Physiotherapists in Ely 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.

The Acromioclavicular Joint

Just above the shoulder joint proper lies a small joint between the acromion part of the scapula and the outward end of the collar bone or clavicle, the acromioclavicular joint. It is usually not troublesome and functions like the suspension strut in a car, keeping the moving parts away from the centre of the body. For the arm to able to exert power the shoulder girdle has got to stay where it is when the strength is applied and the clavicle does this by bracing the chest and shoulder apart, forming joints at the chest end and at the shoulder end.

This is a butt joint linked by strong ligaments and is meant to transmit force and not to move significantly. Acromioclavicular joint injuries are typically sustained by falling directly on the shoulder or other part of the arm, forcing the acromion upwards against the stabilised clavicle. This disrupts the joint and is immediately acutely painful with the patient avoiding anything to do with pushing anything. Minor injuries give pain and heal well, whilst more major injuries can cause a deformity as the two parts of the joint no longer sit next to each other. This gives a non functioning joint which can be a chronic problem.