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

Diagnosing Discogenic Back Pain

Low back pain is very common and a significant cause of pain, disability and work loss in western societies. Diagnosing low back pain is difficult and relating examination and investigation findings to treatments or successful intervention has proved to be elusive. MRI scanning is the investigation of choice for back pain syndromes and can indicate disc narrowing, disc dehydration, annular tears and joint abnormalities. If the disc level identified on the scan fits with the examination and x-ray findings, the surgeon may have some confidence that the painful segment has been identified. However this may not be accurate and treatment based on this can be unreliable.

Discography is an investigative technique where a needle is introduced into the suspect disc and a small amount of contrast material is injected. If the test is to be positive then the individual must complain of their typical pain on this stimulation and not just general discomfort. The injected material may also give some idea of the internal structure of the disc and any disruption which may be present. Injection of local anaesthetic can also be performed, a so called discoblock, may be performed, allowing for the patient to report a reduction in their typical pain for a positive response to the test.

Patellofemoral Pain

The patellofemoral joint is a frequent source of pain and disability and a difficult problem to treat successfully. The patella has two large facets on it.s under surface which are angled in respect to each other. They match the groove between the femoral condyles where the patella lies and moves upwards and downwards as the knee bends and straightens. As the quadriceps, the main thigh muscle, contracts to push us up from a chair, go up stairs or walk uphill, the patella acts like a pulley to increase the forces the muscle is able to exert. High levels of force are developed between the patellar and femoral joint surfaces.

The patella surfaces are lined with articular cartilage, a firm and very slippery material which ensures friction free movement of many of our major joints, even under load. With time this can soften and develop small fissures, making the patellar surface sensitive to loads being applied. If there is also a muscle imbalance or other abnormality which allows the patella to track in its groove a little towards the outside, this can also worsen pain. Degenerative changes can progress to osteoarthritis and cause disabling symptoms due to difficulties with stairs and gait.