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

Spinal Cord Stimulation for Chronic Pain

The use of spinal cord stimulation for the treatment of chronic pain syndromes is taking an increasing part in the management of these complex and difficult problems. Scientific work support the usefulness of this therapy in the pain due to poor circulation in the legs, angina and neuropathic pain. SCS is a technological intervention and chronic pain is a multidimensional problem including physical and psychological aspects which bear on the likely success of the treatment. SCS aims to stimulate the large sensory nerves in the spinal cord which interfere with the transmission of pain towards the brain along the small pain nerves and it also has affects on the circulation although the exact mechanisms of action are not known.

When used to treat neuropathic pain the treatment can be given intermittently as then the pain relief may last for some hours afterwards, indicating that the stimulate causes changes in the nerve transmissions which can last for some time. SCS may also alter the behaviour of heart nerves and by various mechanisms reduce the pain of angina. Apart from the effects on circulatory problems there is good evidence for effectiveness in nerve root problems and complex regional pain syndrome.

Physiotherapy After Back Surgery

Spinal surgery falls into several categories: spinal fusion; disc replacement; decompression for stenosis; microdiscectomy; discectomy. The details vary with the presentation of the patient, the operation and the course of recovery but principles can be noted. Initially a physiotherapist will attend the patient pre-operatively to ascertain the pain presentation and to test the patient.s muscle power and educate them about the operation. On the first post-operative day the physiotherapist will check the patient.s pain presentation again and retest the muscles of the legs to ensure that no untoward changes have occurred.

Mobilising back surgery patients is straightforward. They are rolled onto their most comfortable side and got up sideways while their legs slide off the bed. Sitting is minimised due to the lumbar stresses it imposes and patients are usually walked a distance as long as they feel well. Neural mobilising and core stability exercises may be prescribed by the physio as appropriate. Recent evidence indicates that a more active rehabilitation regime after certain kinds of back surgery may ensure a better result, although in spinal fusions the fusion of the operation site is the priority. Physiotherapists follow up spinal patients on discharge from hospital and design an individualised rehabilitation regime.