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

Ligament Bone and Tendon Bone Inflammation . Enthesitis Symptoms

Inflammation of the entheses, the anatomical junctions (insertions) where the bone meets a ligament or a tendon, cause pain in the local areas, persistent stiffness around the joint and swelling of insertions such as where the Achilles tendon attaches to the heel. If there is obvious joint swelling and other relevant symptoms then the diagnosis of an arthritic condition known as a spondyloarthritis is moderately clear. If the extra symptoms are not present the diagnosis is more difficult and patients may be referred for consideration of more localised musculoskeletal conditions such as sports or overuse injuries.

The pain, stiffness and swelling which typically accompany enthesitis commonly occur at the Achilles tendon and patellar tendon insertions but may also be present in the sole of the foot near the heel, in the elbows where tennis elbow typically occurs, around other ligament insertions of the knee and in the spine. Joint swelling which gives an effusion (water in a joint) may occur to confirm the diagnosis. Despite inflammatory changes of an arthritic disease obviously occurring in some patients the blood markers of inflammatory processes may not be raised, making it easy to miss the diagnosis in the absence of confirmatory tests.

Hypermobility

We are all born with a genetically determined type of fibrous tissue, the collagen material that makes us all or most of our ligaments, tendons, skin and discs. Our collagen varies greatly in the amount of extensibility it allows due partly due to the amount of elastic material included and the length of our tissues. Normal mobility varies from stiff jointed to very mobile and individuals who show very high degrees of flexibility of their joints are termed hypermobile. Hypermobility may be asymptomatic or can cause significant pain problems in other cases. Benign hypermobility syndrome BHS is diagnosed clinically by testing the patient's joint mobility.

The diagnostic tests are: the little finger can be pulled back to 90 degrees to the hand; with the wrist bent the thumb can be pulled back to touch the forearm; the elbows extend back beyond neutral; the knees extend back beyond neutral and the person can bend over with the knees straight and place their palms on the floor. Each joint gets a score of one if positive and this gives a score out of nine. The score indicates the degree of hypermobility the patient is exhibiting and helps decide whether the joint condition is relevant.