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

Sciatica - Physiotherapy Management

True sciatica is uncommon and occurs in less than 5% of people who suffer from low back pain problems. It is characterised by severe leg pain of a surging nature, typically worse in the lower leg and foot and with sitting or bending. Physiotherapists exclude red flag causes for the pain and examine the patient carefully to avoid aggravating the situation. Initial treatment might be explanation, the finding of a comfortable resting position to relieve the nerve root and taking analgesia appropriately because more active treatment would be too painful. Once the patient's pain has settled to a degree then more active treatment can be started.

Spinal mobilisation techniques may be used to mobilise the spinal segments and put mechanical input into the area where the nerve root is being compromised. This can start the process of moving the inflamed area and allow the patient to perform regular mobilising exercises within comfort. Exercises are progressed to put greater and greater mechanical stresses through the back as the patient improves and mobilisation techniques may be continued to open the nerve exits and continue the process of encouraging the nerve to settle down. Neural mobilisations may be prescribed once the pain has settled well to prevent adhesions developing.

Inflammatory Disease of the Entheses

Mechanical factors are thought to be important in inflammatory conditions of the ligament or tendon insertions so addressing these matters may be useful. Physiotherapists can assess the problem and prescribe corrective or cushioning insoles as needed. Local injections of corticosteroids can be useful to treat the pain of enthesitis in a single area. For more widespread inflammation the new biological agents (known as anti-TNF agents) have been shown to be of some use, particularly if the legs are affected as this is so disabling. Typically enthesitis is likely to settle with time so the prognosis is reasonable.

Physiotherapy treatment of this problem includes assessment of joint ranges for restrictions which are developing and the design of an individual exercise regime to maintain the ranges of motion of all the affected joints. Hydrotherapy is a very useful treatment medium for most of the arthritic diseases as it allows the performance of joint movements in a warm and supported environment, minimising the forces on the joints, until the patient is able to progress comfortably to exercises in air. Patient education is important with the physio stressing that the exercise programme, targeted at specific difficulties for each patient, and needs to be maintained daily over the long term.