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

Internal Fixation for Fractures

Many fractures can be managed by immobilisation if not displaced or can be repositioned and maintained in position by a plaster cast. Some fractures cannot be maintained in position, slip out of position once re-positioned or cannot be immobilised because of the length of time required or the awkwardness of the anatomical location. In these cases internal fixation with plates, screws, wires or nails is considered. Internal fixation requires an operation which carries the usual risks including infection so is only performed when required from a clinical standpoint.

Fracture alignment is important to maintain the relative position of the nearby joints so that excessive forces are not thrown onto one part of a joint or another. Wrist fractures which do not remain in a good position can be plated then immobilised until healed. Fractures with many pieces may need re-assembling and maintaining in position by metalwork. Femoral shaft fractures cannot be immobilised except by traction and with the healing period being 12 weeks the decision is usually to place a nail down the femur and get the patient up and out of hospital in a few days. Complex fixation may be used to restore the structure of a badly damaged bone in some cases.

Rest versus Activity for Neck Pain

In the past the recommended treatment for neck and low back pain was to rest flat on the back or wear a collar until the pain subsided, to allow the damaged structures to heal before going back to normal activity. More modern ideas, back by research work, recommend a day or so of rest if necessary, followed by a speedy return to normal as quickly as the condition allows. Long term resting may be the most counterproductive treatment as it has a serious of unfortunate side-effects: joints stiffen; fitness is lost; muscles lose strength; the pain can worsen; depression is common; it.s tough to get going again after.

Modern advice is that prolonged inactivity is unhelpful for pretty much any mechanical pain condition including neck pain. Patients should only rest if the pain forces them to, then get going again. The benefits of movement and activity are: increased muscle strength; maintains fitness; strengthens bones; maintains flexibility; releases the body.s natural feel good chemicals which lift mood. During episodes of neck pain it is still useful to do some exercises such as range of motion, general keep fit, tai chi or yoga and continue to pursue normal daily functional work.