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

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.

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.