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

Neck Posture

The head is a large and heavy object balanced on top of a slender column of bone and ligaments which is known as the neck. Postural neck pain is very common as our mainly sedentary lifestyles mean that we spend long periods in one position often with our necks held in less than optimal postures. Gravity pushes us down all the time and the neck tends to move forward as the lower neck flexes for us to look down at books or computers. As our head is now looking downwards we don't want to look at the floor all the time so we tilt the head back up, extending the upper neck.

This position, when held long term, can lead to the head stuck forward posture and a .dowager's hump., a prominent bony area at the base of the back of the neck. This can lead to neck strain both at the top and bottom of the neck, causing neck and shoulder pain lower down and neck and head pain higher up. The head forward posture forces the neck muscles and the upper trapezius to work harder than normal to hold the head up in its abnormal position.

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.