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

Overdoing and Avoiding in Chronic Pain

Chronic pain can lead to significant levels of distress and disability as sufferers struggle to maintain their activity levels in the face of high levels of pain. People vary enormously in their responses to a chronic pain problem but the two most obvious approaches are avoiding and overdoing. Avoiding is much less common the person doing less and less with time, avoiding activities as they fear damage to their back. With time this evolves into an almost complete avoidance of activity as the person rests for the majority of the day, with others typically taking over all the domestic tasks and often many of the personal ones too. This leads to high levels of unfitness and deconditioning.

The other approach, more common overall, is to keep pushing on with activities because they have to be done, and then cope with the consequences afterwards. These people feel guilty at not being able to do the things they should and when they wake up to a better day than normal they go for it, doing all the things they have wanted to do until the pain increase stops them and then is much worse for several days, forcing them to rest.

Back Pain - Red Flags for Serious Conditions

Most people with back pain have just that, back pain secondary to injury, time and the mechanical stresses of holding a posture or performing an activity. However, a small proportion of people present with back pain when the underlying reason is a serious pathology of some sort. The signs that indicate that mechanical back pain may not be the reason for the patient's pain are called red flags. Physiotherapists routinely ask the red flag questions to try to exclude the likelihood of a patient having a serious underlying condition which might also be worsened by physio treatment. Examples of red flags for back pain are: age over 55 or under 20 when back pain first presents and significant trauma involved (like a fall).

Other red flags include: significant weight loss; significant night pain; use of steroids; a history of cancer; bladder or bowel disturbance and loss of sensation in the saddle area around the genitals and anus. A degree of judgement is required as the outcome of the questions is rarely clear cut and most red flag situations turn out not to be serious conditions but physios routinely evaluate these to ensure safe treatment and refer questionable cases on for medical evaluation.