Physiotherapists in Chichester 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.

Chronic Neck Pain

The risk of long term neck pain and disability has been the subject of much investigation to try and stop this disabling, painful and costly condition developing. The warning signs which indicate a risk of developing this condition are known as yellow flags and are mostly to do with our understanding and emotional state. Physical factors are much less important unless they are very high levels of pain after an injury. Yellow flags include believing that the neck pain is due to serious injury or damage to the neck tissues; avoiding activity or movement due to fear of causing damage; resting excessively; waiting for a cure for the pain instead of working on it themselves; developing depression and becoming withdrawn; not improving over a couple of weeks; believing that hurt equals harm and that disability is likely.

These symptoms and attitudes can sneak up on someone so it is important to work at getting mobile and back to normal as soon as possible after injury or an episode of neck pain. It is useful to analyse how the recovery is going and take steps to fix any of the problems that the patient or an adviser identifies as relevant.