Simeon Niel-Asher Launches Home Study Training Course for his Revolutionary Frozen Shoulder Treatment

Osteopath Simeon Niel-Asher is launching a home study training course to teach fellow practitioners how to treat Frozen Shoulder Syndrome and other complex shoulder problems using his revolutionary technique.

The course, aimed at osteopaths, chiropractors and physiotherapists is in four modules and will enable practitioners to practise using the Niel-Asher Technique which has been proven to significantly improve a patient's symptoms within in weeks rather than years.* Each module provides new information as well as opportunities for revision, including 'reflective-learning' questions and practical exercises.

At the end of the course, practitioners must submit three patient case histories, a completed research questionnaire for one or more of the cases and at least one patient testimonial. ‘I have designed a course that will enable other practitioners to learn my technique,’ explains Simeon. ‘By qualifying as a Niel-Asher Technique practitioner, they will not only be able to successfully relieve many of their patients' shoulder problems, but they will also be able to benefit from membership of the Frozen Shoulder Network and become part of an international community of licensed practitioners - sharing experiences, results, viewpoints and research to improve their practices.’

Simeon Niel-Asher will be running a one-day seminar to introduce interested practitioners to the Defrost Training programme. The seminar will take place on Sunday 20th May at Regents College, London from 10.00am until 4.30pm. The seminar costs just £160 per person and six-hour CED/CPD certificates will be issued to attendees. For more information or to book a place, please contact Sarah Weldon on 01291 671 291.

The home study course is available by subscribing on-line and includes membership of the Frozen Shoulder Network. Details are available on-line at http://www.defrosttraining.com.

For more information, or to find out if you are eligible to train, please call 020 8347 6160.

* Research on the effectiveness of the Technique
A recent study at Addenbrookes Hospital in Cambridge compared the Niel-Asher Technique with physiotherapy and a placebo treatment. Six treatments were performed over a nine-week period. Results demonstrated that this new treatment significantly improved patients' range of movement, strength and power; it was also effective over and above physiotherapy for decreasing shoulder pain and disability. The Niel-Asher Technique is successful at relieving the condition in nine out of 10 cases.

Back into Shape Osteopathic Clinic

Back Into Shape - the North London and East London Osteopathic clinics were set up and are currently run by Simeon Niel-Asher. Simeon qualified with a BSc (Ost) from the British School of Osteopathy in 1992 and a BPhil in Complementary Health Studies from the University of Exeter in 1995.

As a relation of Sidney Rose-Neil, one of the UK's most influential osteopaths and founder of the British Acupuncture Association, Simeon developed an interest in the field at an early age. He opened Back into Shape in Highgate in 1994 and moved the Clinic to its current premises in 1999.

Simeon is renowned for his work on Frozen Shoulder Syndrome and has revolutionised treatment of the condition with his unique and highly effective, Niel-Asher Technique™. He treats clients from around the world and jointly operates a Frozen Shoulder Clinic in New York. He has also been named as one of the top ten Osteopaths in London* and is the author of the best selling 'Concise book of trigger points'.

He is a well-trusted local practitioner with a client-list that includes many people locally from North London and world-wide as well as a dedicated following of celebrities such as George Michael, Eddie Izzard and Victoria Wood.

* Evening Standard - London's top 100 complementary therapists 9th May 2001

Peter Clark
A keen sportsman, Peter spent several years in New Zealand mixing work with competitive mountain biking and surfing. He is a regular competitor in triathlons and has managed to work his love of sports into his profession.

On returning to the UK, Peter wanted to focus his knowledge on sports injury rehabilitation. His qualifications as a Core Stability and Pilates instructor complement his osteopathic training perfectly and provide him with the perfect foundations for developing rehabilitation programmes for Back into Shape's patients.

Julia M Spicer
Julia joined Back into Shape in 1992 retraining as an osteopath after she had her two children.

Julia was inspired to retrain after undergoing a successful course of treatment with Simeon. Before joining Back into Shape, she worked as a care assistant in a warden-assisted home for the elderly in Southwark, in a homeless project at London Bridge and at the Bank of England printing works. She had also assisted at osteopathic clinics, dealing with sports injuries and pregnant women.

Julia treats a wide range of conditions including Frozen Shoulder Syndrome, IBS, PMS, low back pain, headaches, migraines and asthma. She also specialises in treating problems that occur in babies, infants and young children.

Deborah Smith
Deborah qualified with a BSc (Hons) Osteopathic Medicine degree from the British College of Naturopathy and Osteopathy and has worked in a number of private and NHS clinics in Northamptonshire, Buckinghamshire and across North London.

She has also trained in Core Stability Exercise, Podiatric Biomechanics and the Niel-Asher Technique™ and visits schools to educate children on good posture and exercise.

Deborah specialises in treatment of the elderly, ergonomic advice and treatment and rehabilitation of sports injuries.

Paul Strange
Paul qualified at the British College of Osteopathic Medicine and specialises in Osteopathy and Naturopathy.

He is experienced with sports injuries and is an expert in the use of low level laser treatment to speed the recovery of soft tissue, bone, ligament and tendon injuries. He also uses the treatment for skin problems, ulcers and post-operative scars.

Paul is also an expert in Cranial Osteopathy and uses the application of nutrition therapy for weight loss or gain, as well as to treat digestive disorders and joint disorders such as arthritis.

For more information on Back into Shape, please visit http://www.backintoshape.com or contact the Clinic on 020 8347 6160.

Weight-Bearing Exercise Improves Bone Health

After four years, Laurie Cohen knew the drill. Since being diagnosed with osteoporosis, she had received almost the same news at every checkup - her bone density had improved slightly, thanks to prescription medication, vitamin D supplements and calcium supplements. But this time, in November 2005, Cohen's doctor greeted her with big smile and a question: ‘What are you doing different from every other year?’

Cohen's bone density had increased 4.4 percent in less than a year, an improvement that Dr. Kathy Diemer calls ‘impressive.’

The answer was simple. Cohen had begun to work out twice a week with a personal trainer. The additional weight training and resistance training had done exactly what Diemer tells her patients can happen - it had enabled her body to reverse bone loss.

Cohen couldn't believe it. It's not as if she were engaging in hard-core training. She works out with a personal trainer for 30 minutes twice a week and attends one 45-minute class, taught by one of the trainers. The heaviest weight she uses is 12 pounds. And her cardio workouts don't last more than 30 minutes.

‘The problem that most women have is you tell them they need to start working out, and they think they have to start running marathons and lifting 100-pound weights,’ says Diemer, an osteoporosis specialist at Washington University Physicians. ‘But it's mainly basic toning. With cardiovascular, you've got to get your heart rate up. But with osteoporosis, it's mainly getting on your feet and walking.’

Cohen discovered she had osteoporosis shortly after she turned 50; she asked her primary care doctor for a bone-density scan simply because she had read that 50 was the age for a baseline reading. She didn't expect to learn about any problems, but she was told that her bone density was so low that she already had osteoporosis in her left hip and osteopenia, the precursor to osteoporosis, in her right hip.

In retrospect, Cohen realises that the news should not have come as a shock. Her mother has osteoporosis. So did her grandmother. The family history had never affected her diet or exercise decisions. ‘I always liked ice cream,’ she says, ‘but I don't think I tried to get calcium. And I'm not a milk drinker.’

The diagnosis forced some changes. Cohen began to take 35 milligrams of Actonel, a drug that slows the degeneration of bone, every Monday. She needed calcium supplements. Doctors recommend weight-bearing exercise, so Cohen continued to walk for about 20 minutes, four mornings a week, although her years of walking hadn't appeared to help.
But it is possible at any age to make bones stronger.

‘We are always rebuilding our skeleton,’ Diemer says. ‘We're breaking down old bones, rebuilding and replenishing the skeleton in the normal cycle of bone turnover. In osteoporosis, the cells that break down bones, the demolition crew, are working too fast, and the construction crew can't keep up.’

Almost all osteoporosis treatments, she says, slow the ‘demolition crew,’ allowing the ‘construction crew’ to fill in holes in the bone.

Weight-bearing exercise stimulates the ‘construction crew.’ Says Diemer, ‘All the stimuli are telling the bone, `You've got to work a little bit harder.'’

So when Cohen revamped her exercise regimen in 2005, it forced her bones to work harder to replenish themselves.

Along with a co-worker, she had attended classes three times a week at Curves. Then her co-worker suggested that they try a kickboxing class, which they loved. When that class time changed, they found another class at Club One Fitness in Creve Coeur, Mo. They figured they may as well join the club.

‘We got a free session with a personal trainer,’ Cohen says. ‘And I thought, `Well, I may as well try this, too.'’

She couldn't believe how difficult the workouts were. (And still are, for that matter.) Squats. Lunges. Squat jumps. Her trainers varied the exercises, which she did sometimes in place, sometimes moving across the room.
For her upper body, she did push-ups, dips, shoulder presses, rows, biceps curls, planks, crunches. She even began to use an exercise ball, working on her balance.

‘You hurt, and you go back for more and wonder why,’ Cohen says. ‘But I knew it was good for me.’

She had no idea how good. Only 10 months after she started, Cohen discovered her surprisingly large change in bone density.

‘Everybody's bone is different, and there are some people who have bigger increases than others - some bone is just a little lazier than others, if you want to put it that way,’ Diemer says. ‘We can't always predict who's going to have such a response. She had an amazing response.’

Cohen is trimmer, fitter and healthier - overall and within her bones - than she thought possible.

She still doesn't think of herself as an athlete, but she pushes herself harder. Her walks have turned into jogs. Sometimes she squeezes in an hour and a half of workouts, divided into 30-minute blocks in the morning, noon and evening.

‘All of my friends know I'm into working out now, and none of them can believe it,’ she says. ‘But I'm very dedicated now.’

She spends about $50 a session on the trainer.

‘It is expensive,’ she says. ‘But if it's making me healthier to spend that much, it's worth it.’

This year's British School of Osteopathy (BSO) conferment and awards ceremony was held on Monday 16th October 2006, at the Mermaid Conference and Events Centre overlooking the Thames at Blackfriars in central London. Friends and family of students gathered to celebrate the graduation of students from the BSO with their hard earned degrees. A number of BSO staff and faculty were also present to witness the occasion.

The day began with the arrival of students and their guests and a chance for students to have official photographs taken in their academic dress.

Following this, students were gathered together in the auditorium, while guests took their seats ready for the beginning of the ceremony. Prior to the conferral of degrees, Les Ebdon, the Vice-Chancellor of the University of Bedfordshire, gave a speech on the growing link between the University of Bedfordshire and the School. Charles Hunt, BSO’s Principal and Chief Executive, reported on the School's activities over the past year, and expressed thanks on behalf of the School to Dr Martin Collins, who stepped down as Principal and Chief Executive in May 2006.

BSO’s patron, The Princess Royal, presented the degrees and gave a speech on the continuing development of the School through its increasing student and patient numbers and the link with the University of Bedfordshire. The Princess Royal also outlined the importance for the new graduates of maintaining links with the School and of providing an evidence base for the practice of Osteopathy as the next generation of Osteopaths.

This year 64 students successfully completed the course. Particular congratulations go to the 11 students who obtained Distinctions, and to Stuart Walker, who was awarded the Silver Medal. Stephen Sandler was presented with his PhD, and an Honorary Fellowship was awarded to Dr Martin Collins. Dr Tamar Pincus was awarded an Associate Professorship. Prizes were also awarded to students from each year group of current undergraduates.

Following the conferral of degrees Stuart Walker gave a speech on behalf of the graduating class, thanking the Faculty and support staff of the School for their contribution to the successes of the students obtaining BSO degrees this year. Following the degree ceremony, a reception took place, allowing students to meet and 'catch up' with their peers and tutors from the BSO. HRH The Princess Royal attended the reception and met with graduands, their guests, and BSO staff.

Web: http://www.bso.ac.uk

Back Into Shape - Osteopathic Clinic Treatment Case Histories

Miss AG, a 26-year old fashion buyer, presented with 'intense' headaches to the upper front of her face and a constant 'pounding' sensation at the base of her skull.

She had spells where she suffered this pain daily and also experienced occasional 'fear' of bright light, nausea and blurred vision. Her headaches had started when she was 11 and intensified when she reached 14. They seemed to have improved with the contraceptive pill. Her doctor had checked her thoroughly and declared her fine.

A friend recommended osteopathy and suggested she visit Back into Shape. ‘The patient's muscles were extremely tense, her scalp was tight and the movement in her neck bones was restricted,’ explains Simeon Niel-Asher (pictured right, with model). ‘This was a severe case and hormones clearly affected it.’

Simeon treated her with a combination of massage to her neck muscles, manipulative adjustments to her neck bones and the use of a specialist technique called trigger point therapy that is particularly effective for treating headaches. ‘It involves pressure on tender nodules embedded within the muscle fibres; these are manipulated in a specific sequence,’ explains Simeon. ‘I also used cranio-sacral osteopathy; a technique that involves gently cupping the head and putting light pressure on various plates of the skull.’

After seven sessions, for the first time in 10 years the patient reported a significant 60-70% improvement. The patient continues to have treatment every two to three months and a year on; she is virtually symptom-free and rarely takes any medication. Simeon expects her to be totally free of symptoms within the next eight months.

Knee pain
TK had been suffering from severe pain down his left leg for eight months when he visited Back into Shape for the first time. The pain was causing sleepless nights, made him 'walk like a cripple' and had so far not been alleviated by any drugs or treatment.

Believing that the pain could be caused by a problem in his back, the patient had been to see a physiotherapist who had referred him to a back specialist at the Cromwell Hospital. An MRI scan revealed a 'narrowing of the discs' (an incurable, degenerative condition) and the consultant recommended that he learn to live with the condition.

The patient was referred to a pain management specialist who told him that the problem could be cured with an epidural and x-ray to locate the problem. When two epidurals did not do the trick - much to the specialist's disbelief - the patient tried acupuncture and podiatry, but again had an unsatisfactory outcome with both treatments.

When the patient saw Simeon Niel-Asher, he was surprised to hear that his condition was nothing to do with the discs in his back, but was actually due to a dislocated fibular bone. ‘I was so amazed that my initial reaction was 'is this good or bad for me?'’ he explains. ‘Simeon then proceeded to click back the bone - which took about 30 seconds - and hey presto, the magician had cured me!’

Frozen Shoulder Syndrome
60-year old MR consulted Back into Shape at the beginning of July complaining of pain and stiffness in his left shoulder, which he described as 'sharp catching spasms of pain and severe, debilitating night pain'. He also had a very restricted range of movement.

His condition had begun with a fall in the snow four months previously when he jarred his shoulder. His GP had recommended physiotherapy but after five sessions and no relief, an x-ray revealed a 'spiral fracture' of the humerus. A shoulder surgeon recommended rest, a sling and conservative treatment but as the fracture healed, his range of motion and pain worsened. Eventually he was diagnosed with a frozen shoulder.

Frozen Shoulder Syndrome is thought to last an average of 30 months and seriously affects the lives of those who suffer. MR couldn't wait 30 months for his condition to improve and was referred to Simeon by his GP.

‘MR was in the classic first phase of a frozen shoulder,’ explains Simeon.
‘However, within three months of commencing treatment using my special technique, he was 99% better.’ Simeon's technique has been clinically proven to significantly improve range of motion and increase strength and power over and above physiotherapy and placebos*.

*British Journal of Rheumatology Volume 42, Supplement 1, 2003, Article 418 BHPR p.146.

Lower back pain
MT is a 31-year old professional badminton player and coach. He consulted Back into Shape earlier this year with a 'chronic ache' and 'spasms' either side of his spine in the lower back that was significantly worse at night and on waking.

His problem had started three years earlier after lifting heavy boxes. As the pain worsened, he had been forced to stop playing badminton - his life-long passion. Eventually a top consultant diagnosed a stress fracture and spinal anomaly and told him to give up badminton forever and see a physiotherapist.

Two years later he was still suffering and decided to go to Back into Shape for treatment. On examination, the patient was found to have restricted flexibility in the spine and part of the area was very tender to the touch. MT was treated with deep soft tissue manipulation and some gentle 'functional' work to the fracture site.

The pain disappeared within just three sessions and MT has returned to playing and coaching badminton full time.

Atypical low back pain
SP, a 53-year old Company Director and sceptic, consulted Back into Shape somewhat reluctantly, with two inter-related problems: He suffered from stiffness and pain in his lower back and buttocks and experienced constant left buttock, hamstring and calf pain that intensified through the day. He also suffered if he lay too long in bed, lay on his stomach or played sport.

His problems had started 28 years before with a severe prolapsed spinal disc and subsequent surgical fusion of two vertebrae with two long screws which had been left in. A keen amateur badminton player, SP had suffered bouts of agonising spasm and progressively worsening pain and had tried a number of treatments before being told that he suffered from 'wear and tear' and a build up of scar tissue around the surgical site.

Simeon Niel-Asher treated SP from September 2005 for a year - a total of 23 sessions. ‘I treated the spinal muscles with trigger point release around the sacrum, deep soft tissue massage and aggressive manipulation,’ he explains. ‘I also manipulated his fibula bone in his leg to instantly relieve his sciatica which had been caused by heavy impact during badminton.’ SP described Simeon's treatment as 'magic', reporting a 90% reduction in sciatica after three treatments. For the first time in 15 years - and over the course of his therapy - he reported slow but steady improvements. By September 2006, SP reported a 95% improvement in spinal pain and sciatica. For a sceptic, he was truly amazed; after 28 years of pain, he was finally able to experience some relief.

Viral inflammation of the heart
EJD, a 25-year old engineer, consulted Back into shape with fatigue, palpitations and atypical neck, shoulder and middle spine pain.

Her problems had started three and a half months earlier when she experienced palpitations and felt unwell after a period of stress. Hospital tests uncovered a Viral Carditis - inflammation of the heart; a potentially dangerous, but self-limiting condition. EJD had no treatment options other than rest, but suffered increased spinal and neck pain when she did so.

Having found that massage helped to relieve the pain, EJD came to Back into Shape: ‘Although this is not a condition one would usually associate with osteopathic treatment, it is possibly a very interesting example of a phenomenon known as Viscero-Somatic Referral where internal organs such as the heart can cause a secondary spinal pain when they are damaged,’ comments Simeon. ‘This is not the same as the referred pain from a heart attack; it is related to nerves that supply the heart and that are also connected to the spine.
Techniques to treat this condition do exist in old osteopathic texts, and although these techniques have fallen into disuse since the advent of heart drugs, they are extremely effective.’

Simeon treated EJD five times over a two-month period using a focused and specific combination of massage, joint manipulation and old-fashioned functional techniques. Her heart symptoms had already improved and she is now virtually symptom-free.

For more information on Back into Shape, please visit http://www.backintoshape.com or contact the Clinic on 020 8347 6160.

A bogus practitioner was found guilty yesterday on five charges of unlawfully describing himself as an osteopath when not registered with the General Osteopathic Council ( GOsC). Mr Graham Hext, 53, of Whitchurch, Shropshire, was fined £15,000 (£3,000 for each charge) and ordered to pay costs of almost £11,235 - a total of £26,235 - by Market Drayton Magistrates' Court.

Mr Hext refused to plead guilty in the face of overwhelming evidence of his guilt. With the passing of the Osteopaths Act 1993, the title "osteopath" is protected by law. Under Section 32(1) of the Act, it is a criminal offence for anyone to claim, expressly or by implication, to be any kind of osteopath, unless registered with the GOsC. The GOsC is the only statutory regulator in the UK that registers qualified osteopathic professionals and sets standards of osteopathic practice and conduct.

When the Act came into force, any person wishing to be admitted to the GOsC's Statutory Register had to undergo a rigorous assessment. This two-year transition period commenced in May 1998 and only practitioners meeting the highest standards were eligible for entry. Mr Hext applied for registration but was refused, on the grounds of insufficient evidence of safe and competent osteopathic practice. Mr Hext chose not to appeal against the decision, and as such lost the right to describe himself as an osteopath in January 2001.

The charges yesterday related to signage at his practice and written information he provided to patients, all of which suggested he was an osteopath. Despite this, Mr Hext denied describing himself as an osteopath. He argued that the Osteopaths Act protected the title 'Osteopath' and not the practice of Osteopathy. He also said that his membership of the Democratic Osteopathic Council (DOC) [ a membership organisation consisting of a small group o f individuals who either failed or chose not to register with the GOsC] entitled him to advertise his use of 'osteopathic techniques'.

District Judge Lawrence concluded, however, that as a result of Mr Hext's advertising, members of the public would believe him to be an osteopath. Furthermore, Mr Hext, by his own admission, said he practised osteopathy. Judge Lawrence ruled that this amounted to a breach of section 32 of the Osteopaths Act.
Chief Executive of the GOsC Madeleine Craggs said: 'This judgement makes it quite clear that those who use semantics to avoid prosecution will inevitably fail. We [the GOsC] will continue to prosecute anyone who unlawfully describes or passes themselves off as an osteopath, in order to maintain the reputation of the osteopathic profession and, above all, protect patients.'

For details of registered osteopaths in your area, please contact the General Osteopathic Council on tel: 020 7357 6655 or visit the GOsC website: www.osteopathy.org.uk.

Spinal manipulation, as practised by chiropractors and osteopaths, is an ineffective intervention for any condition, say Ernst and Canter in the April issue of the Journal of the Royal Society of Medicine. Both the National Council of Osteopathic Research and The British Osteopathic Association respond.

In the April issue of the Journal of the Royal Society of Medicine (JRSM), authors Ernst and Canter concluded in their systematic review of systematic reviews that spinal manipulation, as practised by chiropractors and osteopaths, is an ineffective intervention for any condition. Furthermore, the authors went on to say that given the possibility of adverse effects, the review suggests that spinal manipulation is not a recommendable treatment.

In response, members of the National Council of Osteopathic Research (NCOR), and others from the chiropractic and research fields, wrote to the JRSM outlining their concerns over the review. These included how Ernst and Canter seemed to consider different types of manual intervention interchangeably when they are, in fact, distinct and produce 'differing physiological effects'.

NCOR also comments on the exclusion of more recent studies such as that by Licciardone et al. (see: www.biomedcentral.com/1471-2474/6/43/abstract), which demonstrated osteopathic manipulative treatment does significantly reduce low back pain.

Meanwhile, in a statement from The British Osteopathic Association in response to The Royal Society of Medicine press release, Nigel Graham, President of the BOA, comments:

'The British Osteopathic Association (BOA) welcomes any research into the causes and treatment of chronic back pain which severely affects the lives of around one in seven people in the UK.

'Osteopathy uniquely treats the whole body and more specifically the cause, not just the immediate location of the pain. The body has a natural ability to self-regulate and self-repair and osteopaths rely on this innate healing ability to treat their patients.

'Spinal Manipulation is just one of the techniques which osteopaths use and there is a general consensus that osteopathy is less risky in terms of spinal injuries because osteopaths usually use less forceful manipulation techniques on the spine.

'Recent independent research suggests that a combination of spinal manipulation, general exercise and active management may produce most relief for back pain sufferers, helping them return to their normal activities'.
The Medical Research Council in November 2004 published research that found that osteopathy, chiropractic or manipulative physiotherapy - plus an exercise programme - was the most effective treatment for people suffering from a bad back.

Back pain is so widespread and so costly to society that the use of osteopathy, along with treatment from GPs, can add up to substantial economic benefits to the NHS.

Please contact: Nigel Graham British Osteopathic Association
Tel: 01582 488455
E-mail: Nigel@osteopathy.org.

At a recent meeting of the Parliamentary Group on Scientific Research into Myalgic Encephalomyelitis (ME), members received osteopathic research findings with interest.

ME, the symptoms of which include unexplained exhaustion, muscle and joint pain, insomnia and nausea, has remained somewhat of a mystery to the medical profession for many years.

The Group, chaired by Dr Ian Gibson MP, is looking at progress made in understanding the cause of the condition since the Chief Medical Officer's Report into ME in 2002. It has heard from sufferers of ME, and will hear further evidence from leading medical experts and government officials.

Osteopath Raymond Perrin PhD has been researching the cause of ME, also known as Chronic Fatigue Syndrome, for the last 17 years. Following clinical trials at the Universities of Salford and Manchester, he has developed a diagnostic and treatment approach which he believes could provide significant benefits to sufferers.

Dr Perrin says, 'The group seemed interested in the physical signs that I have discovered. These signs are common to the hundreds of ME sufferers I have treated since 1989. However, further research is necessary to validate these findings which, if successfully confirmed, may make diagnosis easier and quicker, enabling patients to receive earlier treatment and a speedier recovery.'

A new study published in the British Medical Journal (BMJ) confirms what has long been suspected in the medical community – that high doses of common painkillers, such as ibuprofen and diclofenac, can double the risk of heart attack.

Patients are reassured that the risk of heart attack is moderate and the study findings relate only to the highest doses recommended by medics. Nevertheless, for patients who daily suffer chronic debilitating pain, such as arthritis or back pain, consumption of these non-steroidal anti-inflammatory drugs (NSAIDS) are commonly high.

'Doctors and patients need to work together to find suitable alternatives to reduce the dose of NSAIDS – and reduce the very real risk of vascular events,' stresses Dr Leslie Wootton, GP and osteopath. 'I always strive to make my patients aware of all their options, particularly those with musculoskeletal disorders (MSDs). Osteopathy can do much to alleviate pain, improve patients' mobility, and generally make life more comfortable – without the need for drugs.'

An estimated 25,000 people consult an osteopath every day for common problems such as back and neck pain, as well as sciatica, headaches, postural problems, repetitive strain injury, driving and work strain, the pain of arthritis and sports injuries.

Madeleine Craggs, Chief Executive & Registrar of the General Osteopathic Council (GOsC), concluded: “With MSDs making up 20% of GP consultations and this new piece of research confirming the risks of common painkillers, it is essential that patients with debilitating pain are offered effective alternatives.

'Osteopaths are highly skilled health professionals, an integral part of primary care teams. Their work already does much to reduce the number of GP consultations and the cost and quantity of painkilling drugs prescribed. This study underlines the need for patients to understand the best treatment options for their health.'.

In a study published in the New England Journal of Medicinei , the popular dietary supplement combination of glucosamine plus chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants.
However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements. This research was funded by the National Centre for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), components of the National Institutes of Health (NIH). Researchers led by rheumatologist Daniel O. Clegg, M.D., of the University of Utah, School of Medicine, Salt Lake City, conducted the 4-year study known as the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) at 16 sites across the United States.

'GAIT is another example of NIH's commitment to exploring the potential of complementary and alternative medicine to prevent and treat disease in a manner that is fair, unbiased, and scientifically rigorous,' said Elias A. Zerhouni, M.D., NIH Director.

GAIT enrolled nearly 1,600 participants with documented osteoarthritis of the knee. Participants were randomly assigned to receive one of five treatments daily for 24 weeks: glucosamine alone (1500 mg), chondroitin sulfate alone (1200 mg), glucosamine and chondroitin sulfate combined (same doses), a placebo, or celecoxib (200 mg). Celecoxib is an FDA-approved drug for the management of osteoarthritis pain and served as a positive control for the study. (A positive control is a treatment that investigators expect participants to respond to in a predictable way; it helps validate study results.) A positive response to treatment was defined as a 20 percent or greater reduction in pain at week 24 compared to the start of the study.

The researchers found that participants taking celecoxib experienced statistically significant pain relief, as expected, versus placebo--about 70 percent of those taking celecoxib versus 60 percent taking placebo had a 20 percent or greater pain reduction. For all participants, there were no significant differences between the other treatments tested and placebo. However, for participants in the moderate-to-severe pain subgroup, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared to placebo - about 79 percent in this group had a 20 percent or greater pain reduction compared to 54 percent for placebo. In the subgroup of participants with mild pain, glucosamine and chondroitin sulfate together or alone did not provide statistically significant relief compared to placebo.

'This rigorous, large-scale study showed that the combination of glucosamine and chondroitin sulfate appeared to help people with moderate-to-severe pain from knee osteoarthritis, but not those with mild pain,' said Stephen E. Straus, M.D., NCCAM Director. 'It is important to study dietary supplements with well-designed research in order to find out what works and what does not.'

'Because of the small size of the moderate-to-severe pain subgroup, the findings in this group for glucosamine plus chondroitin sulfate should be considered preliminary and need to be confirmed in a study designed for this purpose,' said Dr. Clegg, Professor of Medicine and Chief of Rheumatology at the University of Utah, School of Medicine.

On entering the study, a participant's level of pain was assessed as either mild or moderate to severe using standard pain assessment tools and scales, such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Of the 1,583 study participants, 78 percent were in the mild pain subgroup and the other 22 percent were in the moderate-to-severe pain subgroup. Level of pain was evaluated at weeks 4, 8, 16, and 24 using the WOMAC scale and other tools. In addition to taking their daily study treatment, participants could take up to 4000 mg of acetaminophen daily for pain, except for the 24 hours before they were assessed by study staff. The use of acetaminophen, however, was low, overall averaging fewer than two 500 mg tablets per day. Participants could not take other non-steroidal anti-inflammatory medicines or narcotic (opioid-based) pain relievers during the study.

'More than 20 million Americans have osteoarthritis, making it a frequent cause of physical disability among adults,' said Stephen I. Katz, M.D., Ph.D., NIAMS Director. 'We are excited to support studies looking at new treatment options that could improve the symptoms and quality of life of people with osteoarthritis.'

GAIT was conducted under an Investigational New Drug application filed with the U.S. Food and Drug Administration. Thus, all of the products used in the study were subject to the FDA's pharmaceutical regulations and evaluated and manufactured by an FDA-licensed clinical research pharmacy centre. The glucosamine and chondroitin sulfate used were tested for purity, potency, quality, and consistency among batches. Products were retested for stability throughout the study. The dosages selected were based on the prevailing doses in the scientific literature. Few side effects from any of the treatments were reported. Those reported were generally mild, such as upset stomach, and distributed evenly across the treatment groups.

'The GAIT team's goal was to assess whether glucosamine and chondroitin sulfate, which we saw our osteoarthritis patients using, provided pain relief,' said Dr. Clegg. 'I urge people with osteoarthritis to follow a comprehensive plan for managing their arthritis pain - eat right, exercise, lose excess weight, and talk to your physician about appropriate treatment options.'

The GAIT team continues their research with a smaller study to see whether glucosamine and chondroitin sulfate can alter the progression of osteoarthritis, such as delaying the narrowing of the joint spaces. About one-half of the participants in the larger GAIT study were eligible to enroll in this ancillary study. The results are expected in about a year.

iClegg D, et al. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. New England Journal of Medicine, 2006;354:795-808.

Dennis Dowling, DO, was in New York earlier this year, promoting osteopathic medicine during a national satellite media tour. Reporters from 17 TV and radio stations, spanning from Boston to Kirksville to Seattle, interviewed Dr. Dowling, who is a member of the editorial advisory board for the JAOA. Dr. Dowling spoke about using osteopathic manipulative treatment to treat patients during the 1917-18 flu pandemic and how the same treatments can be used today to treat similar illnesses including bird flu in the event of a pandemic. In addition, he demonstrated OMT for TV audiences. A past president of the American Academy of Osteopathy, he described the experience in the paragraphs below. (Source: AOA Executive Director's Daily Report 1-14/06).

'The occasion was arranged by the American Osteopathic Association (A.O.A) and utilised the interest in treatment of patients with influenza, especially in light of the current concern with the avian flu. In 1918, another flu outbreak known as the Spanish flu pandemic killed 500,000 Americans and at least 20 million people worldwide. Usually flu outbreaks are related to 30,000 deaths in the U.S. with the large majority being those with immature (infants) or damaged immune systems (i.e. elderly, asthmatics, patients with emphysema, AIDS, renal failure, etc.). In the early twentieth century, osteopathic physicians comprised 5% of the physicians in the U.S. but apparently treated up to 10% of the patients in the country since many M.D.s were away in Europe during WWI. The mortality rate reported by osteopathic physicians was 0.25% vs. the 6-10% reported otherwise in the United States. In a survey article in the Journal of the American Osteopathic Association of that era, 2,000 D.O.s reported 275 deaths out of 110,000 cases treated. The treatments that were utilized addressed the whole patient but specifically worked on the respiratory and immunological systems. These techniques have also been found recently to decrease hospital stays and intravenous antibiotic needs of elderly patients as well as increase antibody levels in normal subjects following some vaccinations.

'The reader can see some of the videos that were recorded by news stations during my satellite media tour. Ignore the first one (it concerns disciplinary action against a D.O. in that community - the tracking service just picks up the term "osteopathic" and relays it to the A.O.A.) and the last one (The station had an ice storm the night before and we had good audio feed but they stated that the visuals were hazy). The last station went with stock videos that were broadcast to them previously. The quickview format skips many frames but the audio plays pretty well. Occasionally there are pauses between questions and responses due to delays that the stations apparently employ during live transmissions.
http://media.vmsnews.com/MonitoringReports/011206/518631/I00049104'

The University of New England College of Osteopathic Medicine has confirmed the appointment of AAO President-elect Kenneth H. Johnson, DO as Interim Associate Dean for Clinical Affairs, effective March 2006. A 1992 graduate of UNECOM, Dr. Johnson currently serves as Chief Medical Officer of Health Access Network in West Enfield, ME. He formerly served as director of the NMM/OMM Plus One residency program at Eastern Maine Medical Centre in Bangor. He is certified in osteopathic family practice as well as neuromusculoskeletal medicine and osteopathic manipulative medicine. Dr. Johnson replaces Boyd R. Buser, DO who recently assumed the position of Interim Dean and Vice President for Health Services at UNECOM.

Keith Barbour, DO of Monroe, MI served as the USA team physician at the 2005 World Disabled Water Ski Championships in Schoten, Belgium, September 8-11. Dr. Barbour is a 1983 graduate of the Michigan State University College of Osteopathic Medicine, who completed his physical medicine and rehabilitation residency at Detroit Rehabilitation Institute. Dr. Barbour operates Rehabilitation Specialists in Monroe. He is certified in physical medicine and rehabilitation, a Fellow of the American Osteopathic College of Rehabilitation Medicine, and a diplomate of the American Academy of Pain Management. He has been an active AAO member since he graduated from MSU-COM.

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