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

Sciatica - Physiotherapy Management

True sciatica is uncommon and occurs in less than 5% of people who suffer from low back pain problems. It is characterised by severe leg pain of a surging nature, typically worse in the lower leg and foot and with sitting or bending. Physiotherapists exclude red flag causes for the pain and examine the patient carefully to avoid aggravating the situation. Initial treatment might be explanation, the finding of a comfortable resting position to relieve the nerve root and taking analgesia appropriately because more active treatment would be too painful. Once the patient's pain has settled to a degree then more active treatment can be started.

Spinal mobilisation techniques may be used to mobilise the spinal segments and put mechanical input into the area where the nerve root is being compromised. This can start the process of moving the inflamed area and allow the patient to perform regular mobilising exercises within comfort. Exercises are progressed to put greater and greater mechanical stresses through the back as the patient improves and mobilisation techniques may be continued to open the nerve exits and continue the process of encouraging the nerve to settle down. Neural mobilisations may be prescribed once the pain has settled well to prevent adhesions developing.

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.