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

The Upper Neck

The upper neck or cervical spine is specialised in its anatomy and function as it has to bear the weight of the head and allow the head to be moved into any position for our sensory organs to receive the information they need. The two upper vertebrae, the atlas and the axis, have a specialised anatomical structure which is designed to satisfy the needs of head positioning in many functions. The upper vertebra, the atlas, has no body and is a bony ring with large facet joints to articulate with the facet joints of the lowest part of the skull, the occiput.

The second vertebra, the axis, has .captured. the body part of the vertebra above and has a upwardly protruding pin called the dens (latin for tooth) which forms a joint with part of the atlas above and also with a ligament which runs round it. The integrity of this joint is very important and if the dens is fractured or the ligament becomes slack then there can be a risk of damage to the spinal cord with death or quadriplegia. For this reason in any patient who may have suffered head or neck trauma the dens is x-rayed and checked carefully.

Low back pain treatment - short, cheap, effective?

A recent article reported in The Lancet has reported a good effect on low back pain without significant input in terms of money or time. Six sessions of cognitive behavioural therapy were offered to 400 back pain sufferers whilst a further group of 200 did not get the therapy. Both groups received the standard care from their general practitioners. The intervention aimed at helping self management by challenging beliefs about physical activity and back pain which could be seen to be unhelpful. Patients were encouraged to discuss their underlying beliefs about what was going on and to challenge negative thinking about the pain and the functional difficulties it presents.

Recognising and countering fear avoidance and managing and recovering from flare ups in the pain were also covered. After a year the intervention group had significantly higher scores on questionnaires intended to measure disability and pain. Overall the intervention was cheap and easy to apply, especially when its effectiveness is taken into account, an uncommon effect with treatments for low back pain. Short term effects are much more common after treatments but they rarely last more than a few weeks. The treatments effects in this case did last and so may reflect patients. ability to better self manage.