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

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.

Hand Injuries - Acute Management

Most injuries, apart from the most minor, benefit from being seen and assessed by a doctor as a relatively minor dysfunction in the hand can cause long term functional disability. Initial management of a hand injury should be to control any bleeding by applying gauze or a clean cloth to the wound and putting some pressure on it. In a closed injury (i.e. no wound) then ice can be applied to the damaged area to reduce inflammation and pain. Jewellery such as rings needs to be immediately removed as hand swelling can be very dramatic, rendering easy removal later impossible.

Once in the Emergency Department the doctor will x-ray the hand routinely and may inject the nerve at the wrist level or at the base of one of the fingers to numb the hand or the finger so that they can examine the area without too much pain. Wounds will be cleaned if they are dirty and then closed by stitching or a related method, with antibiotics prescribed to prevent infection developing. Splinting is often used to immobilise the hand in a specific position to prevent further injury or maintain anatomical integrity. A referral to a hand specialist or a plastic surgeon is typically written and pain control medication will be encouraged for a few days.