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

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.

Pacing to Avoid Overdoing Activities in Chronic Pain

Patients with chronic pain very commonly push themselves hard to get things done, to complete the day to day activities they feel they must continue to perform. Unfortunately this almost always leads to a severe worsening of their pain, forcing them to rest in high levels of pain for several days. This pattern is commonly repeated again and again with the consequence that the person.s abilities tend to reduce over time as they become able to do less and less. This is known as the overdoing and under doing cycle, or activity cycling. It is a counterproductive cycle for pain sufferers, who can learn pacing their activities to their advantage.

Pacing changes the way activities are performed from a pain dependent state, where the person does the activity until pain stops them, to a time dependent state. This means they do an activity for a previously specified length of time then stop, not overdoing it at any one time. The person does the activity until they feel their pain worsen, records that time and then takes 20% off that time to give their quota. They are not allowed to go over their quota initially, to gain control of the activity.