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

Ligament-Bone and Tendon-Bone Conditions - Bone Formation

The behaviour of the bone around the joint varies in differing arthritic conditions. In rheumatoid arthritis the inflammatory joint condition is linked with loss of bone and this contributes to the damage to the joint and the disability which ensues. However, in ankylosing spondylitis (AS) the inflammation is accompanied by the formation of new bone at the inflamed sites. This new bone forms at each insertion site, growing together in the spine to form bony bridges across the vertebrae, stiffening the spine in a poor position in some cases which can cause significant disability. Since inflammation usually breaks bone down this is difficult to understand.

New bone typically forms at normal ligament or tendon insertions as we get older, but in arthritis the inflammatory phase which erodes bone does settle and then bony spurs can form as the bone laying down phase occurs next in time. In the case of AS, if a bony formation phase follows the inflammatory phase, then suppressing the inflammatory phase with medication might accelerate the bony formation process, increasing the disability. AS patients may continue to fuse their joints even in the presence of new biological treatments but they may be shown to inhibit bone formation at the insertions and thereby reduce disability.

The Development of Chronic Neck Pain

Long term neck pain and disability is a difficult and perplexing problem, leading to high degrees of pain, suffering and loss of function in some patients. There are a serious of beliefs which may go with a higher risk of developing chronic pain after neck injury such as: the belief that the pain is due to a serious injury or tissue damage; resisting reassurance; equating hurt with harm and believing the pain will lead to disability; avoiding activities and movement due to the fear of damage; resting and remaining inactive whilst waiting for the pain to settle; expecting someone to cure the pain rather than taking on the responsibility oneself; withdrawing from social contact and becoming depressed.

These tendencies are referred to as .yellow flags. and predict to some extent the likelihood the person will suffer work loss and disability from their pain condition. These problems may develop steadily and without the person being aware of them, so they need identifying and dealing with as soon as possible. If a person is off work for a month with their neck pain then there is a risk of developing long term problems and a ten percent chance of still being off in a year.