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

The Course of Low Back Pain

Low back pain is always described as being either acute, sub acute or chronic with acute pain lasting less than six weeks, sub acute pain from six weeks to twelve weeks and chronic pain lasting over the twelve week point. Most people were assumed to recover quickly and go back to normal with only a small number suffering longer term pain and disability. However, research has shown that it is an episodic and recurring condition and present for much longer than generally thought. 75% of patients with back pain in primary care still had symptoms a year later in one study, indicating back pain is more of a chronic picture overall.

Patients with chronic back pain are not uniformly severe or disabled but rather suffer a varying degree of pain and disability over time. Old views used to be that 80-90 percent of back episodes resolved completed but it is much more realistic to view it as a longer term grumbling problem. The main predictor for people having back pain in the future is having had it in the past and this supports the above idea of back pain as a continuing problem. For most people back pain is a common but limited irritation which recurs from time to time.

Inflammatory Disease of the Entheses

Mechanical factors are thought to be important in inflammatory conditions of the ligament or tendon insertions so addressing these matters may be useful. Physiotherapists can assess the problem and prescribe corrective or cushioning insoles as needed. Local injections of corticosteroids can be useful to treat the pain of enthesitis in a single area. For more widespread inflammation the new biological agents (known as anti-TNF agents) have been shown to be of some use, particularly if the legs are affected as this is so disabling. Typically enthesitis is likely to settle with time so the prognosis is reasonable.

Physiotherapy treatment of this problem includes assessment of joint ranges for restrictions which are developing and the design of an individual exercise regime to maintain the ranges of motion of all the affected joints. Hydrotherapy is a very useful treatment medium for most of the arthritic diseases as it allows the performance of joint movements in a warm and supported environment, minimising the forces on the joints, until the patient is able to progress comfortably to exercises in air. Patient education is important with the physio stressing that the exercise programme, targeted at specific difficulties for each patient, and needs to be maintained daily over the long term.