection, wear a face mask or scarf. And don’t forget sunscreen on your exposed face—especially if you’re skiing.

3/Wear latex gloves under your regular gloves. That way, if you’re doing burpees or push-ups on any potentially wet or icy surface, your hands won’t end up wet, even if your gloves do.

4/Avoid the rain and wind.
The body has a hard time managing its temperature when soaked; water draws heat away from the body 25 times faster than air because of its higher density and heat capacity. And freezing windchill can be dangerous . Not only can it quickly make the outdoors feel much colder than the themometer reads, wind pushes air and moisture through our clothes and removes the layer of warm air that surrounds our body.

5/ Don’t overdress.
Since your body warms up once you get moving, it’s OK to feel cold at first. When performing higher-intensity activities, overdressing can lead to excess sweating, which will cause the body to become wet. Damp skin is an unfortunate conductor of heat loss and will lower body temperature and increase risk of hypothermia.

6/Enjoy the scenery.
Don’t forget that being outside likely means better views—no matter where you live.

1. What is Botox ?

Botox contains very small quantities of a natural protein that originates from bacteria and is specially prepared before use. As with many ingredients in medicines, large amounts of this protein would be harmful but in small amounts that is used in Botox it can be beneficial for certain medical conditions.

How does Botox work ?

Our muscles move in  response to signals received from the brain. In some conditions the Brain sends too many of the signals which makes the muscles work too hard .They may tighten too much or twitch without warning. Botox blocks these signals from affecting the muscles and allows them to remain relaxed .It works on sweat glands in a similar way by blocking the signals they receive from the nervous system

If you would like a consultation to see how Botox could work for you call 07824161408 Dr Rupal Naik

Lloyd Davies(one of our sports therapists )at Rothery Health & Sports Injury clinic is competing in the Britains disabled strongest man competition this year .We wish him well .
Watching the World’s Strongest Man on TV when he was a kid, little did Lloyd Davies think that one day he would be competing for such an event himself.
But that’s exactly what the 24-year-old is doing after a rare illness resulted in him cutting short playing rugby .Lloyd who lost his eyesight five years ago after being diagnosed as suffering from Lebers Hereditary Optical Neuritis (LHON).
He is awaiting surgery in the United States, which will cost £10,000, and in the meantime is trialling a drug from Moorfield Eye Hospital in London.
The former Greenhill School pupil had aspirations of joining the Royal Navy to become a Navy diver and whilst he was waiting to complete the final parts of the admissions process, he enrolled onto the marine biology course at Swansea University.
Sadly, in November 2013, Lloyd’s world was turned upside down when he began to suffer from a slight blurring of vision in his left eye. After putting up with it for a short period, he decided to go for an appointment at his local ophthalmic optician, who immediately referred him to the ophthalmic department at his local hospital who began to run tests to discover the cause of his sight issues.
By Christmas of that year, Lloyd had lost all vision in his left eye – just a month after first noticing any problem at all. By January, he was given the devastating news that the cause of his sudden blindness was that he was suffering from LHON, and that usually the other eye would be affected within a matter of months.
This proved to be correct, as shortly after diagnosis, Lloyd started to lose the sight in his right eye. By August 2014, shortly after celebrating his 21st birthday, he was declared as being legally blind.
The condition has robbed the fun-loving, sports mad individual from doing all the things he enjoys and has prevented him from pursuing the career of his dreams.
However, a chance meeting with 2017 World’s Strongest Man Eddie Hall has led to Lloyd taking up the sport.
Lloyd, along with friends Jason Ronowitz and Tommy D’Ortez, attended an evening with Eddie and during a question and answer session, Lloyd got chatting to Eddie about his eyesight. During the evening, Lloyd also met up with Tony Butcher, Disabled Strongest Man, and now after finding out he is eligible to compete, Lloyd has signed up for England’s Strongest Disabled Man in April.

Lloyd will be among 30 athletes pulling trucks, lifting logs and pumping iron to compete for the title. The event is being held on April 2 at Brands Hatch racing circuit alongside the British Truck Racing Championships. One of the events will be a nine-tonne truck pull!
Lloyd’s also been given a place in Britain’s Disabled Strongest Man in Chard, Somerset, in May.
“I have always weight-trained since I was 16,” said Lloyd. “This is one of the things that hasn’t been taken away from me, but I have had to make changes and do need to be careful.
To book Lloyd click on the link below

Bookings

www.rotheryhealth.com

Your guide to Botox

Did you know many people have medical conditions in which their muscles and nerves do NOT work properly .One way to alleviate these conditions is to use Botox to block the signals from the nerves to the muscles and /or sweat glands

1/post stroke

Spacticity is a term used to describe muscle tightness .It is a common problem in people who have had a stroke with damage to nerves responsible for controlling muscles.Making muscles hard to move and difficult to control .Botox can help stroke patients with this  condition

2/Cerebral palsy

Spasticity effects Children with CP creating stiffness in the arms ,thighs and hips .As with adults who’ve had a stroke, muscles and tendons become shorter.Botox can help these children

3/Cervical dystonia

In this condition the neck and shoulders suddenly tense up for no reason .You may find it hard to speak,swallow or look straight ahead.Botox can help this condition

4/Hemifascial spasm

A condition where one side of your face causes spasm .In severe cases your mouth may clamp shut ,making it hard to eat.Botox can help

5/ Excess sweating

This embarrassing condition can be helped with Botox

6/Cosmetic use -Botox can also aid with skin health and anti -aging

If you want to speak to our GP Dr Rupal Naik at the clinic about the benefits of Botox just call 01834 813975 and she can help advise you

What is Botox ?
Botulinum toxin injections, such as Botox and Dysport, are medical treatments that can also be used to help relax facial muscles.
This makes lines and wrinkles, such as crow’s feet and frown lines, less obvious.

How do they work ?
They can temporarily alter your appearance without the need for surgery.
When Botox or Dysport injections are used in this way for cosmetic reasons, they are not available on the NHS.
Before you go ahead ………
If you’re considering Botox or Dysport injections, be certain about why you want to have them.
Cost ?
In the UK, botulinum toxin injections cost £150-£350 per session, depending on the amount of product used.
Is the process safe ?
Take time to find a reputable practitioner who is properly qualified and practises in a clean, safe and appropriate environment. Ask the practitioner what you should do if something were to go wrong.At Rothery Health the injections are delivered by Dr Naik a GP of over 20 years.

From her base at Rothery Health Clinic Saundersfoot ,South Wales Dr Rupal Naik performs a range of non-surgical cosmetic procedures from dermal fillers ,micro-needling to wrinkle injections .

Always striving to achieve the best possible results for her patients the Botox wrinkle relaxing injections will ONLY ever be administered Dr Rupal Naik .So your safety is guaranteed and you will look radiant and more confident .

Botox works by stopping nerve cells sending signals to muscles, helping them relax and in turn, improving the appearance of wrinkles.
To book a free appointment to see how Dr Rupal Naik can help you please call her on 07824161408 or e mail
[email protected]

We are thrilled to announce that Dr Rupal Naik will be joining Rothery Health in the next few months offering private GP appointments , cosmetic medicine and steroid injections under ultrasound .  Rupal has been a GP for well over 20 years and is qualified in cosmetic medicine and is able to offer –

1/dermal fillers

2/wrinkle injections

3/skin treatments

Plus as a qualified GP she will be available to offer private consultations and steroid injections under ultrasound(the gold standard ) for upper and lower limb sports injuries  .This is fantastic news for the clinic and adds to the already diverse team of podiatry,osteopathy ,sports therapy and holistic therapy .

You can contact Dr Naik on 07824161408 if you wish to book an appointment

10 Evidence based facts about back pain and Exercise !!!

1 /Exercise is helpful for back pain

Staying as active as possible and returning to all usual activities gradually is very important in aiding recovery. You can start by doing some gentle activity and then increase your levels when you feel confident to do so.

2 /Rest is not helpful but getting back moving and to normal activities is

Scientific studies now indicate that prolonged rest and avoidance of activity for people with low back pain actually leads to higher levels of pain, greater disability, poorer recovery and longer absence from work.

3 /Exercise can prevent recurrence of back pain

Exercise can significantly prevent the recurrence of an episode of low back pain. Exercise also helps reduce low back pain and disability levels, when people stick with it in the long-term.

4 /Moving with confidence and without fear is important for back pain

Many people start moving slowly and minding themselves. Moving slowly and tensing actually puts more strain on your muscles

5 /Exercising in a relaxed manner is important

Doing the exercises in a relaxed manner (e.g. moving normally, not guarding and not breath-holding) and progressing gradually is also important

6 /The best type of exercise is the one you enjoy

People should do an exercise that they enjoy, that is affordable and easy to access (e.g. not too far or difficult to fit into your daily routine). For example, walking, running, cycling, swimming, yoga and pilates, all have similar effects for back pain.

7 /Feeling sore after exercise does not indicate damage to your body

Underused muscles get sore more quickly than healthy muscles. Feeling stiff and sore after exercise does not indicate harm or damage to your body, it simply reflects your body not being used to the activity.

8 /Exercising regularly is a must

The amount of exercise you do is probably more important than the type of exercise. The greatest gains result when an inactive person starts doing any exercise. Getting more than 150 minutes a week has the greatest health benefits.

9 /Running on the road and swimming the breaststroke are not bad for back pain

Scientific research does not show that any of these activities are bad for your back or ‘wear out’ your joints. The amount of exercise you do is more important than the type of exercise. Any amount you can manage will result in benefit, but more than 30 minutes per day would be ideal.

10 /No drug or tablet delivers the diverse range of benefits as exercise

This is a fact that is often overlooked as part of the management of low back pain. Be aware too that all low back pain is not the same. So if you tried one form of exercise that has not helped you, talk to a healthcare professional like an osteopath or chiropractor who can help
www.rotheryhealth.com

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10 facts about your sleep patterns and back pain

1 Poor sleep can be a cause of persistent pain in healthy people

Poor sleep increases risk of developing pain. While many realise that being in pain can cause poor sleep, studies now show that poor sleep among people without any pain at all also increases the risk of developing pain

2 Being tired can give you pain

Sleep is an essential function for survival, like eating or drinking. Therefore, when your body is not getting enough quality sleep, it can react. It does this by creating an inflammatory response which can make you feel sick, tired and irritable.

3 Poor sleep can lead to persistent pain or recovery delay

The critical role of poor sleep in the development and increasing of pain is only being explored in detail in recent years. Poor sleep can be the cause of an acute pain becoming persistent or recovery delay.

4 The number of hours sleep needed depends on the person

Most healthy adults need between 7.5 to 8 hours of sleep per night to function at their best. For some, less than 6 hours per night can lead to worsening back and/or neck pain

5 It is not only quantity, but also quality

You should not only consider the length of sleep, but also questions such as ‘do I feel refreshed in the morning, and throughout the day?’ ‘Do I not always need an alarm clock?’ Do I have enough energy throughout the day?’ If you answer yes to these, you probably have enough sleep.

6 Pain is one of the body’s protective responses to poor sleep

Back pain is typically the person’s body being overprotective due to different factors, such as poor sleep, which makes the body vulnerable to pain. For people who already have pain, it is important to note that the pathways for sleep and pain are linked and affect each other. Thus, poor sleep can turn the volume switch up on pain

7 Sleep schedule is important

Going to bed at the same time everyday (or most days) is important to establish a routine (the same goes for waking up). This rhythm will help keep you refreshed throughout the day. Sometimes, people in pain go to bed very late, as they seek to make themselves exhausted before bedtime so that they sleep when they go to bed. Unfortunately, this cycle can further exacerbate their pain.

8 Exercising regularly is a must

Even though exercise has been consistently shown to help both sleep patterns and pain, many people in pain avoid it as they are afraid that it will make things worse. Therefore, you should not fear, exercise, but rather build it up gradually to let your body get used to it.

9 Boosting mood and reducing stress is key

If someone suffers from stress, depression or anxiety, the chances of them having pain and sleep problems are much higher. Addressing these issues is not always easy. Taking steps to address stress, mood and anxiety could have a significant effect on your quality of sleep and on your pain.

10 Poor sleep doesn’t always lead to back pain

People can have pain and not have a sleep problem or have poor sleep and not have any pain. However, this shouldn’t make you think that addressing sleep is not important.

Speak to your osteopath if unsure

Thanks 

The vast majority of spine surgery procedures to treat severe back pain and/or leg pain are elective by the patient .However, there are a few symptoms that are possible indications of a serious medical condition, and patients with these symptoms should seek emergency medical care ASAP . These symptoms include:

1/Sudden bowel and/or bladder incontinence (either the inability to retain or hold waste) or progressive weakness in the legs. Either of these symptoms could indicate nerve damage or cauda equina syndrome

2/Severe, continuous abdominal and back pain, which could indicate an abdominal aortic aneurysm.

Don’t waste time seeing your GP or Osteopath head straight to A & E immediately if you have any of these symptoms .Often though by seeing an osteopath for conditions like a pinched nerve or disk degeneration surgery can be avoided.

Speak to us if your unsure regarding your Lower back issue

Frozen shoulder is a condition that affects your shoulder joint. It usually involves pain and stiffness that develops gradually, gets worse and then finally goes away. This can take anywhere from a year to 3 years.

Your shoulder is made up of three bones that form a ball-and-socket joint. They are your upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). There’s also tissue surrounding your shoulder joint that holds everything together. This is called the shoulder capsule.

With frozen shoulder, the capsule becomes so thick and tight that it’s hard to move. Bands of scar tissue form and there’s less of a liquid called synovial fluid to keep the joint lubricated. These things limit motion even more.

If you have a frozen shoulder speak to us at the clinic to see how we can help

The rotator cuff is a group of four muscles and their tendons. It controls shoulder movement and also helps to hold your shoulder joint together. When rotator cuff tendons become inflamed or worn, it causes a painful arc or ‘impingement’ syndrome.

Osteopaths or Chiropractors may use different terms to describe the same condition, such as supraspinatus tendinitis or subacromial bursitis.

If you have a painful arc you’ll usually feel pain as you lift your arm away from your body. This may happen because there isn’t enough space for the tendons to pass freely.

This can happen if:
1/the tendon becomes swollen, thickened or torn – this can be due to an injury, overuse of the shoulder (for example, from sports such as swimming or tennis) or “wear and tear” with age

2/the fluid-filled sac (bursa) found between the tendon and acromion becomes irritated and inflamed (bursitis) – this can also be caused by an injury or overuse of the shoulder

3/the acromion is curved or hooked, rather than flat – this tends to be something you’re born with
there are bony growths (spurs) on the acromion – these can develop as you get older

speak to us at the clinic if unsure

Heel pain may well be a condition we call plantar fasciitis .What causes plantar fasciitis?

Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if:

1/Your feet roll inward too much when you walk (excessive pronation)
2/You have high arches or flat feet.
3/You walk, stand, or run for long periods of time, especially on hard surfaces.
4/You are overweight.
5/You wear running shoes that don’t fit well or are worn out.
5/You have tight Achilles’ tendons

6/You have tight calf muscles

Over-pronation of the foot has often been implicated in plantar fascia problems. As the arch flattens as we age the plantar fascia takes up a tensile force and needs to support the bones of the medial longitudinal arch.It is therefore a good idea to get treatment from both a sports osteopath and Podiatrist .

Recently a semi professional footballer came into the clinic with pain under his knee cap.He had tight hamstrings and overdeveloped quads creating a condition known as anterior knee pain or Chondromalacia patellae .

This is damage to the cartilage at the back of the kneecap (patella). The usual treatment advised is to avoid overuse of the knee and to have physiotherapy or Osteopath treatment which is effective in most cases.

What is the patella?

The patella is the kneecap bone. It lies within the quadriceps tendon. This large tendon from the powerful thigh muscles (quadriceps) wraps round the patella and inserts into the top of the lower leg bone (tibia). The quadriceps muscles straighten the leg.

The back of the patella is covered with smooth cartilage. This helps the patella to glide over the lower part of the thigh bone (femur) when you straighten your leg.

What is chondromalacia patellae?

Chondromalacia patellae is damage to the kneecap (patellar) cartilage. It is like a softening or wear and tear of the cartilage.

The roughening or damage can range from slight to severe.

What causes chondromalacia patellae?

Chondromalacia patellae occurs most often in young adults and teenagers. It is more common in women. The reason why damage occurs to the cartilage is not clear. It is thought that the kneecap (patella) may rub against the lower part of the thigh bone (femur) instead of gliding smoothly over it. This may damage the patellar cartilage. Situations where this is more likely include the following:

-Overuse of the knee, such as in certain sports like football or rugby
-Some people may have a slight problem in the alignment of the knee. This may cause the patella to rub on, rather than glide over, the lower femur.

-It may be due to the way the knee has developed.

-Or, it may be due to an imbalance in the muscles around the knee – for example, the large quadriceps muscle above the knee. If one side of the quadriceps muscles pulls harder than the other side, the patella may not glide smoothly and may rub on one side.
A combination of an alignment problem (as above) and overuse with sports, may be the most common reason for getting chondromalacia patellae.
Injury to the knee may contribute – perhaps repeated small injuries or stresses due to sports, or due to slack ligaments (hypermobile joints).
In older people it may develop as part of the ageing process where there is wear and tear of cartilage in many joints.

Speak to us at the clinic if unsure

Common causes of a stiff neck are a muscle strain or a soft tissue sprain or a joint lock . Examples include

1/sleeping with the neck in an awkward position

2/falling or sudden impact that pushes the Head to the side, should such as sports injuries

3/turning the head to the side repeatedly during an activity such as swimming especially front-crawl

4/slouching with Poor Posture whilst viewing the computer or watching TV or reading a book in bed

5/experiencing excessive stress or anxiety which can lead to tension in the neck

6/holding the neck in an abnormal position for a long period such as cradling a phone between the neck and shoulder

Speak to us at Rothery Health if you would like us to examine your neck

Jamie Tilley Sports Podiatrist is based at Rothery Health and Sports Injury Clinic every Wednesday morning and will be offering runners and triathletes the opportunity to have custom insoles by Footbalance made within the clinic .Everyone’s feet are different and often our own feet differ from right to left. FootBalances foot analysis identifies your foot type while FootBalance Custom Insoles are individually moulded to your unique feet to support them in a neutral position aiding a balanced stance and correct posture. Over 75% of the population suffers from misalignment such as overpronation or excessive supination. The effects can be felt throughout the body, whether in muscle and joint pain or through more serious injuries.The insoles are custom moulded to your unique feet, FootBalance custom insoles support your feet in proper alignment to promote healthy foot function and improve overall body alignment.

Pain can be caused by problems related to incorrect alignment as well as poorly fitting insoles and shoes which in turn can place your feet in unhealthy positions, impairing foot function, mobility and further negatively affecting overall body alignment.

FootBalance 100% Custom Insoles are individually custom moulded to each foot offering dynamic support to your feet without unhealthy excess rigidity, providing improved comfort and pain relief.

Speak to us at the clinic 01834 813975

John Rothery Principal Osteopath at Rothery Health Centre,Saundersfoot Pembrokeshire will be attending a 1 day training course in Electrical Acupuncture by the British Medical Acupuncure in June in Northwich, Cheshire.

The British Medical Acupuncture Society was formed in 1980 as an association of medical practitioners interested in acupuncture. Since 2002, membership has been open to most statutory regulated healthcare professionals. In 2017 this was extended to healthcare professionals who are voluntary regulated, provided the regulator is overseen by the PSA and the professional body considers acupuncture with the scope of practice There are now over 1,900 members who use acupuncture in primary or secondary care settings.

The BMAS promotes the use of acupuncture as a therapy following orthodox medical diagnosis by suitably trained practitioners. The course will be held by Dr Mike Cummings who is Medical Director of the British Medical Acupuncture Society (BMAS). Mike is an Honorary Clinical Specialist at the Royal London Hospital for Integrated Medicine, which is part of the University College London Hospitals NHS Foundation Trust, where he supports acupuncture services. John said he is really looking forward to the course and its application in clinic.