Physiotherapists in Aylesbury treat many different conditions including the issues profiled below.

Back Pain and Pathology

It is difficult to connect back pain symptoms to causative factors but some pathological findings are easier to link. Disc herniation can be objectively observed on MRI scanning and is reliably connected with sciatica but MRI scans on normal subjects show disc herniations in people who do not have symptoms. Lumbar disc degeneration seems very common in people of middle age but it is difficult to clearly define so that it can be measured in a way relevant to clinical practice. Disc degeneration starts sooner and is more developed in the L4/5 and the L5/S1 disc levels than in higher lumbar levels.

Even 15 year old school children have been found to have a significant incidence of these disc changes, with the incidence rising to close to 100 percent in people who have reached 50 years of age. MRI findings are not well correlated with requirements for medical care for back pain or for the levels of disability which can result. Narrowing of disc spaces, bony outgrowths and increases in bone density are connected to a degree with levels of back pain. Eastern societies which depend a lot more on the squatting posture are reported to have lower levels of degeneration than western societies.

Total Shoulder Replacement

Shoulder replacement is less commonly performed than replacement of the hip or knee but remains a very useful treatment for a variety of shoulder conditions. Osteoarthritis is much less common in the shoulder than in the knee or hip so replacement is more frequently performed for arthritic diseases such as rheumatoid arthritis and for painful conditions secondary to trauma such as fractures or rotator cuff dysfunction. Replacing the shoulder is a different matter from the main weight bearing joints of the lower limbs which can be thought of as .hard tissue joints.

The shoulder is more of a .soft tissue joint. in that the orientation and sufficiency of the soft tissues are what allows the joint to function properly. Typically the socket is replaced by a plastic socket component and the humeral head by a metal component which has a stem down the humeral shaft. The correct positioning of the humeral head in relation to the soft tissues such as the rotator cuff tendons is vital as if this is not correct then the joint surfaces may be fine but the shoulder will not function correctly. Patients are routinely referred to physiotherapy, initially for range of motion and later for strengthening and functional work.