UNDERSTANDING CHRONIC PAIN

Kieran is passionate about helping people get out of chronic pain and back to what they do best.


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Kieran is a chartered physiotherapist, registered nutritional therapist and corrective exercise specialist who specialises in helping people in chronic pain get back to what they do best.

Kieran is fascinated to understand the causes of someone's pain. From here he puts together a plan using physiotherapy, exercise, nutritional therapy and education to help you get back to what you do best.

Kieran is based at the Bowskill Clinic, 4 Duke Street, W1U 3EL near Bond Street tube station. Where patients are unable to attend the clinic he can do home appointments.

To find out more about Kieran see his bio here

To ask Kieran a question or book an appointment; call 07830160323 email kieran@kieranmacphail.com

Olive Oil
Olive oil has potent anti-nociceptive, anti-inflammatory and anti-oxidant properties. Olives contain Decarboxymethyl-aglycone ligstroside or oleocanthal, a phenolic compound that mimics the inhibitory action of cyclooxygenase (COX) by the NSAID ibuprofen, as a natural NSAID (Beauchamp et al 2005). Takeda et al (2013) showed olive oil to be effective in reducing VAS scores in patients with early stage knee osteoarthritis. Extracts from the leaves have been investigated with the n-hexane extract displayed 12.7–27·8 % inhibition on the carrageenan-induced hind paw oedema model at the 400 mg/kg dose (Süntar et al 2010).

References
Beauchamp, G.K., Keast, R.S., Morel, D., Lin, J., Pika, J., Han, Q., Lee, C.H., Smith, A.B. and Breslin, P.A., 2005. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature, 437(7055), p.45.
Süntar, İ.P., Akkol, E.K. and Baykal, T., 2010. Assessment of anti-inflammatory and antinociceptive activities of Olea europaea L. Journal of medicinal food, 13(2), pp.352-356.
Takeda, R., Koike, T., Taniguchi, I. and Tanaka, K., 2013. Double-blind placebo-controlled trial of hydroxytyrosol of Olea europaea on pain in gonarthrosis. Phytomedicine, 20(10), pp.861-864.
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Plant Based Diet
Towery et al (2018) reduced pain and increased function in 14 subjects with chronic musculoskeletal pain with an 8-week plant based diet intervention. 20 subjects started and only 14 finished the trial. Numeric Pain Rating Scale (NPRS) and the Short Form Health Survey (SF-36) were measured. A registered dietitian nutritionist provided a sample menu cycle and education on a plant-based diet. Subjects utilized a phone app to log food intake and to receive support from the dietitian. Diet adherence by ten of fourteen subjects was 89% based on completion of food intake records and adherence to allowed foods. Thus even with these results, adherence was poor and thus quite likely there is potential for even greater improvement if adherence can be improved.

References
Towery, P., Guffey, J.S., Doerflein, C., Stroup, K., Saucedo, S. and Taylor, J., 2018. Chronic musculoskeletal pain and function improve with a plant-based diet. Complementary therapies in medicine, 40, pp.64-69.
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Axoplasmic Transport
Dilley and Bove (2008b) showed that axonal transport disruption without inflammation or degeneration also leads to axonal mechanical sensitivity but does not cause ongoing activity at the time point when axonal mechanical sensitivity occurs, despite causing cutaneous hypersensitivity.

Local nerve inflammation, known as neuritis leads to ongoing activity and axonal mechanical sensitivity along intact nociceptor axons and disrupts axonal transport. Satkeviciute et al (2018) suggest this phenomenon forms the most feasible cause of radiating pain, such as sciatica.
Satkeviciute et al (2018) present the time course of ongoing activity from primary sensory neurons following neuritis and vinblastine-induced axonal transport disruption. Whereas 24% of C/slow Aδ-fiber neurons had ongoing activity during neuritis, few (<10%) A- and C-fiber neurons showed ongoing activity 1–15 days following vinblastine treatment. In contrast, axonal mechanical sensitivty increased transiently at the vinblastine treatment site, peaking on days 4–5 (28% of C/slow Aδ-fiber neurons) and resolved by day 15. Conduction velocities were slowed in all groups.
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