Physiotherapists in Dover 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.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.