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

Tiredness and Fatigue - Normal and Abnormal

Patients easily distinguish between normal tiredness and the tiredness they suffer as a consequence of their musculoskeletal conditions. Healthy adults report fatigue after stressful activity or physical work which is relieved by rest or sleep completely. Fatigue in sufferers from long term musculoskeletal conditions is very common, more intense, not predictable and does not resolve with rest. Fibromyalgia consists mainly of widespread muscular pain with fatigue whilst chronic fatigue syndrome is primarily fatigue with degrees of pain. Chronic fatigue syndrome is diagnosed by the presence of unexplained fatigue for more than six months which is not connected to activity and not eased by resting. Severe reduction in activity levels is common.

Fatigue is common also in musculoskeletal disorders such as osteoarthritis and rheumatoid arthritis, with patients often rating the fatigue as or more severe than the pain itself. Research work has found that the levels of fatigue have strong effects on the quality of life in rheumatoid arthritis and if severe it is connected with a deterioration of the ability to live life normally. As tiredness is as or more difficult to cope with than the pain of these arthritic diseases it is understandable that patients consider fatigue to be an important aspect of their presentation.

Physiotherapy After Back Surgery

Spinal surgery falls into several categories: spinal fusion; disc replacement; decompression for stenosis; microdiscectomy; discectomy. The details vary with the presentation of the patient, the operation and the course of recovery but principles can be noted. Initially a physiotherapist will attend the patient pre-operatively to ascertain the pain presentation and to test the patient.s muscle power and educate them about the operation. On the first post-operative day the physiotherapist will check the patient.s pain presentation again and retest the muscles of the legs to ensure that no untoward changes have occurred.

Mobilising back surgery patients is straightforward. They are rolled onto their most comfortable side and got up sideways while their legs slide off the bed. Sitting is minimised due to the lumbar stresses it imposes and patients are usually walked a distance as long as they feel well. Neural mobilising and core stability exercises may be prescribed by the physio as appropriate. Recent evidence indicates that a more active rehabilitation regime after certain kinds of back surgery may ensure a better result, although in spinal fusions the fusion of the operation site is the priority. Physiotherapists follow up spinal patients on discharge from hospital and design an individualised rehabilitation regime.