Breakthrough painThe new painkillers helping cancer patients

Quality of lifeManaging the effects of pain

Treatment options Know what’s available to help you cope

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FINDING STRENGTH OVER PAIN

Olympic Gold medallist, Etienne Stott, talks about his experience of injury and pain

3STEPS

PAINNo. 2 / February 2013

2 · FEBRUARY 2013 AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Easing the emotional distress of pain

Medical experts have come a long way in understanding and treating di� erent types of pain; whether it’s acute pain, chronic pain or even the kind of pain endured by elite athletes to push themselves to superhuman extremes. Dr William Campbell of the British Pain Society is optimistic that innovative approaches can help millions of su� erers.

As many as 20 out of every 100 peo-ple in the UK will suffer prolonged chronic pain dur-ing their lifetime. Although acute

pain has a valuable role in warning of harm, chronic pain provides no useful function and should be rec-ognised as a disease in its own right.

Many challengesWithout adequate manage-ment, chronic pain leads to

frustration, depression and a spiral-ling decline in quality of life. It may result in disruption of family rela-tionships and the ability to continue in employment.

Morphine-like analgesics are of little value in managing chronic pain when used alone and can cause complications as the nervous system

adapts. After the initial benefi t, there is often a need to escalate the dose.

Often low dose antidepressants and antiepileptic medicines can ease chronic pain. The pharmaceutical in-dustry is researching and developing analgesics with minimal side e� ects.

Pain management programmeThe challenge of reversing the destructive process of chronic

pain can also be met through multi-disciplinary healthcare input, along with tailored use of medicines.

When chronic pain patients engage with a healthcare team such as a pain clinician, psychol-ogist and physiotherapist who devise a pain management pro-gramme (PMP), the result is re-duced pain intensity and im-proved coping skills. This is not surprising because pain is a per-ception of potential tissue dam-age and often associated with emotional distress.

Better understandingEmotional distress has been shown to intensify the per-

ception of pain and any PMP that improves a patient’s understand-ing of their pain and allows for better functioning can only be a good thing.

Dr William CampbellBritish Pain Society

‘There are a signifi cant number of patients who go on from an acute pain episode with surgery to develop long-term pain’

Richard Langford, Professor of Anaesthesia and Pain Medicine, Barts Health NHS Trust and President of the British Pain SocietyPAGE 10

PAIN, 2ND EDITION, FEBRUARY 2013

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Dr Andrew Davies, Consultant in Palliative Medicine at the Royal Surrey County Hospital NHS Foun-dation Trust, explains: “Many can-cer patients experience ‘break-through pain’, which is short-lived exacerbations of their constant ‘background pain’.

“This pain may be triggered by an activity or come on out of the blue. Breakthrough pain is short-lived, from 30 to 60 minutes, but is moderate to severe in intensity. It has a signifi cant impact on quality of life and is diffi cult to manage be-cause it is so short-lived.

“Most traditional painkillers are ineff ective in managing the condi-tion because they only start to work

after about 30 minutes. However, a variety of new painkillers, with a quicker onset of eff ect, have been de-veloped to manage this type of pain.”

Dr Davies says breakthrough pain should be considered as a sep-arate condition because its man-agement is diff erent to background pain, and all patients with can-cer pain should be assessed for the presence of breakthrough pain.

Improving quality of life“There are different strategies for treating patients with break-through pain including manage-ment of the underlying cancer and modifi cation of regular medication.

“However, most patients require specifi c ‘rescue medication’ to treat the breakthrough pain episodes.

“Some of these products are swal-lowed, some dissolve in the mouth and some are sprayed in the nose.

Importantly, some of the newer products start to work after about fi ve to ten minutes. The choice of treatment is individualised as there is no ‘one size fi ts all’” he explains.

Dr Davies, who has been treating cancer patients for 20 years, adds: “Unfortunately, many patients will not be cured of their cancer and so maintaining and improving quality of life is a fundamental aspect of care.

“Breakthrough pain has a nega-tive impact on quality of life and can aff ect all of the daily activities and increase anxiety and depres-sion. It can occur at any stage of cancer but is more common in pa-tients with more advanced disease. It is a problem in patients with can-cer in the bones, but it can occur in any type of cancer.”

Thankfully new fast-acting pain relief offers cancer patients in-creased peace of mind and improved quality of life.

■ Question: What is ‘breakthrough pain’ and how do cancer patients cope?

■ Answer: Breakthrough pain is an episode of intense pain that erupts through constant ‘background pain’. A range of new painkillers can help cancer patients manage.

DIANE PRIESTLEY

info.uk@mediaplanet.com

MANAGING PAIN

Fast pain relief gives cancer patients quality of life

HOPE FOR THE FUTUREDr Davies says that new treatments that have been developed to manage breakthrough painPHOTO: SHUTTERSTOCK

Dr Andrew DaviesConsultant in Palliative Medicine, Royal Surrey County Hospital NHS Foundation Trust

INSPIRATION

THE NEED TO COMMUNICATE

How does it feel? We gain insight from those who suffer.

REFERENCES:

1. ASSOCIATION OF COMMUNITY CANCER

CENTRES – ACCCBUZZ.

2. KNUDSEN AK ET AL. SUPPORT CARE CANCER

2012; 20: 2491-2500.

3. WEBBER K ET AL. SUPPORT CARE CANCER 2011;

19: 2041-2046.

““Breakthrough cancer pain feels like episodes of losing control. It hurts to a degree that you can’t even imagine sometimes. It can just bring you to your knees.” 1

““I felt shrivelled up. I’m not sure if it’s possible that pain consumed all muscles. I was unable to read a book because I needed the second hand to support the fi rst one. I had to support every movement.” 2

““I would say peaks of pain; extensive shooting would be the right word. If I had to draw it, it would be a slight plateau that reaches high peaks.” 2

““If you are feeling pain then you are feeling down and the cancer is constantly on your mind and it is kind of like more of an uphill struggle, you feel like you are climbing up a great big mountain.” 3

““You learn to live your life differently…I do think that to live in less pain you have to literally do the things or not do the things that are going to cause the pain. And you always feel selfi sh…you have to do a lot of soul searching and coming to terms with what you can and can’t do. Why do things that put you in pain?” 3

Editorial content was produced entirely independently of any corporate involvement.

1STEP

BREAKING THE

SILENCE

This article has been funded by ProStrakan. The opinions expressed are those of Mediaplanet and not necessarily those of ProStrakan. ProStrakan have checked

this article for compliance with the relevant Codes of Practice and other applicable Laws and Regulations, but have otherwise made no contribution to the content.

What’s different about Breakthrough Cancer Pain?

BTcP occurs even when a patient is taking the right dose of medication on a regular basis. A large European survey of over 5,000 patients, reported that 63% of cancer patients experienced BTcP even though they were taking medicine to control their background pain. It can attack suddenly and for no apparent reason, or it might be triggered by something mundane like a cough or sneeze, or an everyday activity like getting dressed or taking a shower.

How does it affect patients?

For the majority of cancer patients who experience it, BTcP disrupts sleep, affects relationships with family members and puts them off taking part in activities they

challenging aspects of having cancer. A survey carried out by the American Pain Foundation revealed that 91% of patients suffering from BTcP believed that their quality of life would improve if they could get it under control.

Why is it under-treated?

Healthcare professionals may not recognise BTcP as a different type of pain from background pain. They may also have concerns about potentially ‘over-medicating’ patients. On the other side, patients keep quiet because they worry that it might be a sign that the cancer is getting worse, while some feel that their healthcare provider does not have time to discuss pain. Tragically, this may lead them to suffer in silence.

Managing BTcP

It is important to differentiate between uncontrolled background pain, and breakthrough pain occurring in patients whose background pain is controlled. The management of these two scenarios is likely to be different. Once distinguished, the treatment of BTcP should be individualised, taking into account both the features of the pain and the patient. Currently, most people with BTcP are treated with the same painkillers they receive for their background cancer pain. But there are now a number of fast-acting treatments designed

and in addition to, the regular pain medication.

Talking to a healthcare professional

Patients don’t need to put up with breakthrough pain. If you, or someone you know, suffer from BTcP, speak to your GP to discuss the treatment options available.

Breakthrough cancer pain The majority of people with cancer experience pain at some point in their illness, however there are actually different types of cancer pain. Persistent pain that occurs most of the time is known as ‘background pain’ and is usually controlled with regular painkillers. ‘Breakthrough pain’ on the

literally ‘break through’ the background pain. Although it is common and can be extremely painful while it lasts, breakthrough cancer pain (BTcP) is under-recognised, under-reported and under-treated in the UK.

6 · FEBRUARY 2013 AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Don’t suffer in silence

THE IMPORTANCE OF COMMUNICATIONDr Henderson highlights the importance of talking to your doctor about your pain to help you understand how best to manage itPHOTO: SHUTTERSTOCK

Chronic pain is a serious prob-lem that aff ects around fi ve mil-lion people in the UK. Media Med-ic Dr Roger Henderson is a sen-ior partner in a general practice in the West Midlands who sees countless patients suff ering from chronic pain every day. He has em-pathy for pain suff erers when he recalls his own agony.

“About 12 years ago, I slipped a disc and needed surgery. I experi-enced severe pain that no amount of painkillers could ease and I’d never been more miserable. All I could think about was the pain.”

He explains that because you can’t see or measure pain, doctors have to believe patients who must be able to communicate their pain levels.

Personal experience“Everyone perceives pain differ-ently as we all have diff erent pain thresholds. What is mild discomfort

to one person, to another is excru-ciating. Yet about 25 per cent of people suff er pain in silence.”

There are various causes of pain such as nerve conditions like shingles and neuralgia, me-chanical pain due to arthritis or muscular-skeletal problems and inflammatory pain caused by menstrual cycle or malignancies. “GPs diagnose the type of pain and score the degree of pain be-fore prescribing treatments such as tablet medications in various strengths, nerve blocking epidur-als and pain patches.”

Understanding chronic painDr Adam Al-Kashi, Head of Re-search at BackCare, the UK’s na-tional back pain association, takes a diff erent approach to chronic back and neck pain.

“Our understanding of chronic pain has moved on. We now under-stand that where physical disease,

such as cancer or rheumatoid ar-thritis, has been ruled out, chron-ic pain represents a mis-program-ming of the central nervous system, rather than relating to any local dysfunction at the site of pain.”

Managing pain“Medicine can be divided into four tiers: palliative, management, cu-rative and preventative. Pallia-tive care seeks to suppress symp-toms; pain management reduces the ongoing impact, incorporat-ing psychology and exercise to improve quality of life; the cura-tive approach targets the underly-ing causative imbalance to trigger healing and recovery; and preven-tative medicine is education that fosters positive lifestyle decisions that avoid illness.

“Humans are biochemical but also psychosocial. The more a medical approach can address the total person, the further reaching its outcomes can be.

“This approach requires deep-er patient engagement and best practice in all approaches to chronic pain.”

DIANE PRIESTLEY

info.uk@mediaplanet.com

Dr Roger Henderson

NEWS

UNDERSTAND YOUR PAIN

2STEP

■ Question: What is chronic pain?

■ Answer: Pain that lasts for more than three months on a daily basis on a level that can be unbearable and make everyday activities diffi cult, in some cases impossible.

■ Julia Kelly, 37, was on top of the world with a great job and her own home when a car accident in 2005 changed her life.

Julia says: “It wasn’t a high speed crash but I suff ered whip-lash and from that moment on I had persistent pain that got worse and worse. I was off work for over three months and the pain was controlled by physio-therapy but there were times I would roll out of bed and crawl around the fl oor in agony.”

In 2009, an MRI scan showed her lower discs were com-pressed and in 2010 unbearable pain spread down her right leg and she had major spinal sur-gery. However the pain returned to her back and both legs.

“It has been tough. I get very little sleep because of the pain. I can’t sit back in a chair and I can’t drive far. The hardest thing is people don’t understand what you are going through. Pain suf-ferers don’t want sympathy but they do want understanding.”

Counselling sessions have helped Julia adjust. “Within the fl ick of a switch my life changed. I went from having a home and job I loved and a busy social life to moving back with my parents who have copped the brunt of my anger and frustration.

I haven’t been on holiday in four years. I’ve battled with feel-ing useless and lonely. I just want to get on with my life.”

But through counselling, yo-ga and a range of therapies, her self worth has returned.

Julia has set up a charity and website called www.awaywith-pain.co.uk to support people suff ering from chronic pain.

Finding a way forward

8 · FEBRUARY 2013 AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Athletes are negotiating pain eve-ry day of their lives when they are training, according to Dr Rod Jaques, Director of Medical Servic-es at the English Institute of Sport, where 250 highly skilled staff pro-vide medical and sport science backup to summer and winter Olympic and Paralympic athletes, as well as some professional sports.

EIS experts worked with TeamGB Olympic and Paralympic medal-ists in their preparation for the out-standing London 2012 Games.

Dr Jaques explains: “Athletes are always wanting to push physical frontiers and their bodies will

send them signals to caution them against

the demands. Pain becomes a ‘mentor’ to re-mind them of

their tolerance limits. “Adaptation takes place so that athletes toler-ate higher and higher levels of dis-comfort. They habituate them-selves to tolerating greater train-ing loads in terms of speed, power and distance.”

Dr Jaques likens an athlete’s will-ingness to endure pain for the re-ward of sporting achievement to a woman’s willingness to endure pain for the reward of giving birth to a baby. “However, he quips, the gestation of an Olympic medal is not nine months but up to 12 years of gruelling training!”

Injury and recovery“In elite sport the agenda for re-covery from injury is to move on as quickly as possible so we work a little ahead of the curve in pain tolerance.”

One champion who mastered pain and recovered quickly is Gold Medal-ist Etienne Stott. A freak training acci-dent left the Men’s C2 slalom canoeist nursing a badly dislocated shoulder.

“I was devastated when it hap-pened as it was clearly a serious inju-ry,” Stott says. “But within two days I had an MRI scan, my surgery was booked and all the options had been clearly explained to me, which was really reassuring” he recalls.

“The speed at which everything came together was crucial not just in terms of my physical recovery, but also my state of mind” he says.

The EIS physiotherapist, physi-cian, nutritionist, external psychol-ogist and specialist shoulder sur-geon worked together to have him back in the water with his canoeing partner Tim Baille within 11 weeks, in time for the World Champions which qualifi ed them for Team GB. The dynamic pair went on to win Olympic Gold.

Looking back Stott says: “The co-herence and coordination of the whole support team made it happen.”

DIANE PRIESTLEY

info.uk@mediaplanet.com

Question: How do Olympic athletes overcome injury and pain? Answer: By responding to their body’s tolerance limits and ensuring a balanced recovery.

INSPIRATION

Elite athletes push the frontiers of pain

Dr Rod Jaques, Director of Medical Services, English Institute of Sport

Injury/Illness Performance Project

(IIPP) statistics, set up by the EIS and

UK Sport working with Nottingham

University, to better understand

injury and illness incidence and

inform strategies for preventative

tools. Data is from 11 sports; 428 high

performance elite athletes.

FACTS

36%Injury data has shown that

of athletes will get at least one injury

per season, some suffering multiple

injuries, with each causing on

average 15 days lost to training and 1

competition to be missed.

■ The level of pain at the time of

injury was recorded by athletes

during the study. With 0 equating

no pain and 10 equating the worst

pain (VAS Score).

Mean pain score at the date of

injury for athletes was 6, showing

athletes experienced moderate to

severe pain at the time of injury.

■ Interestingly 39% of athletes

returning from injury to their full

and normal training reported still

experiencing some pain at 1.6

VAS score.

■ For recurrent injuries the athlete

rate of return with pain was higher

with 46% of athletes returning

to full and normal training from a

recurrent injury still experiencing

pain, although their reported levels

of pain were not greater.

FEBRUARY 2013 · 9AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

PUSHING BOUNDARIESEtienne Stott (right) overcame injury to win an Olympic Gold medal for Team GBPHOTO: A E PHOTOS

Innovative surgery and treatments mean people no longer need to suffer pain in their knees and joints.

Consultant knee surgeon and clinical director of the Orthopae-dic Department of the Universi-ty Hospital of Southampton, Mr Philip Chapman-Sheath explains that surgeons can now harvest cells from a patient’s own knee cartilage. Cells are multiplied by up to six million in a laboratory and can be frozen and stored be-fore being re-inserted to re-grow the damaged knee.

This regenerative surgery is ide-al for adults under 45 who have suffered damage to their knees or other joints through accident trau-ma or sporting injury.

According to Mr Chapman-Sheath, using stem cells that can be grown into any tissue or organ needed by a patient is the exciting new frontier of research.

He adds: “There have been enor-mous advances in the last decade in knee surgery engineering and the design of implants so that ar-tificial knees feel like a real knee.”

Mr Chapman-Sheath says when treating pain in joints includ-ing knees, wrists, elbows, shoul-ders, ankles and hips, specialists always start with the low end of the scale, firstly using kinematics to analyse why a patient is expe-riencing joint pain and imaging such as MRI scans.

He says treatments for joint pain relief include weight reduc-tion, activity modification, physi-otherapy, orthotics, anti-inflam-matory analgesics and injections of steroids and lubricants.

He says surgery is the last option and there are several types of sur-gical techniques that repair knees and other joints and alleviate pain.

In elderly patients suffering ar-thritis one, two or all three areas of the knee can be replaced if pain is restricting the quality of life.

Mr Chapman-Sheath advises: “Go early to a specialist if you’ve got joint pain to find out the options. Get as much information as you can from websites. I like to see patients who come fully informed.”

Regenerative medicine gives hope for joint pain relief

DIANE PRIESTLEY

info.uk@mediaplanet.com

10 · FEBRUARY 2013 AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET

Saying goodbye to acute pain

ACUTE-ON-CHRONIC PAINProf Langford explains how recurring acute pain such as headaches, period or back pain is described as acute-on-chronic PHOTO: SHUTTERSTOCK

Acute pain can range from mild to very severe according to Pro-fessor Richard Langford, Pro-fessor of Anaesthesia and Pain Medicine at Barts Health NHS Trust and President of the British Pain Society.

Prof Langford explains that pain due to surgery or an injury is expected to be short-term, how-ever doctors become concerned when pain is disproportionately prolonged.

“If you break your ankle it hurts and then it mends in a steady way and pain melts away over a few weeks. That’s normal. With a hernia repair you shouldn’t have much pain after a week or two and if after three weeks you still have severe pain that’s abnormal.

“Anaesthetics and pain man-agement experts now understand

that there are a significant num-ber of patients who go on from an acute pain episode with surgery to develop long-term pain. This can happen with chest or breast surgery, hernia repair or joint re-placement. We are working on strategies to reduce this.”

Pain reliefProf Langford says recurring headaches; period pain or back pain is described as acute-on-chronic. It’s a condition that keeps rearing its head.

He explains that acute pain re-lief ranges from over-the-coun-ter paracetamol and ibupro-fen to codeine or injections of a stronger opioid (morphine-like) painkiller for severe onset pain such as a gall bladder attack or

urinary tract blockage, which can be excruciating.

“In the case of surgery, rather than waiting for the pain to de-velop, we include a local anaes-thetic block along with general anaesthetic and multi-modal in-travenous therapy proportionate to the expected level of pain.

“In some cases, local anaesthet-ic is applied around the wound to numb the nerves or injected deep into the spine either into the fl uid bathing the spinal cord, or around this layer in the epidural space. Epidurals are used to prevent pain during and after major chest or abdominal surgery, or hip and knee replacements.”

The National Pain Audit and the Health Survey England were pub-lished in December. Prof Langford says: “These major reports dem-onstrated the severity, plight and impact of long-term pain on peo-ple’s lives and the benefi ts of spe-cialist pain management.”

DIANE PRIESTLEY

info.uk@mediaplanet.com

Richard Langford, Professor of Anaesthesia and Pain Medicine, Barts Health NHS Trust and President of the British Pain Society

NEWS

■ Question: What is acute pain and what causes it?

■ Answer: Acute pain is short-term pain as a result of surgery, injury, trauma or a medical illness.

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WANT TO KNOW MORE? See the videos www.apostherapy.co.uk

When physiotherapy and a course of pain killers failed to provide relief for her KNEE PAIN, Lynn was faced with the prospect of KNEE SURGERY – luckily, she discovered AposTherapy fi rst.

Using a unique process of measuring the footfall on a computerised gait analysis machine, AposTherapy applies this information to a clinically proven biomechanical device to improve mobility and alleviate pain 1. 2. 3. 4. 5..

Lynn Batham knows all about knee

pain and the effect it has on lives.

It became so severe that even the

simplest tasks like coping with stairs

became a well rehearsed, sideways

balancing act.

The impact on Lynn’s social and

daily life was equally painful; days out

were cancelled, meetings with friends

postponed even doing the weekly shop

became unthinkable because she had

to rest her legs.

Eventually, after visiting a physio-

therapist, Lynn began treatment.

Six months later with only limited

success, she was fi nally referred to an

Orthopaedic Consultant Surgeon.

It was bad news. Surgery! A knee

arthroscopy seemed the only answer as

a torn meniscus and knee osteoarthritis

were diagnosed as the cause of her

agony.

Life reappeared in the letterboxThe prospect of undergoing

surgery that isn’t always successful

and continuous painkilling drugs was

a major concern and a risk she didn’t

really want to take. Lynn still viewed

herself as a young and energetic

woman with much more to offer in life.

The decision weighed on her mind

causing a mild depression, further

restricting the lifestyle of a once

optimistic woman.

Picking up the post one sunny

morning is a day Lynn clearly remembers.

It was the day the AposTherapy leafl et

changed her life forever.

Just 1 hour a day for long lasting relief!“I was initially really sceptical, why

hadn’t I heard of it? Was it really true? A pair of what looked like high-tech trainers… could they really prevent my knee op?

The moment I fastened the velcro and began walking I was amazed at the immediate reduction in pain. Using the device for just one hour a day this past year, I can honestly say AposTherapy worked for me. The biggest change is being able to walk virtually pain-free and living a normal, active life doing all the things that I could before. My life is my own again.”

The confi dence to be more active“The AposTherapy team is so

supportive. They regularly monitor me and I can see my progress. Not only feeling but seeing the improvements in black and white from the computerised gait analysis makes you feel so much better. The AposTherapy teams’ encouragement really, really lifts you. You want to be more active as you become more and more pain-free.”

The walks I dreamed of …I used to enjoy walking around a lake

near where I live. The team said to me they’d have me walking around that lake in no time. I was doubtful, but a few months on I’m doing just that. I still can’t believe how simple the whole process was and the beauty of the AposTherapy shoes is it fi ts so easily into your daily routine. I just wear them for an hour a day at work or home.”

FREE NO OBLIGATION ASSESSMENT WITH A QUALIFIED PHYSIOTHERAPIST Call and Quote code MP10 NOW!

A KNEE PAIN TREATMENT THAT STARTS WITH SOME SOLE SEARCHING!Just one hour at any time of the day is all it takes…

� Do you suffer from knee pain?

� Are you taking anything for the pain?

� Do you have limited mobility?

� Have you tried everything else?

� Would you like a non-surgical solution?

� Do you want an active lifestyle again?

Is this you?

AposTherapy – the facts

FOR A FREE NO OBLIGATION ASSESSMENT with a chartered physiotherapist CALL

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CLINICS IN LONDON AND BIRMINGHAM

1. Bar-Ziv Y. et al. BMC Musculoskeletal Disorders 2010 2. Elbaz A. et al. Clinical Biomechanics 2010 3. Haim, A,. et al., Journal of Biomechanics 2011 4. Elbaz A et al, Knee Surg Traumatol Arthrosc 2012 5. Independent telephone survey conducted by Network Research in Nov. 2009 amongst 150 AposTherapy patients in the UK. *Subject to eligibility criteria.

The AposTherapy biomechanical deviceFor the treatment of worn or arthritic knees, the AposTherapy treatment is based around a unique, medically designed, foot-worn biomechanical device. Worn at home for an hour a day and calibrated by a specially-trained physiotherapist for each patient. Simply put, the exact positioning of the multi-adjustable pods moves the loads away from the painful area of the joint and their convex shape introduces controllable instability which stimulates the muscle and brain to adopt a correct walking pattern.

Monitoring your progressProgress is closely monitored during the treatment by scheduling regular follow-up consultations to make sure optimum results are achieved and the patient’s personal goals are met.

95%OF PATIENTS

ARE SATISFIED WITH THE

TREATMENT

Knee Osteoarthritis and AposTherapyOsteoarthritis (also known as wear and tear of the cartilage) is the most common cause of knee pain. The muscles and the instructions they receive from the brain play a major role in the aggravation of the illness. Abnormal walking patterns can be caused by this process.

Healthy Knee Worn Knee

Data is collected as a patient walks through the computerised gait lab.

Lynn having a follow-up assessment

The full treatment cost of

AposTherapy is also covered by

Bupafor severe knee pain*

A Unique ApproachAposTherapy analyses and corrects the way you walk by changing the distribution of weight as you walk. Just by walking around for an hour a day at home or in the offi ce while wearing the biomechanical device is all it takes for long lasting relief.