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

Back Pain - Red Flags for Serious Conditions

Most people with back pain have just that, back pain secondary to injury, time and the mechanical stresses of holding a posture or performing an activity. However, a small proportion of people present with back pain when the underlying reason is a serious pathology of some sort. The signs that indicate that mechanical back pain may not be the reason for the patient's pain are called red flags. Physiotherapists routinely ask the red flag questions to try to exclude the likelihood of a patient having a serious underlying condition which might also be worsened by physio treatment. Examples of red flags for back pain are: age over 55 or under 20 when back pain first presents and significant trauma involved (like a fall).

Other red flags include: significant weight loss; significant night pain; use of steroids; a history of cancer; bladder or bowel disturbance and loss of sensation in the saddle area around the genitals and anus. A degree of judgement is required as the outcome of the questions is rarely clear cut and most red flag situations turn out not to be serious conditions but physios routinely evaluate these to ensure safe treatment and refer questionable cases on for medical evaluation.

Bone Metabolism

Bone, like muscle, is an adaptive tissue and bony mass and its structure changes to resist the forces which are applied to it in activity. Changes in the bone require that a large number of cells which are quite far apart join in to perform a particular activity and they do this by chemical messengers but also by long outgrowths from their cells connecting with others. How fast bones can strengthen or become weaker is not clear, although experiments have shown that a bone can increase its mineral content by 40% in six weeks if it is frequently loaded. A loss of 10-15% of bone mass can be expected if a bone is kept unloaded for eight weeks.

Cortical bone may be 35% greater in mass in the playing arm of a professional male tennis player and bone can react even more strongly as its density is very high in expert weight lifters. Sclerosis, an increase in density of vertebrae adjacent to discs which are suffering degeneration, is less beneficial a process and may impede nutritional transport through the bone. Osteophytes, bony outgrowths, may be an attempt to stabilise a joint but can also get in the way and cause nerve impingement.