You have to find out what makes you happy. Like yawning, laughter is contagious. Try making faces in a mirror, using all thirteen muscles needed for laughing. It will help to put you in the right frame of mind.

Your thoughts are important, too. If your little voice inside insists on thinking sad, depressed thoughts, then life can be difficult and tiring. This is why Norman Cousins wrote his book, Anatomy of an Illness. He had a severe spinal arthritis and found that, together with massive doses of vitamin C, laughter lessened his pain. While doing everything possible to get well, he was determined that his positive attitude would help him to not succumb to ankylosing spondylosis. He hired lots of humorous movies, gave himself a daily dose of fun and eventually recovered.

When a patient comes to me to be dragged out of the ‘miseries’, I usually decide acupuncture is the therapy. Invariably there is a deficiency of the fire energy in the channels and it is usually a simple matter to correct this imbalance. Olive and clematis are both Bach Flower remedies helpful for this condition.

*129\19\2*

If you’ve had varicose veins for a long time, it is more a matter of easing than curing. Vitamin E is necessary to maintain the elasticity of the veins. Remember though, that you must start on a low dosage and gradually increase it.

Take vitamin C with bioflavinoids, vitamin B6, buckwheat, calcium fluoride and silicea cell salts. All are recommended food supplements to persevere with. Constipation must be treated early so keep the motion soft by taking slippery elm.

Use calendula or witch hazel ointment with a pharmaceutical anti-coagulant to rub gently into the soreness. Drink rose hip and equisteum tea instead of ordinary tea and coffee.

Those in severe pain with varicose veins should put on their elastic support stockings before they get out of bed.

*115\19\2*

A direct injury to the disc happens through sudden movements done with force. Jumping from a roof is one way of hurting the disc. It ruptures in severe cases, and regardless of your adopted position you cannot relieve the pain. There are times when surgery is the only way out.

But if you are lucky, the injury has only allowed the disc to bulge because of stretched ligaments. This is where the experienced chiropractor excels. He has specially built couches where the adjustment is done with minimum movement on your behalf. You really appreciate these plinths when your every movement is agony. The adjustment is direct and very accurate. To your immense relief, the couch can stand you up after the adjustment, and you can walk away knowing that there is life after your first careless rupture! But be careful.

This herniation injury needs ‘babying’ for months to allow time for the soft disc matter to reabsorb. I recommend that patients wear an elastic support belt to give the disc a safety margin for movement.

Playing tennis in this condition, I believe, is the ultimate in insanity. These discs can bulge when pressured at the wrong angle, and, before you know it, you are back to walking like a crab again. (We call that situation an antalgic spine).

Do not despair, help is available from your chiropractor. When patients feel they can depend on us to straighten them up again, it is hard to make them aware of the gravity of the situation. You must take responsibility for looking after your own back when it comes to sport, driving, exercising, sex, even coughing and sneezing. Do the latter by dropping your head back a little and keep your head straight on.

Our treatment for disc cases is conservative and is a better bet than possible costly hospital care, irreversible surgery and real pain.

*101\19\2*

If a child has backache, don’t ignore him/her when he suffers and complains. Too often the child is accused of attempting to gain attention. Injuries can occur easily when a healthy child is active and vigorous. A child who cries after a fall needs to have his back checked for a possible spinal strain.

Headaches are an indicator that a child needs his neck felt by an expert to identify if there is a problem. Other signs of spinal problems are changes to the usual patterns of sleeping and eating, or changes to a normal, happy personality. Ignoring these facts could be the beginning of troubles at school – fatigue and inattention.

When you child gets a ‘stitch’ while running, it means that there is an imbalance in the pelvis throwing the spine out of line, car that he/she has rib sprains that need adjusting. Why ruin their sporting career just for the sake of a spinal check up!

Check your child. Turn him/her away from you. Is the spine forming an exaggerated ‘S’ bend (scoliosis)? Turn sideways, is the stomach well forward in front of the shoulders (lordosis)? Good posture isn’t a matter of telling them to hold their shoulders back! Once the middle spine is adjusted, the child can’t slouch. Follow lap with a few specific exercises and the posture problem is solved.

Does your child stand on one leg all the time? This is another indicator of pelvic strain! Get this one fixed (often in one treatment), and many times it straightens a spinal scoliosis (curvature) immediately if it is not a congenital deformity.

These injuries are easily sustained in sport or at play. A heavy fall on the hip sprains the sacroiliac (pelvic) joint . . . not an easy one to fix unless you know what you’re doing! And who would, unless it is their profession? My son tells me it’s great to have a chiropractor in the house to fix him after soccer!

Bed rest certainly can be a good thing and the inflammation will usually settle in three days. Be warned, however. The uncorrected misalignment will remain until it is adjusted. This situation is an ‘accident waiting to happening’ — which it will, one day, perhaps when you bend over to pick up the soap.

Warning signs that a child needs a spinal adjustment include:

• Always tired, interested in nothing.

• One hip or shoulder is higher than the other.

• Shoulder blades flare out (catch them in their swimmers).

• Neck tilts (are the ears level?)

• One leg is apparently shorter than the other.

• Stands on one leg, with one knee bent constantly.

• Droopy shoulders.

• Constant sinus congestion.

• Skin conditions.

• One foot turns in and the other turns out.

• Joint aches through incorrect balance.

• Finds it difficult to stand (or sit) still.

• Hyperactivity.

• Growing pains.

• Clumsy or frequent falling.

• Noisy bones or ‘clicky’ joints.

• Nervousness. Insomnia.

• Headaches with neck pain.

• Backache after injury.

• Restless legs.

The first question asked when adults complain of an acute backache is ‘Are you icing it or heating it?’ They nearly always reply that they have been heating it all night and, although it feels more comfortable, they can’t walk! This is a classic situation and shows ignorance of back care.

Would you put your sprained ankle in a bucket of cold or hot water? The answer is obvious. The sprained pelvic joint, which is the one that takes the weight, needs to be iced – especially if there is leg pain.

The three classic moves for a sprain are:

1. Ice the injured joint.

2. Take the weight off it.

3. Support it with a bandage or elastic belt until the pain eases (if you have to walk around).

You won’t get into trouble, as you wait for help, if you apply these rules. Icing will ease the pain in about three hours and then you can walk to your chiropractor or osteopath. Heat is helpful when you have tight or cramped muscles: not when you are suffering from a sprain which has torn tissue, and is inflamed and swollen. Then the answer is ice, but be sure to first apply a little petroleum jelly on the spot to avoid chilling the skin.

Lying down (but not on a mattress that dips) takes the weight off the joint. Two or three days later the pain has decreased and healing is under way. When you get around to going to the toilet, a support belt allows you to get up and down easily. Just because the pain is easing, don’t think that you are out of trouble. You aren’t until the joint is adjusted and realigned.

Latest studies show that chiropractic is highly effective relative to cost and application in the management of chronic and severe back pain. The benefits of adjustment hold over a twelve-month and two-year follow up. Studies also show that back pain is the most rapidly increasing cause of disability, with work and play becoming more sedentary and intensifying stress.

A so-called ‘pinched’ or aggravated nerve is a different problem from a strain and this requires a quick direct adjustment.

Many orthodox X-rays are useless for us diagnostically, especially if taken in a lying position. The patient is left with pain and frustration when the report reads ‘no obvious injury’. Only standing X-rays show a soft tissue injury (one that involves muscles, ligaments and tendons), because they show the effect on the injury when gravity and body weight affect the joint.

X-rays do show if there is any pathology, such as arthritis, cancer or fractures. This is rarely the case in simple strains or sprains. But it is the reason that chiropractors like to X-ray a new case to eliminate these possibilities. Osteopaths don’t routinely X-ray unless it is called for by past history or needed for clinical diagnosis.

Adjustments which quickly fix back pain have given chiropractors and osteopaths an excellent reputation over the past fifty years.

*87\19\2*

It takes years for a shoulder to get into such a state. Because the injury was not acute, it has taken years to become troublesome. Some of my best friends have started out as frozen shoulder cases, because we have time to get to know each other very well over about twenty treatments.

It is a cruel condition and requires lots of sympathy with the therapy. You learn patience and become philosophical about why you needed such a pain in your life! I use all my therapies for this one.

One of the interesting observations that we have made is that a frozen shoulder is nearly always accompanied by an old pelvic (or sacro-iliac) joint injury. Fixing this as well seems to hasten recovery. It is understandable when you know how muscles function. Nothing in the body acts on its own.

Belle’s story-I was fifty-three years old, and working quite hard running a successful cake business, when my left arm, shoulder and neck started to give me trouble.

On my doctor’s advice I had many treatments from a physiotherapist, including some most uncomfortable traction sessions. Becoming gradually worse, I had to give up work and finished up with a frozen shoulder and in a great deal of pain.

After taking a prescribed course of anti-inflammatory tablets, I added flatulence and indigestion to my list of woes. The tablets affected me badly as far as my stomach goes and didn’t help my shoulder any. I refused to take any more and asked the doctor was there nothing else to be done for my now useless arm?

By good luck, not by good management, I found my osteopath. She said, ‘Why didn’t you get something done for your arm before it became so bad?’ I would have slapped her only I couldn’t use my arm! Having undergone eighteen months of pain and cancelling a long-wished-for overseas trip, there had seemed to be no answer. She tested it, and said: ‘Of course it will take a while but yes, it can be fixed.’

The cure was not quick: it involved many treatments, osteopathic massage, change of diet, supplements and exercise in water. At last came the big day when I could put my arm straight up over my head! I will never forget how good that felt, how thankful I felt and still do feel. Twenty years later I can continue to indulge myself playing my violin.

*71\19\2*

One way to monitor the progress of the disease is by repeatedly measuring the ESR. The initial dose of steroids will be high, maybe as much as sixty mg in twenty four hours. As soon as steroids are given the high ESR quickly reduces, and the doctor will adjust the dose of steroid according to whether the ESR has gone back to normal or not. The dose needed varies from patient to patient.

Once the dose has been adjusted your doctor will want to monitor the progress of (he disease regularly. Good control of temporal arteritis is achieved through a combination of monitoring the ESR and making sure that your symptoms don’t return. At the same time your doctor will want to make sure that you are on the minimum dose of steroids that is compatible with achieving both these objectives.

Treatment is often long term, possibly even for life, though sometimes it is possible to tail off the steroids entirely after some years. Please note: after long term use of steroids, stopping or reducing the dose should always be done very slowly, and only ewer done with the express permission of your doctor.

*75\20\2*

Motorbike helmets are deceptive – they are very effective in reducing head injury, but they rapidly lose their strength if previously dropped or banged, even if tin’ blow wasn’t particularly hard.

Helmets don’t respond well to being painted, either. The solvent in some paints dissolves the plastic of the helmet, weakening it considerably.

Increasingly, cyclists are being recommended to wear helmets; the neurosurgical units are spearheading campaigns to encourage their use.

Repeated violent head movements can result in torn nerve fibres, small bleeds in the brain, and in some cases more serious bleeds from ruptured blood vessels. ‘Headbanging’, a dance popular more in the Seventies and Eighties, in which the head is repeatedly jerked violently up and down, can cause severe brain damage and even death as a result of rupturing blood vessels inside the head.

The second dangerous activity is boxing. You can suffer brain damage even when wearing headguards. Although a headguard may protect against direct blows to the face, there is virtually no protection against the twisting force of a sideways blow to the chin, and it is these twisting, rotating forces on the brain that probably do the greatest damage in producing a punch-drunk fighter.

Contrary to the impression given in the movies, keeping the patient awake after a head injury doesn’t help. In any case, the stress of the circumstances surrounding the head injury usually makes him want to sleep – especially if the patient is a child.

Self-help after a head injury is largely a matter of common sense. If you’ve been knocked out, or show any of the symptoms described above, then you will need to get to hospital as soon as possible. On the other hand, if the injury is minor, you haven’t been knocked out, and you haven’t got any of the other symptoms, then a couple of paracetamol (or in adults, aspirin, if you’re able to take it) may be all that you need to get rid of the headache. If you’ve jarred your neck as well as banging your head, then an anti-inflammatory drug such as ibuprofen can often be more effective than simple analgesics. (This is available over the counter as Nurofen; don’t take it if you have stomach ulcers.)

If there is a lot of spasm in the neck muscles then a cold compress and massage may be helpful. However, don’t apply heat to the site of a recent soft-tissue injury; it will make the swelling worse. Instead, cold compresses will reduce the swelling, the inflammation, and the pain. Warmth is for a few days later, after the initial injury has started to settle down.

One very important word of warning: where there has been a head injury, there may also be a neck injury. If the patient is complaining of severe neck pain, or if you think the neck may have been damaged, then do not move them. If the neck has been broken, moving the head or body may rupture the delicate spinal cord inside the neck. There have been instances where patients have been damaged more by the actions of their first-aid ‘helpers’ than they were by the original injury. There is one horrific case of a motorcyclist who came off his machine and was found lying on the ground with his neck broken but his spinal cord intact. Somebody took his helmet off, and in doing so bent his neck, and severed his spinal cord, paralysing him permanently. So, if there is a neck injury of any severity (which usually means the patient is in severe pain, and perhaps unable to move without experiencing agonising pain), or else is unconscious, then do not move them. Wait for the ambulance to arrive: ambulancemen and paramedics have specialised equipment to allow them to move patients without causing further movement to the head and neck.

*60\20\2*

Typically aura symptoms occur before the headache starts. Only about ten to twenty per cent of migraineurs get an aura, and the side affected in the aura is not related to the side on which the headache occurs.

To have an aura you must have one or more of the following symptoms:

Disturbances of vision, which are often the same in both eyes

One-sided tingling or numbness

One-sided weakness

Inability to speak normally, usually caused by difficulty in forming sentences. Aura symptoms are reversible, usually going away completely after less than an

hour,, and there is a distinct order of severity. Most common are the visual symptoms; then disorders of sensation; then (much less frequently) speech disorders, altered level of consciousness, and finally weakness or paralysis.

*8\20\2*

Uncomplicated viral infections don’t need a doctor. On the other hand, you should call the doctor if other symptoms occur, such as: earache, coloured sputum, or jaundice; if the patient seems particularly ill or is getting much worse; if there is pre-existing disease such as diabetes, chest disease or heart trouble. If the sufferer is very old or young you will probably want to call the doctor earlier, too. It’s also worth contacting the doctor if they don’t seem to improve after three or four days.

Most febrile illnesses start to resolve themselves after a few days, and there is normally little that the doctor can do, other than advise treatment of the symptoms with paracetamol and fluids. It’s only the complications of viral infections that the doctor can treat.

*34\20\2*

Cluster headache occurs in groups (called the cluster period) of about six to twelve weeks in duration. This is then followed by a long period of remission, which on average lasts about twelve months. Although the headache is one-sided, the similarity with migraine ends there. In cluster headache it is always the same eye that is affected, while in migraine, although one side may dominate, headaches can occur on either side in individual attacks. Cluster headache affects predominantly men, by a ratio of four to one. The pain of cluster headache is constant; the pain of migraine is throbbing. For some reason cluster headache is more prevalent in smokers and alcoholics. At the moment we don’t know what causes cluster headache but it shares a number of features with the neuralgias, so irritability of the nerves supplying the area may be at the heart of the problem.

The treatment for cluster headache falls into two sections: aborting the existing attack, and preventing further attacks. Prevention of future attacks is by using drugs such as amitriptyline, propranolol, ergotamine, methysergide, calcium channel-blockers and lithium. An injection of sumatriptan will abort an existing attack. Some patients can prevent an attack by breathing pure oxygen (this is not appropriate for those with chronic bronchitis or respiratory failure, as it stops them breathing). Other methods include inhaling ergotamine.

Type of headache

Constant, sharp excrutiating pain centred behind or around one eye.

What else could it be?

Migraine shares some features, but principally the redness and watering of the eye provides easy distinction between the two. Migraine isn’t always on the same side of the face, as cluster headaches are.

Acute glaucoma is similar in that the pain of both is sharp and very strong, but with glaucoma the pupil is wide, and the central part of the eye greenish-grey and misty-looking. In glaucoma, the eye is tender to the touch, and just before an attack haloes might appear around bright lights. A family history of glaucoma, or known raised pressure inside the eye may also point to the diagnosis. Finally, acute glaucoma usually gives rise to vomiting, while cluster headaches do not.

*19\20\2*