The Back Pain Podcast

If you have been told you have failed physiotherapy what does it mean and what can you do about it?

Dave and Rob share great content about the many different tools that help with recovery and why everyone needs an individualised approach to support effective recovery. It can take repetition, trial and error to find the right combination and your therapist should be talking to you to understand what the right approach is for you because - can a patient fail manual therapy…absolutely not, can a manual therapist fail a patient …definitely.

KEY TAKEAWAYS

• It’s not a condition or diagnosis to say you’ve failed it’s a confusion between professions and treatment
• Professions use lots of different things to help with recovery. They are your teacher and guide to getting better
• The physiotherapy techniques that have been used haven’t been utilised effectively
• It’s not that the patient has failed it’s that the technique hasn’t worked at that time
• There are a myriad of different approaches and there has to be an individualised approach
• If a patient is given a label it can become part of their identity
• It’s a multitude of different things working that stack up to make recovery successful and it can take repetition trial and error to find the right combination.
• If a clinic is taking a ‘cookie cutter’ approach with the same treatment for every patient it’s a red flag
• Every therapist should talk with you to understand what the right approach is for you.

BEST MOMENTS

‘It’s quite a shocking statement to read’

‘As humans, we all need different things to get to the end goal’

‘Different people with the same treatment will all have different outcomes because what works for one person may not work for another’

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

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Support the show: https://thebackpainpodcast.com

Clare joins Rob and Dave and discusses her own journey of treatment and learning  around sciatica

She explains how trial and error is a vital part of recovery and why mindset and belief play an important role in getting well.

This is a journey that many will resonant with and Clare shares some key points that altered her thinking, impacted positively on her recovery and have led to success.

KEY TAKEAWAYS

• My stoic attitude helped because it was a routine but battling through and just putting up with the pain was detrimental
• I’ve been the one who has made all the discoveries because nobody told me anything
• If you are changing how you think about things you are changing the neural pathways
• You have to have an open mind and consider everything
• I discovered my body didn’t move in the way it should do, years of pain had led to overcompensation and I was stuck in a vicious cycle of pain
• Exercise and movement are two of the most important things for pain
• My brain said to certain areas of my body don’t move because it will hurt creating internal fear avoidance
• I’m now tricking my brain to make myself  believe I’m well and healthy  and to calm my central nervous system
• We are all unique and individual and this is the same with the pain we experience
• Engaging people around you and helping them to understand will help you
• Everything matters when it comes to pain because of how it impacts
• People can get well; it is possible to recover but people need to understand that their pain is their responsibility

BEST MOMENTS

‘It’s all been about me being curious and wanting to find out about my body’

‘When people keep telling you there is nothing wrong it makes you want to scream’

‘You have to try things, trial and error is a massive thing’

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

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CONTACT METHOD

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[email protected]  

Support the show: https://thebackpainpodcast.com

Rob and Dave talk with Chad about aspects of manual therapy techniques covering everything from massage through to joint based techniques.

They discuss how manual therapies work as tools for the clinician with the mechanisms impacting both directly on the site and influencing the spinal cord and brain.

If you believe it and want it bringing this together with the mechanisms of manual therapies can improve outcomes and this informative episode will help anyone understand better how and why manual therapies can be part of the  solution

KEY TAKEAWAYS

• Manual therapy involves the skilled use of the hands to decrease pain and increase the range of movement
• It can be a range of different techniques
• Joint based techniques, soft tissue techniques and nerve based techniques all makeup manual therapy
• The techniques have mechanisms directly impacting the site and also influence the spinal cord and the brain.
• You need to find the right clinician; it should be someone you trust
• Manipulation frees up endorphins that are associated with pain relief
• Following manipulation, the feeling of well-being is recognised as being from the endorphins and influence the brain and how it controls pain modulation
• Contextual factors also play a role in improving patient outcomes
• If you believe it and want it and really think it’s going to work its likely to work
• It’s about matching the expectations of the patient and working together towards the goals
• Manual therapy is recommended and in conjunction with other treatments, it can aid recovery.
• Research indicates that massage results in a large dopamine release along with serotonin.

BEST MOMENTS

‘Manual therapy is a lot of things and it has a bit of an identity crisis’

‘Shared decision making is finding a common joint belief that will help the patient’

‘As clinicians, we need to open the window of opportunity for manual therapies’

VALUABLE RESOURCES

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 Chad Cook Twitter

ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

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CONTACT METHOD

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[email protected]  

Support the show: https://thebackpainpodcast.com

Dave goes solo in this episode and discusses the long-held and widely shared idea that

your back pain, neck pain, headaches, hip pain whatever it is have been caused by your posture.

He delves into the question around what is and isn’t ‘good’ posture and looks at when posture plays a role and when it doesn’t.

Listen in to find out exactly how your posture affects your pain and what you can effectively do to help your pain.

KEY TAKEAWAYS

• The research says sitting up straight isn’t correlated with less back pain
• People who slouch are less likely to have back pain than those who are trying to sit up straight
• Posture is only significant when you are not able to change the position you are in when your position is fixed
• It’s the inability to move out of a fixed position that is likely to cause pain
• There is no evidence of a particular posture causing pain
• Posture is a lot about conforming to society norms
• Your body is designed to move so let it move
• If it is within your body’s pain-free movement let your body do its thing
• Your posture does not correlate with pain in the future
• The best advice for back pain is to move
• In the short term, position might be important but posture has been proven to not be the cause of pain.

BEST MOMENTS

‘Your posture is reflective of a particular moment in time’

‘Your position is not dependant on your pain outcome’

‘At some point, your posture may have been blamed for your pain’

VALUABLE RESOURCES

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

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CONTACT METHOD

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[email protected]  

Support the show: https://thebackpainpodcast.com

This is the first of the ‘Ask Me Anything’ episodes and includes great questions from listeners covering diverse aspects around the subject of back pain.

Hear about red flags and how your clinician is trained to consider what the signs may be indicating whether you should be requesting a scan or surgical referral and what to do if your exercise is causing pain.

This is an episode packed with actionable content that is clear and concise helping anyone who is suffering from back pain understand more.

KEY TAKEAWAYS

• If a particular intervention isn’t harmful and gives you benefit even though the evidence says it doesn’t work you could continue to use it.
• We started this podcast because we love chatting about backpain and sharing information along with busting some myths.
• We wanted patients to be able to take the information and act on it
• A red flag is when something raises the index of suspicion
• It may require further investigation, a referral, deeper questioning
• Clinicians are trained to go down the rabbit holes and consider what the signs are indicating
• Scans are often used to rule out things
• Being  referred to a surgeon doesn’t mean the outcome will be surgery
• Interventions are dependent on the individual patient
• Pain from exercise should be kept low, the exercise shouldn’t be causing pain or a flareup afterwards
• Sometimes exercise can change the pain and if repeated movements result in a positive change to the pain then you should be doing it
• A partner can help if you explain what you can or can’t do, it’s about good communication
• The Stand Up App is great for reminding you to keep moving throughout the day
• The Headspace App is a great App helping with mindfulness and meditation

BEST MOMENTS

‘We break down what is a hugely complex subject into more realistic language’

‘For my own learning the podcast,  it’s been invaluable

‘Talk, talk, talk it’s so vital’

VALUABLE RESOURCES

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Headspace

Stand Up! 

ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

-Twitter

CONTACT METHOD

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[email protected]  

Support the show: https://thebackpainpodcast.com

Previously Rob and Dave have shared great content on how to prepare yourself before visiting a professional such as a physiotherapist or chiropractor and this week it’s all about what questions you should be asking when you are in the consulting room with your clinician.

This is about getting the most from your consultation so that you can be involved in your recovery and have the tools to manage your pain and recovery outside of the consulting room.

KEY TAKEAWAYS

• Write down your questions before you go to your consultation, questions are an important part of your consultation.
• Asking your therapist what you can do to manage your pain is vital, you need tools that you can use when you are at home
• The clinician will explain why or why not you need a scan at a particular point. There has to be particular reasoning around having a scan
• The practitioner goes through a mental probability calculator when they are reviewing your history
• When you ask what’s happening you are asking to be let in and involved in your recovery
• If you open up to your practitioner then you can work together in partnership with them towards your successful recovery.
• Make sure you ask about what you should look out for to indicate things are becoming more serious
• At the end of a session, the professional should provide a summary so that you leave knowing what you need to do.
• Don’t take home any misbeliefs or misunderstandings

BEST MOMENTS

‘All clinicians are trained to assess whether you need a scan’

‘Knowing what it isn’t, is as important as knowing what it is’

‘As a practitioner, I love explaining to people what I’m doing’

VALUABLE RESOURCES

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

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CONTACT METHOD

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Facebook

[email protected]  

Support the show: https://thebackpainpodcast.com

If you are suffering from back pain this is the episode for you as Rob and Dave share great content about how to create a self-management protocol.

Self-management is everything that takes place outside of the treatment room and understanding what you can do to self-manage your pain to heal in the best way possible is a hugely valuable aspect of recovery.

This is a great opportunity to understand what you can do to help yourself and to hear about the key elements of a good self-management protocol.

KEY TAKEAWAYS

• Education around your problem and pain is vital, pain doesn’t necessarily equate to damage
• Pain although painful isn’t necessarily a bad thing
• Recognise the triggers for your back pain and you can incorporate activities to help throughout the day.
• Keeping a pain diary is an easy way to gain a macro view and the pattern of your pain
• You need to recognise that lifestyle, environment, diet and exercise are all possible factors in your pain
• Positive mental and physical stimulus impact your pain
• Movement and finding the early intervention movements that make a positive difference is beneficial in self-management of pain.
• You need to exercise throughout the day in the same way you drink water throughout the day
• Self-monitoring is about looking or the signs of change and recovery
• What can you do now that you couldn’t before? It can be easy to forget where you were when you started.
• You need to understand and enforce a  positive mindset but also understand and identify when you are in a negative space.
• It’s normal to have both good and bad days, the journey to recovery will be up and down

BEST MOMENTS

‘People developing self-management skills is so important’

‘You can ask your therapist ‘what can I do to help myself?’

 ‘Reassurance that what is happening is normal is important’

VALUABLE RESOURCES

The Back Pain Podcast

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

-Twitter

CONTACT METHOD

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Facebook

[email protected]  

Support the show: https://thebackpainpodcast.com

Benn Boshell, a podiatrist who is also known as the heel pain expert has a specialist interest in plantar fasciitis and shares great content in this episode about the condition of plantar fasciitis and the various treatments available.

This common condition affects around 10% of the population and for those who have it, the condition can have a huge impact on their lives.

This is an episode that provides accurate information that anyone suffering from plantar fasciitis needs to be able to make the right choices about treatment to ensure they get results.

KEY TAKEAWAYS

• The plantar fascia there to support the arch of your foot
• There are a number of different reasons why someone may develop plantar fasciitis
• Acute pain when you first stand up is a possible symptom of plantar fasciitis
• Palpation can help to diagnose which part of the plantar fasciitis  is injured
• Taking a detailed history and information about the symptom pattern means other conditions can be ruled out.
• You need to treat the person, not the scan as every individual is different
• Initial treatment includes pain management and may mean taping the foot to offer more support
• The most common error patients make is not resting enough and not wearing footwear that supports the foot.
• Consistency is the key with any exercises, a  difference only comes with consistent exercises
• A custom made orthotic can make a significant difference helping to support plantar fasciitis
• Shockwave therapy has gained popularity and the research indicates it is successful in treating plantar fasciitis
• Shockwave therapy is a high energy soundwave that can help stimulate the inflammatory cycle and enable the body to heal its self
• A steroid injection is a common treatment and provides relief in the short term and it masks the symptoms but doesn’t address the cause so shouldn’t be used as a stand-alone treatment

BEST MOMENTS

‘Don’t self-diagnose because the treatment is very dependent on correct diagnosis’

‘Palpation can help to diagnose which part of the plantar fascia is injured’

 ‘Around 10% of the population have this condition’

VALUABLE RESOURCES

 The Heel Pain Expert

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

-Twitter

CONTACT METHOD

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Twitter

Facebook

[email protected] 

Support the show: https://thebackpainpodcast.com

Julie Gover is a Chiropractor with a special interest in pain and in this fascinating episode, she talks about what pain is and why some pain becomes chronic.

Whatever your pain experience it’s real and valid and a part of the protective mechanism in place.

As humans, we are designed to move and recovery is something our bodies can do so pain does not have to be permanent. Changing your perception of pain and changing your behaviours around pain can all help you to move forward.

KEY TAKEAWAYS

• That pain is a result of an injury such as tissue damage seems logical but it’s not supported by the science.
• You can have an injury with no pain and pain with no injury
• Pain is about protecting you and  relates to the perceived threat by the brain
• Your back is designed to move and the more you move the better you will feel.
• Pain nerves do not have specific sensors, they react to everything but are high threshold nerves so when activated it’s a signal that a lot of something is happening
• The brain has to evaluate what’s going on and decide to output it as a pain experience
• Any time a pain experience is triggered it’s real and valid but doesn’t always mean what people think it means it’s part of a protective mechanism and doesn’t always mean tissue damage.
• It’s more than one thing that starts the experience of pain
• Repeated movement is good for your back and for your mental health
• You can recover and there is nothing to suggest pain has to be permanent because nerves change how they are wired all the time.

BEST MOMENTS

‘We are not fragile structures and we are designed to move’

‘It’s about finding the right combination of things to help with the pain’

‘Pain is an output from the brain’

VALUABLE RESOURCES

Flourish Chiropractor

The Back Pain Podcast

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ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

-Instagram

Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

-Instagram

-Twitter

CONTACT METHOD

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Twitter

Facebook

[email protected] 

Support the show: https://thebackpainpodcast.com

Mehmet Gem is a specialist Hip Physiotherapist and in this episode, he discusses Hip Osteoarthritis, Femoroacetabular impingement (FAI) and Greater Trochanteric Pain Syndrome (GTPS) common conditions with three different demographics but all of which impact an individual’s ability to complete daily activities and on their daily lives.

He also shares why asking the right questions is key and how understanding the detail in a patients history is so important in the process of an accurate diagnosis

KEY TAKEAWAYS

• Much of the information a patient shares about their issue is communicated verbally but they may also indicate where they are experiencing pain.
• The hip joint is very unique and can present with groin and buttock pain.
• As a clinician you need to ask the right questions and understand what you want to know from your patients.
• The in-depth subjective questions are those which help with better differentiation and understanding of the issue.
• There is no one test that will give a definitive answer
• It’s about a combination of questions and understanding the history of the patient in detail.
• The differences in humans means effective diagnosis needs to be a cluster of approaches.
• There are no quick fixes and individual hip profiles are very different.
• Arthritis is one of the most common causes of hip pain in the adult population.
• It’s a process that can lead to a restricted range of movement and pain around the hip. It has an impact on daily life for those who have it.
• Femoroacetabular impingement (FAI) is a condition where there is a bony growth on the hip and it can restrict daily activities in the longer term it’s important to get treatment to support hip preservation
• Greater Trochanteric Pain Syndrome (GTPS) is a common condition that causes pain in the buttock and thigh area and presents in a very specific demographic.

BEST MOMENTS

‘It can be easy to fall into a pattern of these are the symptoms and these are the tests’

‘Patients need to empowered and feel confident’

‘Ultimately life isn’t there to be lived in pain’

VALUABLE RESOURCES

The Hip Physio

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Dr Grimaldi’s  Blog for patients https://hippainhelp.com

Dr Grimaldi's Blog for Clinician’s https://hippainhelp.com/dr-alison-grimaldi/

ABOUT THE HOSTS

Dave Elliot

Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at [email protected] if you have any questions for him.

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Rob Beaven

Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better.

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-Twitter

CONTACT METHOD

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[email protected] 

Support the show: https://thebackpainpodcast.com