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

The Development of Chronic Neck Pain

Long term neck pain and disability is a difficult and perplexing problem, leading to high degrees of pain, suffering and loss of function in some patients. There are a serious of beliefs which may go with a higher risk of developing chronic pain after neck injury such as: the belief that the pain is due to a serious injury or tissue damage; resisting reassurance; equating hurt with harm and believing the pain will lead to disability; avoiding activities and movement due to the fear of damage; resting and remaining inactive whilst waiting for the pain to settle; expecting someone to cure the pain rather than taking on the responsibility oneself; withdrawing from social contact and becoming depressed.

These tendencies are referred to as .yellow flags. and predict to some extent the likelihood the person will suffer work loss and disability from their pain condition. These problems may develop steadily and without the person being aware of them, so they need identifying and dealing with as soon as possible. If a person is off work for a month with their neck pain then there is a risk of developing long term problems and a ten percent chance of still being off in a year.

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.