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

Neck Posture

The head is a large and heavy object balanced on top of a slender column of bone and ligaments which is known as the neck. Postural neck pain is very common as our mainly sedentary lifestyles mean that we spend long periods in one position often with our necks held in less than optimal postures. Gravity pushes us down all the time and the neck tends to move forward as the lower neck flexes for us to look down at books or computers. As our head is now looking downwards we don't want to look at the floor all the time so we tilt the head back up, extending the upper neck.

This position, when held long term, can lead to the head stuck forward posture and a .dowager's hump., a prominent bony area at the base of the back of the neck. This can lead to neck strain both at the top and bottom of the neck, causing neck and shoulder pain lower down and neck and head pain higher up. The head forward posture forces the neck muscles and the upper trapezius to work harder than normal to hold the head up in its abnormal position.

Fatigue and Tiredness - The Management of the Condition

Drug therapies given for arthritic condition, known as disease modifying anti rheumatoid drugs and the new biological treatments, have been shown to reduce the fatigue reported by patients, perhaps partly at least by reducing inflammation and pain levels which have some effects on fatigue levels. While fatigue can be improved by these drugs and by antidepressants, it can occur in the absence of depression or inflammation. Exercise therapy in groups has shown some trends towards improvement of fatigue, although the effects of exercise therapy on chronic fatigue syndrome are not clear.

Group therapy may be included in self management programmes which combine this with education and psychological interventions. Both these therapies have shown some effects in particular circumstances. Acupuncture however has shown no effect in chronic fatigue syndrome. Evidence for non-drug treatments is limited by the number of good quality research trials available, most of which are not set up to examine the fatigue nor the potential treatments for it. A good definition of fatigue does not yet exist nor is there any possibility of logically grading the degrees of tiredness from slight to exhaustion, limiting meaningful work on the condition. Pain management programmes, which often have a physiotherapist and a clinical psychologist, presently address these patients.