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

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.

Back Pain - Yellow Flags for Disability and Work Loss

Low back pain is one of the most common and disabling musculoskeletal conditions prevalent in the population, causing high degrees of work loss, suffering and expense. Back pain sufferers are affected by a variety of physical and psychological issues which affect the severity, duration and outcome of the back pain episode. The ideas of yellow flags, to add to red flags which are an indication of serious spinal pathology, has been formalised by work in New Zealand under the title of .Yellow Flags . Indicators for Work Loss and Disability.. These psychosocial factors are important and they are much stronger predictors of how well the person is going to turn out with their back pain than any of the physical factors.

Physiotherapists ask yellow flag questions to find out what their patients are thinking and thereby to be able to target their interventions more closely to the presenting problems. Typical yellow flag positive indications might be the belief that activity is harmful, the belief that pain means there is damage going on in the back and the idea that work is harmful. These beliefs are important in holding some people back from going back to doing normal activities.