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

Fatigue and Tiredness - The Management of the Condition

Drug therapies given for arthritic condition, known as disease modifying anti rheumatoid drugs and the new biological treatments, have been shown to reduce the fatigue reported by patients, perhaps partly at least by reducing inflammation and pain levels which have some effects on fatigue levels. While fatigue can be improved by these drugs and by antidepressants, it can occur in the absence of depression or inflammation. Exercise therapy in groups has shown some trends towards improvement of fatigue, although the effects of exercise therapy on chronic fatigue syndrome are not clear.

Group therapy may be included in self management programmes which combine this with education and psychological interventions. Both these therapies have shown some effects in particular circumstances. Acupuncture however has shown no effect in chronic fatigue syndrome. Evidence for non-drug treatments is limited by the number of good quality research trials available, most of which are not set up to examine the fatigue nor the potential treatments for it. A good definition of fatigue does not yet exist nor is there any possibility of logically grading the degrees of tiredness from slight to exhaustion, limiting meaningful work on the condition. Pain management programmes, which often have a physiotherapist and a clinical psychologist, presently address these patients.

Internal Fixation for Fractures

Many fractures can be managed by immobilisation if not displaced or can be repositioned and maintained in position by a plaster cast. Some fractures cannot be maintained in position, slip out of position once re-positioned or cannot be immobilised because of the length of time required or the awkwardness of the anatomical location. In these cases internal fixation with plates, screws, wires or nails is considered. Internal fixation requires an operation which carries the usual risks including infection so is only performed when required from a clinical standpoint.

Fracture alignment is important to maintain the relative position of the nearby joints so that excessive forces are not thrown onto one part of a joint or another. Wrist fractures which do not remain in a good position can be plated then immobilised until healed. Fractures with many pieces may need re-assembling and maintaining in position by metalwork. Femoral shaft fractures cannot be immobilised except by traction and with the healing period being 12 weeks the decision is usually to place a nail down the femur and get the patient up and out of hospital in a few days. Complex fixation may be used to restore the structure of a badly damaged bone in some cases.