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

Fatigue and Tiredness - The Management of the Condition

Drug therapies given for arthritic condition, known as disease modifying anti rheumatoid drugs and the new biological treatments, have been shown to reduce the fatigue reported by patients, perhaps partly at least by reducing inflammation and pain levels which have some effects on fatigue levels. While fatigue can be improved by these drugs and by antidepressants, it can occur in the absence of depression or inflammation. Exercise therapy in groups has shown some trends towards improvement of fatigue, although the effects of exercise therapy on chronic fatigue syndrome are not clear.

Group therapy may be included in self management programmes which combine this with education and psychological interventions. Both these therapies have shown some effects in particular circumstances. Acupuncture however has shown no effect in chronic fatigue syndrome. Evidence for non-drug treatments is limited by the number of good quality research trials available, most of which are not set up to examine the fatigue nor the potential treatments for it. A good definition of fatigue does not yet exist nor is there any possibility of logically grading the degrees of tiredness from slight to exhaustion, limiting meaningful work on the condition. Pain management programmes, which often have a physiotherapist and a clinical psychologist, presently address these patients.

The Development of Chronic Neck Pain

Long term neck pain and disability is a difficult and perplexing problem, leading to high degrees of pain, suffering and loss of function in some patients. There are a serious of beliefs which may go with a higher risk of developing chronic pain after neck injury such as: the belief that the pain is due to a serious injury or tissue damage; resisting reassurance; equating hurt with harm and believing the pain will lead to disability; avoiding activities and movement due to the fear of damage; resting and remaining inactive whilst waiting for the pain to settle; expecting someone to cure the pain rather than taking on the responsibility oneself; withdrawing from social contact and becoming depressed.

These tendencies are referred to as .yellow flags. and predict to some extent the likelihood the person will suffer work loss and disability from their pain condition. These problems may develop steadily and without the person being aware of them, so they need identifying and dealing with as soon as possible. If a person is off work for a month with their neck pain then there is a risk of developing long term problems and a ten percent chance of still being off in a year.