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

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.

Falls and Healthy Bones

Falling in adults is an important matter with involvement of around 30% of people over sixty-five years old and half of those over eighty-five years. There are significant risks to falling for elderly people, with many much older people dying and or suffering loss of mobility or other problems. Ninety percent of hip fractures are caused by falling and this comes with a very high cost both personally and financially. Only twenty percent of people who fracture their hip recover well enough to attain their previous level of functional abilities which includes walking. There may be many reasons for a person falling and the evidence for the many interventions proposed being effective is not very good.

Physiotherapists prescribe exercise programmes as part of their main arsenal of skills, with good evidence that well designed programmes which include training balance and strength can be effective at reducing falls in the community. Patient access to assessment and treatment by a physiotherapist is however variable in the UK, with hip fracture patients likely to receive this (due to admission to hospital) but patients with non-hip fractures are much less likely to receive this even when admitted. Physios have a much greater role in this matter which they have not taken up.