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

Diagnosing Discogenic Back Pain

Low back pain is very common and a significant cause of pain, disability and work loss in western societies. Diagnosing low back pain is difficult and relating examination and investigation findings to treatments or successful intervention has proved to be elusive. MRI scanning is the investigation of choice for back pain syndromes and can indicate disc narrowing, disc dehydration, annular tears and joint abnormalities. If the disc level identified on the scan fits with the examination and x-ray findings, the surgeon may have some confidence that the painful segment has been identified. However this may not be accurate and treatment based on this can be unreliable.

Discography is an investigative technique where a needle is introduced into the suspect disc and a small amount of contrast material is injected. If the test is to be positive then the individual must complain of their typical pain on this stimulation and not just general discomfort. The injected material may also give some idea of the internal structure of the disc and any disruption which may be present. Injection of local anaesthetic can also be performed, a so called discoblock, may be performed, allowing for the patient to report a reduction in their typical pain for a positive response to the test.

Knee Cartilage Injuries

The knee cartilages are properly known as menisci and are almost circular cartilaginous structures which look like banked tracks, sitting between the flat upper surfaces of the tibia and the large rounded condyles of the lower end of the femur. Their function is not entirely understood but may be to guide the femoral condyles as they slide and glide, to distribute synovial fluid evenly around the knee or to give sensory feedback about the complex positions adopted by the knee at any moment. The menisci are vulnerable at times as the large femoral condyles can roll over them and being attached to the tibial upper surface they cannot always move out of the way.

This can result in the meniscus suffering compressive forces applied by the condyle and becoming injured in the process. Tears of the menisci are common injuries and occur in various patterns, common examples being a parrot beak tear and a bucket handle tear. The parrot beak is a small tear at the edge which then appears like a bird.s beak. If the tear is along the substance of the meniscus it can cause a loop with attachments at both ends, like a bucket handle.