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

Hand Injuries - Diagnosis

The diagnosis of most hand injuries is not difficult as the damage is usually readily apparent to the examiner. There will typically be a history of trauma and this should be carefully attended to as it may give clues to a more complex injury than first appears. Bruising and swelling are very typical signs apparent on initial inspection, with pain a common and often localising feature. There may be an obvious deformity if the joints are dislocated or bones fractures with displacement, the patient will have lost the ability to grip firmly and there may be reduced range of movement in the fingers and thumb.

Examination starts with a visual examination of the hand which guides the doctor as to further required tests and investigations. The doctor will palpate the hand systematically to look for areas of particular pain or abnormal movement which would point to an underlying injury. The ranges of movement of the shoulder, elbow, wrist and hand is assessed and recorded, with the tendon actions tested in turn to search out any tendon involvement. Circulatory function will be checked to exclude blood vessel damage. Investigations will routinely include x-rays to look for fractures, dislocations or embedded objects such as glass.

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.