Physiotherapists in Middlesex treat many different conditions including the condition profiled below.

Severe Arm Pain and Physiotherapy

Neck pain is very common but, like sciatica in the leg, severe arm pain is uncommon but distressing for the sufferer. Nerve root conditions are caused typically by compression or inflammation from a disc protrusion near to the nerve exit in the spinal column or by bony encroachment on the same areas in older people. Patients complain of severe pain in the arm, often worse below the elbow and into the hand, with a surging quality which is very unpleasant. Typically patients are not able to sleep with this so appear tired and miserable due to the loss of sleep and constant severe pain.

Physiotherapy management starts with a careful assessment of the neck and arm but this may be severely limited by the severity of the pain and the irritability, the ease by which the condition can be stirred up by minimal input. Initial treatment is aimed at pain relief with analgesia, restriction of aggravating activities and a collar at night to restrict neck movements. Once the pain begins to settle the patient is encouraged to start gentle exercises or the physiotherapist performs mobilisation techniques to put mechanical stresses through the joint to start the process of restoring the area's capacity to cope with stress.

Diagnosing Discogenic Back Pain

Low back pain is very common and a significant cause of pain, disability and work loss in western societies. Diagnosing low back pain is difficult and relating examination and investigation findings to treatments or successful intervention has proved to be elusive. MRI scanning is the investigation of choice for back pain syndromes and can indicate disc narrowing, disc dehydration, annular tears and joint abnormalities. If the disc level identified on the scan fits with the examination and x-ray findings, the surgeon may have some confidence that the painful segment has been identified. However this may not be accurate and treatment based on this can be unreliable.

Discography is an investigative technique where a needle is introduced into the suspect disc and a small amount of contrast material is injected. If the test is to be positive then the individual must complain of their typical pain on this stimulation and not just general discomfort. The injected material may also give some idea of the internal structure of the disc and any disruption which may be present. Injection of local anaesthetic can also be performed, a so called discoblock, may be performed, allowing for the patient to report a reduction in their typical pain for a positive response to the test.

Physiotherapists in Middlesex have contributed some of the many articles on this site such as the one extracted below.

Thoracic outlet syndrome is not one condition but the overall name for a number of different conditions thought to be related to compression of the nerves and blood vessels as they travel through the anatomical area known as the thoracic outlet. The thoracic outlet is an area in the neck which has as its boundaries the collar bone or clavicle, the first rib and the scalene muscles, through which the vessels and nerves must pass to reach the armpit and so the arm. It is often not clear what the patient is suffering from and there is little agreement about this condition.The wide variation in signs and symptoms of sufferers with thoracic outlet syndrome and the absence of any test to confirm or deny its presence means that correct diagnoses of patients with thoracic outlet syndrome is difficult. The numbers of people who suffer from this syndrome is as a consequence not clear although it is known that higher numbers of women occur in this group, especially if they have poor muscle tone a...

more Thoracic Outlet Syndrome-Part 1