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

Tiredness and Fatigue - Normal and Abnormal

Patients easily distinguish between normal tiredness and the tiredness they suffer as a consequence of their musculoskeletal conditions. Healthy adults report fatigue after stressful activity or physical work which is relieved by rest or sleep completely. Fatigue in sufferers from long term musculoskeletal conditions is very common, more intense, not predictable and does not resolve with rest. Fibromyalgia consists mainly of widespread muscular pain with fatigue whilst chronic fatigue syndrome is primarily fatigue with degrees of pain. Chronic fatigue syndrome is diagnosed by the presence of unexplained fatigue for more than six months which is not connected to activity and not eased by resting. Severe reduction in activity levels is common.

Fatigue is common also in musculoskeletal disorders such as osteoarthritis and rheumatoid arthritis, with patients often rating the fatigue as or more severe than the pain itself. Research work has found that the levels of fatigue have strong effects on the quality of life in rheumatoid arthritis and if severe it is connected with a deterioration of the ability to live life normally. As tiredness is as or more difficult to cope with than the pain of these arthritic diseases it is understandable that patients consider fatigue to be an important aspect of their presentation.

Bunions

Bunions is the term given to problems which occur with the joint of the big toe as it meets the foot, the first metatarsophalangeal joint or MTP joint. Problems with this joint may be familial with some inherited tendency but can also be do to poor foot use such as ill fitting footwear. Signs may start with an increased prominence at the inner border of the foot as the big toe drifts slightly towards the outside of the foot, eventually leading to rubbing of the prominence on the shoe in walking. Progression may occur as the deformity becomes worse and the joint itself becomes painful, with the big toe compressing the second toe and perhaps overriding or under riding it.

A highly arthritic joint can be very disabling, severely restrict the ability to walk very far and cause huge problems in choosing suitable footwear. Initial physiotherapy treatment can be provision of insoles, mobilisation techniques, gait correction, provision of walking aids and moderation of aggravating activities. More severe problems can be treated by joint injection, shaving of the joint surgically, removal of the joint to leave a fibrous union, fusion of the joint (arthrodesis) or replacement of the joint with a prosthesis.