Physiotherapists in Clacton On Sea treat many different conditions including the issues profiled below.

Overdoing and Avoiding in Chronic Pain

Chronic pain can lead to significant levels of distress and disability as sufferers struggle to maintain their activity levels in the face of high levels of pain. People vary enormously in their responses to a chronic pain problem but the two most obvious approaches are avoiding and overdoing. Avoiding is much less common the person doing less and less with time, avoiding activities as they fear damage to their back. With time this evolves into an almost complete avoidance of activity as the person rests for the majority of the day, with others typically taking over all the domestic tasks and often many of the personal ones too. This leads to high levels of unfitness and deconditioning.

The other approach, more common overall, is to keep pushing on with activities because they have to be done, and then cope with the consequences afterwards. These people feel guilty at not being able to do the things they should and when they wake up to a better day than normal they go for it, doing all the things they have wanted to do until the pain increase stops them and then is much worse for several days, forcing them to rest.

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.