May is Lyme Disease Awareness Month. Lyme disease is bacterial infection spread by infected deer ticks. It is the most common tick-borne infectious disease with 2000- 3000 new cases in the UK every year, and is particularly prevalent in the Southern Counties, Yorkshire Moors, Lake District and the Scottish Highlands, probably due to increasing numbers of wild deer in these areas.
Ticks are tiny spider-like creatures found on foliage and long grass in parks, woodlands, heathland and gardens. Ticks cannot jump or fly but climb on to humans and animals as they pass by. They then attach themselves by burrowing their head under the skin, where they can remain for up to 72 hours, swelling up considerably as they suck blood. Because they are so small, and their bite is not painful, it is very easy to have a tick bite without noticing. Most tick bites are not a problem, but a bite from an infected tick can cause Lyme disease.
Infected ticks only release the bacterium into the bloodstream 24-48 hours after the tick bite, so the longer an infected tick remains attached, the greater the risk of contracting Lyme disease. Initial symptoms can include a circular red rash, which is not itchy or painful, within 3-30 days of being bitten. The rash may spread outwards slowly until it resembles the bullseye on a dartboard, before gradually fading. There may also be mild flu-like symptoms such as headaches, high temperature, tiredness, neck stiffness, and arm and leg pains, which usually resolve after a few days.
If diagnosed early, Lyme disease can easily be treated with a 2-4 week course of antibiotics. Failure to diagnose and treat early can cause more serious symptoms to develop weeks, months, or even years after the original bite. These include painful and swollen joints (inflammatory arthritis), limb pain and numbness, facial muscle paralysis, memory or concentration problems, heart problems (myocarditis or pericarditis), and disorders of the nervous system such as meningitis or encephalitis. These may require a prolonged course of antibiotics, often given intravenously, but some symptoms may persist for a long time. A few people develop “post-infectious Lyme disease” with long-term symptoms similar to those of Chronic Fatigue Syndrome or Fibromyalgia, but it is not know why this happens, or how best to treat it.
You can reduce your risk of getting Lyme disease by using an insect repellent on exposed skin, wearing long-sleeved tops and tucking trousers into your socks, and keeping to footpaths and avoiding long grass or dense vegetation in tick-infested areas. If you go out into the countryside check for ticks on your clothes or exposed skin, and in particular check the head, neck and scalp of your children, before returning home to avoid taking ticks home with you. You should also regularly check your pet cats and dogs for ticks, and consider using a tick preventative medication.
If you find a tick on your skin, remove it as soon as possible using either fine-tipped tweezers or a tick removal tool as close to the head of the tick as possible, and pull upwards slowly and firmly to avoid leaving the mouthparts in the skin, where they can cause a localised infection. Wash the area thoroughly and apply an antiseptic. Monitor the area for any changes for several weeks. If you develop symptoms, visit your GP and tell them you have been bitten by a tick. NEVER try to burn the tick off, squeeze the tick or apply any other substances like petroleum jelly to the tick as these may cause the tick to regurgitate infected material into the skin, increasing the risk of getting Lyme disease.
Enjoy yourself in the British countryside, but be tick aware.
One common question we are asked time and time again does not relate to medical matters. It usually starts by: “Can you tell me the difference between …” and at that stage we can usually finish the sentence: “…a chiropractor, an osteopath and a physiotherapist?”
We practitioners, have a tendency to forget that, if the answer to such a question is evident for us, this is not the case for members of the general public. Here is what I usually say:
Although chiropractic and osteopathy have distinct professional identities and philosophies, they are both founded on the two pillars of science and vitalism. Vitalism recognizes the patient’s own capacity for self-healing. Both professions have a holistic approach to health, integrating body, mind and spirit and use a hands-on approach. However, despite these basic similarities, there are some significant contrasts between and even within the two professions. This results in very different styles of practitioners leading to situations where one chiropractor and one osteopath will practise in a very similar way and two chiropractors or two osteopaths may be practising very differently.
In any case, practice tends to concentrate on treating the patient’s condition and leaves philosophy some way behind. Both professions treat similar conditions in a generally similar way and get similar results. The success of any treatment is therefore dependent on a wide variety of factors such as the condition, the patient, the practitioner etc. So, there is no simple answer to the “what’s the difference” question!
Physiotherapy emphasises the use of physical approaches to the prevention and treatment of disease and disability. In the face of growing competition from chiropractic and osteopathy, some physiotherapists have taken a greater interest in the use of mobilization and manipulation. As a result, there is now wider competition between the three professions with regard to the treatment of neuro-musculoskeletal conditions (a very long word referring to the aches and pains and disabilities caused by the dysfunction of the framework of the human body).
As a member of both the physiotherapy and the chiropractic professions I can only emphasize the importance of touch and physical contact between practitioner and patient. In addition, chiropractic and osteopathy are both wellness-orientated rather than sickness-orientated. They are concerned with the patient rather than the illness. My advice is, whatever professional you decide to consult for your aches and pains and/or your disability, make sure he uses a hands-on approach.
Is exercise really good for you?
Patients often ask me how to prevent recurrent episodes of back problems. The simple answer is exercise, essentially it is anything that is going to stimulate your musculoskeletal system in a positive way.
But first let’s start by going to the other end of the spectrum and looking at the physiological effects on the body of not exercising. In addition, to make it more interesting, let’s consider the effect of smoking as well as not exercising as this intensifies the lack of exercise. We all know smoking kills and I wouldn’t dream of telling anyone how to run their lives, but if you want to ruin every cell in your body, smoking is just about the most destructive thing you can do. Buerger’s disease, or Thromboangiitis Obliterans, is the result of the gradual narrowing or occlusion of ALL your small blood vessels so that each time you have a cigarette you’re effectively suffocating the body bit by bit not only of oxygen but also of blood. You’re slowly killing yourself, what a cheery thought. So much for looking cool with a fag! Ah well, enough of that negativity let’s look at the other end of the spectrum.
What about choosing life and health? Cells like being fed with the right things. Therefore, the best thing to do is get the good stuff in and the toxic rubbish out. The best way of doing this is by exercising. Increasing the blood flow to every cell in your body helps prevent and reduce the incidence of or improve most conditions. The extra-oxygenated blood brings nutrients to the body’s cells and removes the products of metabolism. This is the best way to improve cell health. The added benefit of all this exercise is improved muscle tone. This protects your joints, holding your body in its correct position. This in turn aids better blood flow, which in turn gives you more energy, which in turn… oh, you get the gist…
The body is fantastic: give it a chance, give it a little of the good stuff and it will do you proud. Of course, treat yourself to some coffee too, or whatever takes your fancy because you cannot be good all the time.