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

Fatigue or Tiredness with Musculoskeletal Conditions

Tiredness or fatigue is an extremely common accompanying condition to a large number of musculoskeletal conditions. Patients may rate fatigue just as important and severe as their pain problems but there is little consensus on the diagnosis and treatment of this distressing condition. Fatigue has been studied in good quality trials of people with arthritic conditions. If fatigue is an issue it is commonly present in varying degrees from a low level of weariness to complete exhaustion. Fatigue may also be shattering and force the person to lie down and rest or sleep, is not necessarily related to activity at all and can involve cognitive faculties such as thinking and memory.

Tiredness interferes with all aspects of a patient.s life including employment, personal relationships, normal daily chores, looking after children, social life and leisure. Patients often save energy for essential activities such as work or chores at the expense of a social life or any kind of recreational activity. Typical consequences of this forced inability to participate in normal life are frustration, anger, resentment and depression. Fibromyalgia and chronic fatigue syndrome overlap in their presentation of pain and tiredness symptoms, with fibromyalgia typically exhibiting pain as its main symptom but accompanied sometimes by high fatigue levels.

Tennis Elbow

Tennis elbow is a troublesome pain condition affecting the outer part of the forearm around the elbow. It is common is people who do repetitive forearm activities in work or hobbies and while it mostly occurs in people who do not play tennis, it can occur in tennis players too. In the acute stage tennis elbow can be very disabling as it interferes significantly with the function of the arm and hand and can produce high levels of pain. A more gradual onset of pain over the outer part of the elbow may be more common, with difficulty gripping and holding objects or performing repeated actions.

Physiotherapy examination consists of palpating the musculotendinous junction of the extensor muscles of the forearm for tenderness and pain, testing resisted forearm extension and the ability to grip strongly. An abnormality of the tendon, a tendinosis, is thought to contribute to the pain of this condition. Physiotherapy treatment consists of reducing the stresses by activity modification and use of an epicondylitis brace, ultrasound, deep frictions and eccentric exercises to the forearm extensors. Local injections of corticosteroid or even a surgical tendon release can be used in difficult cases.