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

The Upper Neck

The upper neck or cervical spine is specialised in its anatomy and function as it has to bear the weight of the head and allow the head to be moved into any position for our sensory organs to receive the information they need. The two upper vertebrae, the atlas and the axis, have a specialised anatomical structure which is designed to satisfy the needs of head positioning in many functions. The upper vertebra, the atlas, has no body and is a bony ring with large facet joints to articulate with the facet joints of the lowest part of the skull, the occiput.

The second vertebra, the axis, has .captured. the body part of the vertebra above and has a upwardly protruding pin called the dens (latin for tooth) which forms a joint with part of the atlas above and also with a ligament which runs round it. The integrity of this joint is very important and if the dens is fractured or the ligament becomes slack then there can be a risk of damage to the spinal cord with death or quadriplegia. For this reason in any patient who may have suffered head or neck trauma the dens is x-rayed and checked carefully.

The Facet Joints

The facet joints, also known as the zygapophysial joints, are small synovial joints like the joints of our fingers, but with much flatter surfaces which give the name .facet. to them. They are made up of part of the vertebra above and part below, are lined by articular cartilage and surrounded by a joint capsule lined with synovial membrane. In the lumbar spine the facets joints act to stabilise whilst the area is under compression and to resist excessive movement between the individual vertebrae. This protects the intervertebral discs from damage from inappropriate ranges of movement.

The joint surfaces of the facet joints vary in orientation through the spine, allowing and preventing different movements. In the neck both rotation and flexion/extension is permitted, in the thoracic spine rotation is the dominant movement and in the lumbar spine flexion and extension is permitted and rotation is limited. With disc degeneration in the lumbar spine the loads on the lumbar facet joints can be great and result in osteoarthritic changes in these joints which can be symptomatic and result in low back pain. Facet joint pain occurs in a significant proportion of people with low back pain and can be difficult to manage.