Physiotherapists in Ware 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.

Disc Prolapses

In a disc prolapse the internal material of the disc becomes displaced in relation to the outer annulus. The annular rings should be around the disc and the water retaining nucleus at the centre of the disc should remain there. In one kind of protrusion the disc bulges the annular fibres outwards but the nuclear material remains inside the disc. If the annular fibres rupture right through their thickness then part of the nucleus can extrude outside the confines of the disc but it still remains in contact with the rest of the nucleus inside the disc.

A third type of disc prolapse can occur where the disc tissue is extruded from the disc but then is separated from the nucleus and exists as an independent fragment outside the disc walls. Disc prolapses or herniations do not seem to be well connected with age or changes of degeneration of the discs even though it is again most common at lower lumbar levels which are subject to both degeneration and stresses more than other spinal regions. Even though disc prolapses are often called .slipped discs., the disc cannot slip as it is tightly bound to the vertebrae above and below.