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

Tiredness and Fatigue - Normal and Abnormal

Patients easily distinguish between normal tiredness and the tiredness they suffer as a consequence of their musculoskeletal conditions. Healthy adults report fatigue after stressful activity or physical work which is relieved by rest or sleep completely. Fatigue in sufferers from long term musculoskeletal conditions is very common, more intense, not predictable and does not resolve with rest. Fibromyalgia consists mainly of widespread muscular pain with fatigue whilst chronic fatigue syndrome is primarily fatigue with degrees of pain. Chronic fatigue syndrome is diagnosed by the presence of unexplained fatigue for more than six months which is not connected to activity and not eased by resting. Severe reduction in activity levels is common.

Fatigue is common also in musculoskeletal disorders such as osteoarthritis and rheumatoid arthritis, with patients often rating the fatigue as or more severe than the pain itself. Research work has found that the levels of fatigue have strong effects on the quality of life in rheumatoid arthritis and if severe it is connected with a deterioration of the ability to live life normally. As tiredness is as or more difficult to cope with than the pain of these arthritic diseases it is understandable that patients consider fatigue to be an important aspect of their presentation.

Physiotherapy Shoulder Exercises after Breast Cancer Operation

Breast cancer is the commonest cancer in women and in England there are over 36,000 people diagnosed yearly. Treatment is complex but surgery is common to remove the tumour and to remove four or more lymph nodes in the axilla or armpit. This is to work out what stage the cancer is at and prevent it recurring in the axilla. A side effect of this treatment is the development of swelling in the affected arm, known as lymphoedema, which can remain over time and cause physical and psychological problems. Physiotherapists routinely assess and treat patients with cancer, pre or post operatively, to manage the mobility and joint problems which develop after diagnosis and treatment.

Removal of the axillary nodes impacts upon movement of the shoulder as the tissues in the axilla are stretched by raising the arm above the head. A paper in Physiotherapy (December 2008) by Todd and co-workers compared two groups of post operative patients, with one group having unrestricted shoulder movement after 48 hours and the other with this delayed for seven days. The results showed that delaying the movement for seven days avoided the incidence of increased arm lymphoedema, an important consideration as the level of swelling can remain long term.