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

Physiotherapy Ultrasound

Ultrasound therapy is one of the large number of treatment techniques available to physiotherapists in treating the variety of conditions their patients present with. The frequencies used are in the range of 0.8 to 3.0 Megahertz, with a metal head used to generate the ultrasonic waves and ultrasound gel used between the skin and the head to facilitate transmission. A crystal in the head generates the waves by high frequency vibration and the waves pass through the gel and into the patient.s tissues to cause their effects. A local deep heating effect can be generated but this is typically not desirable so the machine head is kept moving and the settings may be set to pulsed mode so the beam of ultrasound is not continuous. This allows cooling and prevents heat build-up.

The effects of ultrasound can be many, including increasing the local blood flow, breaking down scar tissue or inhibiting its formation, a reduction in local swelling and inflammation. The physiotherapist will determine the size of the area to be treated and its tissue depth, choosing the size of machine head and the frequency and pulsed mode as appropriate. Higher doses and longer times are used for more chronic cases with the reverse for acute inflammatory conditions.

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.