Tuesday, 7 May 2013

Disability and "drug free" options for musculoskeletal pain

Many people are reluctant to take pain medication. Muscular pain for disabled people can be more debilitating than the physical impairment itself and it appears to be on the increase as we age. If you are thinking of how you can maintain and possibly improve your health and you don't know where to start then here is a list of recognised alternative treatments, with links to their professional associations. Make sure you check with your Doctor that you are a suitable candidate for these type of therapies. I do no recommend any particular treatment, This blog just is an information base, a place to start to explore.

I have provided where possible UK associations for these therapies. Many therapist work with disabled athletes and the association should be able to assist you in finding a therapist who has experience with disability and its additional demands so it is worth checking with them to see if there is anyone in your area.

Exercise - One of the NHS top tips for pain management is exercise. "Simple, everyday activity like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain. Activity also helps to stretch stiff and tense muscles, ligaments and joints, which can lessen pain"

"It’s natural to be hesitant if exercise is painful and you’re worried about doing more damage. But if you become more active gradually, it's unlikely you will cause any damage or harm. The pain you feel when you start gentle exercise is because the muscles and joints are getting fitter"

Avoiding exercise completely could lead to other problems like stiff joints, weight gain, heart disease, osteoporosis, poor balance and falls.

 In recent years, studies have shown that regular physical activity also has benefits for mental health. Exercise can help people recover from depression and prevent them from becoming depressed in the first place. Please see the section on psychology for further details.

If you need some help, think about investing in your health and employ a Personal Trainer to guide and motivate you. Have a look at The Inclusive Fitness Initiative (IFI) this is a model that supports the fitness industry to become more inclusive to both disabled and non-disabled people. 

Working within the English Federation of Disability Sport (EFDS) nearly 400 IFI Mark accredited facilities, accreditation consists of three levels; Provisional, Registered and Excellent. These venues support and lead the way in providing accessible physical activity and in increasing participation amongst disabled people.

The IFI model addresses inclusion holistically through the following areas:-

• Accessible facilities in terms of physical access and accessible service provision
• Inclusive fitness equipment
• Staff training; customer service and adaptive exercise programming
• Marketing and local partnership development within the local community
• Wider accessible sport and social activities

When visiting an IFI Mark facility you should find accessible facilities, equipment that is appropriate for the vast majority of disabled people, a positive culture and staff attitude and a facility that understands the value of a diverse and inclusive customer base.

To find your nearest IFI Mark facility ring 01509 227750 or email

or visit

Physiotherapy - is a type of therapy that can help ill, injured or disabled people recover movement and function to their full potential. Physiotherapy covers a broad and varied range of work which involves working with people to promote their own health and well being. they may use a variety of techniques including ice, heat, ultrasound and exercise as well as advice about posture and lifestyle. 

Specialist physiotherapist work in many areas including neurology (including stroke) men's and women's health (including incontinence),recovery after major surgery, orthopaedics and trauma, sports and workplace health.

You can access physiotherapy through the NHS or private practitioners. It is also sometimes possible to access physiotherapy treatment through other routes, such as charities and the voluntary sector. In some areas, 'self-referral' systems are in place that allow you to access physiotherapy directly. If you acquire an injury it can be beneficial to use your health care grant to access private therapist quickly.

The Chartered Society of Physiotherapy (CSP)

Osteopathy - is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.

To an osteopath, for your body to work well, its structure must also work well. So osteopaths work to restore your body to a state of balance, where possible without the use of drugs or surgery. Osteopaths use touch, physical manipulation, stretching and massage to increase the mobility of joints, to relieve muscle tension, to enhance the blood and nerve supply to tissues, and to help your body’s own healing mechanisms. They may also provide advice on posture and exercise to aid recovery, promote health and prevent symptoms recurring.

 The General Osteopathic Council

Registered Dieticians (RDs) are uniquely qualified to translate scientific information about food into practical dietary advice. As well as providing impartial advice about nutrition and health, dieticians also advise about food related problems and treat disease and ill health. Many dieticians work in the National Health Service (NHS) and may work in one or more specialist areas e.g. diabetes, children's health, cancer, whilst others work with people in the community, often visiting them in their own homes. 

The British Dietetic Association

Psychology - is the scientific study of people, the mind and behaviour. Tackling depression without drugs is possible. Many GP surgeries across the country prescribe exercise as a treatment for a range of conditions, including depression.

Exercise on prescription - If you haven’t exercised for a long time or are concerned about the effects of exercise on your health, ask your GP about the exercise on prescription programme.

Your GP will refer you to a local active health team for a fixed number of sessions under the supervision of a qualified trainer.

You decide with your GP and the active health team what type of activity will suit you. Depending on your circumstances and what’s available locally, the exercise programme may be offered free or at a reduced cost

Cognitive behavioural therapy (CBT) Some beneficiaries have found helpful and it is recommended on the NHS web site. CBT has been shown to be particularly helpful at tackling problems such as anxiety, depression, post-traumatic stress disorder (PTSD), eating disorders and drug misuse.

Unlike other types of talking treatments, such as psychotherapy, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

CBT can also be used to treat people with long-term health conditions, such as arthritis and irritable bowel syndrome (IBS). CBT cannot cure the physical symptoms of these health conditions, but can help people cope better with them.

The British Psychological Society is the representative body for psychology and psychologists in the UK. The British Psychological Society

Pilates is a form of exercise designed to elongate, developed by Joseph Pilates, which emphasizes the balanced development of the body through core strength, ie your abdominal and pelvic muscles, developing flexibility, and awareness in order to support your back and strengthen and restore the body to balance. Pilates builds on your body's core strength and improves your posture through a series of low repetition low impact stretching and conditioning exercises. 

Pilates goes far beyond your core muscles however and not only provides a complete body workout you will be working muscles you didn't even know you had!, but also helps you develop an awareness of how your body works, helping your mind and body to work in harmony. Pilates can be beneficial for just about everyone, regardless of age and fitness level.

Pilates is an Adaptable Method Modification is the key to Pilates exercise success with a variety of populations. All exercises are developed with modifications that can make a workout safe and challenging for everyone.

Sports Massage - is the management, manipulation and rehabilitation of soft tissues of the body including muscles, ligaments and tendons. The therapist can physically enable the disabled body to stretch in a way that is not possible to do on its own.

Some of the reported benefits of Sports Massage include: Improve circulation & lymphatic flow, sedate or stimulate nerve endings, Increase or decrease muscle tone Increase or decrease muscle length, and remodel scar tissue when required. To benefit from a sports massage you do not need to be a sports performer. There are many practitioners that work with a great range of clients. The benefits above can also help relieve many day to day problems that everyone experiences. Look for a SMA LEVEL 4 or above accredited practitioner, these practitioners have a higher level of qualification in anatomy and physiology. Try and find someone who has experience within disability sport.

Sports Massage Association

Acupuncture - Based on traditional belief, acupuncturists are trained to use subtle diagnostic techniques that have been developed and refined for centuries. The focus is on the individual, not their illness, and all the symptoms are seen in relation to each other. Each patient is unique; two people with the same western diagnosis may well receive different acupuncture treatments.

 Traditional acupuncturists believe that the underlying principle of treatment is that illness and pain occur when the body's qi, or vital energy, cannot flow freely. There can be many reasons for this; emotional and physical stress, poor nutrition, infection or injury are among the most common. By inserting ultra-fine sterile needles into specific acupuncture points, a traditional acupuncturist seeks to re-establish the free flow of qi to restore balance and trigger the body's natural healing response.

 The British Acupuncture Council

 Yoga - offers a holistic approach to body, mind and spirit, which can provide us with the ‘tools’ to cope with the challenges of daily life. Yoga can also complement medical science and therapy for specific conditions. Everyone can practice yoga, regardless of age, sex or ability. Different types of Yoga will suit different people, you might need to try a few teachers

Active self help treatments are not to be overlooked because some of our body parts are differently formed. A good Yoga or Pilates teacher will design a program to suit your needs even if you are working from a wheel chair, using exercises that integrate the whole body to re-educate and restore it to optimum muscular and skeletal function. A private lesson might be a great way to start with one to one attention the teacher can focus in on your requirements and potential. 

British Wheel of Yoga teachers are trained to modify yoga positions for individuals with medical conditions ranging from pregnancy to arthritis.

The Alexander technique - is a way of learning how you can get rid of harmful tension in your body, a way of learning to move mindfully through life. The Alexander process shines a light on inefficient habits of movement and patterns of accumulated tension, which interferes with our innate ability to move easily and according to how we are designed. It’s a simple yet powerful approach that offers the opportunity to take charge of one’s own learning and healing process, because it’s not a series of passive treatments but an active exploration that changes the way one thinks and responds in activity.

What to expect - Alexander lessons are not painful. There is nothing physically aggressive about the work. On the contrary, it is a process of allowing the pupil to release tension and the harmful habits that were responsible for it - at the pace that suits him or her, individually. This is a clothes-on therapy, as table work often forms part of the lesson, women pupils usually feel more comfortable wearing slacks, or jeans, rather than a skirt. 

During the lesson your teacher will be observing your posture and movement patterns. She will also supplement the visual information in a very important way by using her hands, gently placing them on your neck, shoulders, back and so on. The teacher is using her hands in order to get more refined information about your patterns of breathing and moving.

Teachers vary somewhat in their approaches to teaching. This is not a cheap or quick fix; 24 sessions Alexander technique are needed or 6 sessions Alexander technique plus seeing a personal trainer. For further information -

Find a therapist